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Furosemide - instructions for use, analogs, reviews and release forms (tablets 40 mg, injections in ampoules for injections in solution) of a drug for the treatment of edema and diuretic effect in adults, children and in pregnancy

Furosemide - instructions for use, analogs, reviews and release forms (tablets 40 mg, injections in ampoules for injections in solution) of a drug for the treatment of edema and diuretic effect in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Furosemide. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Furosemide in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Furosemide in the presence of existing structural analogs. Use of a diuretic for the treatment of edema, arterial hypertension and kidney disease in adults, children, as well as during pregnancy and lactation.

 

Furosemide - loop diuretic; causes a rapidly advancing, strong and short-term diuresis. It blocks the reabsorption of sodium and chlorine ions in both the proximal and distal sections of the renal tubules and in the thick segment of the ascending part of the Gentle loop. Furosemide has a pronounced diuretic, natriuretic and chlororetic action. Due to the increase in the release of sodium ions, a secondary (osmotically bound water-mediated) enhanced water removal and an increase in the secretion of potassium ions in the distal part of the renal tubule occur. At the same time, the excretion of calcium and magnesium ions increases. Has secondary effects due to the release of intracellular mediators and redistribution of the intrarenal blood flow. Against the background of course treatment there is no weakening of the effect.

 

In heart failure, furosemide rapidly reduces preload (by expanding the veins), reduces pulmonary artery pressure and the filling pressure of the left ventricle. It has an antihypertensive effect due to an increase in the excretion of sodium chloride and a decrease in the response of the smooth muscles of the vessels to vasoconstrictive effects and as a result of a decrease in the volume of circulating blood.

 

After ingestion of 40 mg furosemide diuretic effect begins within 60 minutes and lasts about 3-6 hours (with reduced renal function - up to 8 hours). During the period of action, excretion of sodium ions increases significantly, but after its termination, the elimination rate decreases below the initial level ("rebound" syndrome, or "cancellation"). The phenomenon is caused by a sharp activation of the renin-angiotensin-aldosterone system and other antinatriuretic neurohumoral regulating units in response to massive diuresis; stimulates arginine-vasopressive and sympathetic systems. Reduces the level of the atrial natriuretic factor in the blood plasma, causes vasoconstriction. Due to the syndrome of "ricochet" when taken 1 time per day may not cause a significant effect on the daily release of sodium ions and blood pressure.

 

Pharmacokinetics

 

Absorption is high. Bioavailability is 60-70%. Penetrates through the placental barrier, excreted in breast milk. It is excreted mainly (88%) by the kidneys in unchanged form and in the form of metabolites; the rest is intestinal.

 

Indications

 

Edema Syndrome:

  • with chronic heart failure;
  • with chronic renal failure;
  • with nephrotic syndrome (with nephrotic syndrome in the foreground is the treatment of the underlying disease);
  • with liver diseases;
  • arterial hypertension;
  • some forms of hypertensive crisis;
  • pulmonary edema;
  • cardiac asthma;
  • edema of the brain;
  • eclampsia;
  • conducting forced diuresis;
  • hypercalcemia.

 

Forms of release

 

Tablets of 40 mg.

 

Solution for intravenous and intramuscular injection (injections in ampoules for injection).

 

Instructions for use and dosage

 

Pills

 

Tablets should be taken on an empty stomach without chewing and drinking with a sufficient amount of liquid. When administering Furosemide, it is recommended that its lowest doses be used to achieve the desired effect. The maximum daily intake for adults is 1500 mg. Initial single dose in children is determined from the calculation of 1-2 mg / kg body weight per day with a possible increase in the dose to a maximum of 6 mg / kg per day, subject to taking the drug no more than 6 hours later. The duration of treatment is determined by the doctor individually, depending on the indications.

 

Dosing regimen in adults

 

Edema Syndrome in Chronic Heart Failure

 

The initial dose is 20-80 mg per day. The required dose is selected depending on the diuretic response. It is recommended to divide the daily dose by 2-3 doses.

 

Edema Syndrome in Chronic Renal Failure

 

Patients with chronic renal failure require a careful dose selection, by gradually increasing it so that fluid loss occurs gradually (at the beginning of treatment, a loss of fluid of up to about 2 kg of body weight per day is possible). The recommended initial dose is 40-80 mg per day. The necessary dose is selected depending on the diuretic response. The entire daily dose should be taken once or divided into two doses. In patients on hemodialysis, the usual maintenance dose is 250-1500 mg per day.

 

Edema with nephrotic syndrome

 

The initial dose is 40-80 mg per day. The necessary dose is selected depending on the diuretic response. The daily dose can be taken at one time or divided into several doses.

 

Edema syndrome with liver diseases

 

Furosemide is prescribed in addition to treatment with aldosterone antagonists in case of their insufficient effectiveness.To prevent the development of complications such as inappropriate regulation orthostatic circulation disturbances or electrolyte or acid-base status, it requires careful selection of the dose so that the fluid loss occurs gradually (at the beginning of the treatment liquid can be a loss of approximately do0.5 body kgmassy day). The initial dose is 20-80 mg per day.

 

Arterial hypertension

 

Furosemide can be used in monotherapy or in combination with other antihypertensive agents. The usual maintenance dose is a dose of 20-40 mg per day. When furosemide is added to already prescribed medications, their dose should be reduced 2 times. With arterial hypertension in combination with chronic renal failure may require the use of higher doses of the drug.

 

Ampoules

 

For intravenous (inkjet) or intramuscular administration dose for adults is 20-40 mg 1 time per day in some cases - 2 times a day. For children, the initial daily dose for parenteral use is 1 mg / kg.

 

Side effect

  • marked decrease in blood pressure;
  • collapse;
  • tachycardia;
  • arrhythmias;
  • propensity to thrombosis;
  • dizziness;
  • headache;
  • muscle weakness;
  • cramps of calf muscles (tetany);
  • paresthesia;
  • weakness, lethargy, drowsiness;
  • confusion of consciousness;
  • impaired vision and hearing;
  • noise in ears;
  • anorexia;
  • dryness of the oral mucosa;
  • thirst;
  • nausea, vomiting;
  • diarrhea;
  • constipation;
  • oliguria;
  • acute urinary retention (in patients with benign prostatic hyperplasia);
  • interstitial nephritis;
  • hematuria;
  • decreased potency;
  • decreased glucose tolerance;
  • manifestation of latent diabetes mellitus;
  • hives;
  • exfoliative dermatitis;
  • vasculitis;
  • itching;
  • chills;
  • fever;
  • photosensitization;
  • anaphylactic shock;
  • Stevens-Johnson syndrome;
  • toxic epidermal necrolysis;
  • leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia, eosinophilia;
  • hypokalemia, hyponatremia, hypochloraemia, hypocalcemia, hypomagnesemia.

 

Contraindications

  • acute renal failure with anuria;
  • severe hepatic insufficiency, "hepatic" coma and precoma;
  • acute glomerulonephritis, severe disorders of urinary efflux of any etiology (including unilateral urinary tract damage), hyperuricemia;
  • decompensated mitral or aortic stenosis, hypertrophic obstructive cardiomyopathy, increased central venous pressure (> 10 mm Hg);
  • violation of water-electrolyte metabolism (hypovolemia, pronounced hyponatremia and hypokalemia, hypochloraemia, hypocalcemia, hypomagnesemia);
  • digitalis intoxication;
  • pregnancy;
  • lactation period;
  • age up to 3 years (solid dosage form);
  • lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome (due to the presence of lactose monohydrate in the formulation);
  • allergy to wheat (not celiac disease);
  • hypersensitivity to the active substance and to any of the components of the drug.

 

Application in pregnancy and lactation

 

Furosemide penetrates the placental barrier, so it should not be administered during pregnancy. If you need Furosemide in pregnancy, you should evaluate the ratio of the benefits of using the drug for the mother at risk for the fetus. Excreted in breast milk. If it is necessary to treat the drug, breastfeeding should be discontinued.

 

special instructions

 

Before starting therapy with Furosemide, the presence of severe urine outflow disorders should be excluded, patients with partial impairment of urine outflow should be closely monitored. Against the background of course treatment, it is necessary to periodically monitor blood pressure, the content of plasma electrolytes (including sodium, calcium, potassium, magnesium ions), acid-base state, residual nitrogen, creatinine, uric acid, liver function and, if necessary, appropriate correction of treatment.

 

The use of furosemide slows the excretion of uric acid, which can provoke an exacerbation of gout.

 

It is believed that it can be used to treat obesity and weight loss, although it is an ordinary diuretic, has nothing to do with the diet and simply reduces the weight of a person within the withdrawn liquid.

 

Patients with increased sensitivity to sulfonamides and sulfonylureas may have cross-sensitivity to furosemide.

 

Patients receiving high doses of furosemide, in order to avoid the development of hyponatremia and metabolic alkalosis, it is inappropriate to limit the intake of table salt.For the prevention of hypokalemia, simultaneous administration of potassium and potassium-sparing diuretics is recommended, as well as adherence to a diet rich in potassium. Selection of the dosing regimen for patients with ascites against the background of cirrhosis of the liver should be done in a stationary setting (violations of the water-electrolyte balance may lead to the development of the hepatic coma). This category of patients shows regular control over the content of plasma electrolytes.

 

When azotemia and oliguria appear or increase in patients with severe progressive kidney disease, it is recommended to suspend treatment.

 

In patients with diabetes mellitus or with reduced glucose tolerance, periodic monitoring of the level of glucose in the blood and urine is required.

 

In patients with unconsciousness, benign prostatic hyperplasia, narrowing of the ureters, or hydronephrosis, monitoring of urinary excretion is necessary because of the possibility of acute urinary retention.

 

The drug contains lactose monohydrate, so patients with rare hereditary problems of galactose intolerance, lactase deficiency lapp or malabsorption of glucose-galactose, should not take this drug.

 

The composition of the drug includes wheat starch in an amount that is safe for use in patients with celiac disease (gluten enteropathy).

 

Patients with wheat allergy (other than celiac disease) should not use this drug.

 

Impact on the ability to drive vehicles and manage mechanisms

 

During the treatment with Furosemide, one should avoid practicing potentially dangerous activities that require increased attention and speed of psychomotor reactions (vehicle management and work with mechanisms).

 

Drug Interactions

 

With simultaneous use with Phenobarbital and phenytoin, the action of furosemide is reduced.

 

Increases the concentration and risk of nephro- and ototoxic effects of cephalosporins, chloramphenicol, ethacrynic acid, cisplatin, amphotericin B (due to competitive renal excretion).

 

With the simultaneous use of aminoglycosides with furosemide, aminoglycoside excretion slows down and the risk of developing their ototoxic and nephrotoxic action increases. For this reason, use of this combination of drugs should be avoided, except when it is necessary for life indications,and in this case correction (reduction) of maintenance doses of aminoglycosides is required.

 

Increases the effectiveness of diazoxide and theophylline, reduces - hypoglycemic agents, allopurinol.

 

Drugs that block tubular secretion increase the concentration of furosemide in serum. Medicines with nephrotoxic action - when combined with furosemide, the risk of developing their nephrotoxic effect increases.

 

Glucocorticosteroids and carbenoxolone combined with furosemide increase the risk of hypokalemia.

 

With simultaneous use with cardiac glycosides, the risk of developing digital intoxication against a background of water-electrolyte disorders (hypokalemia or hypomagnesemia) increases.

 

Strengthens the neuromuscular blockade of depolarizing muscle relaxants (suxamethonium) and weakens the effect of nondepolarizing muscle relaxants (tubocurarine).

 

Non-steroidal anti-inflammatory drugs (including Indomethacin and acetylsalicylic acid) in combination with furosemide can cause a temporary decrease in creatinine clearance and an increase in serum potassium content and reduce the diuretic and antihypertensive effects of furosemide.In patients with hypovolemia and dehydration (including furosemide), NSAIDs can cause acute renal failure. Furosemide can enhance the toxic effect of salicylates (due to competitive renal excretion).

 

Sucralfate reduces the absorption of furosemide and weakens its effect (these preparations should be taken at intervals of not less than 2 hours).

 

Combination with Carbamazepine may increase the risk of hyponotism.

 

Antihypertensives, diuretics or other agents that can reduce blood pressure when combined with furosemide can lead to more severe antihypertensive effects.

 

The administration of ACE inhibitors to patients previously treated with furosemide may lead to an excessive decrease in blood pressure with impaired renal function and, in some cases, to acute renal failure, therefore, three days before the start of treatment with AIF inhibitors or an increase in their dose, it is recommended that furosemide be canceled, or reduction of its dose.

 

Probenecid, Methotrexate and other medications that, like furosemide,are secreted in the renal tubules, can reduce the action of furosemide (the same pathway of kidney secretion); on the other hand, furosemide can lead to a decrease in the excretion of these drugs by the kidneys.

 

Lithium salts - under the influence of furosemide, lithium excretion decreases, which increases the serum concentration of lithium and increases the risk of toxic effects of lithium, including its damaging effects on the heart and nervous system. Therefore, when using this combination, control of serum lithium concentrations is required.

 

Simultaneous administration of cyclosporin A and furosemide increases the risk of gouty arthritis due to hyperuricemia caused by furosemide and cyclosporine disruption of urate excretion by the kidneys.

 

Pressor amines (epinephrine, norepinephrine) and furosemide mutually reduce efficacy.

 

Radiopaque substances - in patients with a high risk of developing nephropathy for the introduction of radiocontrast preparations receiving furosemide, a higher incidence of renal dysfunction was observed compared to patients at high risk of developing nephropathy for the introduction of radiocontrast preparations,who received only intravenous hydration before the introduction of the radiopaque preparation.

 

Analogues of the drug Furosemide

 

Structural analogs for the active substance:

  • Lasix;
  • Furon;
  • Furosemide (Mifar);
  • Furosemide Lannacher;
  • Furosemide Sopharma;
  • Furosemide-Vial;
  • Furosemide-Darnitsa;
  • Furosemide-ratopharm;
  • Furosemide-Ferein;
  • Furosemide injection 1%;
  • Fursemide.

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Reviews (23):
Guests
Marishka
Perfectly helps with swelling and pressure, we helped my mother very quickly to get rid of excess fluid, only by the appointment of furosemide (before that, in the hospital, she was rubbed with a dropper Lasix, but the doctors said that it is the same - a substitute for furosemide). The truth is to periodically check the salt in the body and take biochemistry, since diuretics very much remove healthy salts from the body.
Guests
Lena
With fainting you can take?
Administrators
admin
LenaIf fainting is caused by brain edema, then you can, although you can not take it. And so, too, it's useful, you'll want to go to the toilet - every faint will pass.

And now seriously - who and for what purpose do such appointments do? Need specificity.
Guests
Alyosha
Who wants ahead of time to the next world, eat furosemide tablets.
Administrators
admin
Alyosha, And clarify and clarify?
Guests
nailya
Kolim intramuscularly once a day to grandmother 78 years. 4 days as prescribed by the doctor (heart failure, severe swelling on the legs) no changes, the liquid does not come out. What to do?
Administrators
admin
nailyaFurosemide is the strongest of diuretics. Therefore, consult a doctor, the dosage may have been prescribed small, and perhaps the grandmother shows inpatient treatment. In hospitals, water is good at driving.
Guests
Sergei
It helps to relieve swelling of the feet.The patient is 81 years old (thrombophlebitis, prostatitis, hypertension). The doctor recommended taking no more than three days (a surgeon, a specialist is not), why three did not explain. After the termination of reception, puffiness comes back. How often can I go back to the drug? Sincerely, thanks in advance.
Administrators
admin
Sergei, This diuretic can be taken for a long time, but this remedy is strong and is used for great puffiness and under medical supervision. As soon as the puffiness decreases - it is better to cancel it. Furosemide strongly removes potassium from the body (to eliminate this negative effect, you can take Asparcum or any other means that supplies the body with additional potassium), which can adversely affect the work of the cardiovascular system, therefore, as a supporting therapy after the termination of the course of taking Furosemide, you can use potassium-sparing diuretic, for example Veroshpiron (this drug can be taken for a long time and without medical supervision).
Guests
Sergei
admin, thank you very much! It became more and more clear.The site is one of the best in the field of pharmaceuticals. Thanks again. Yours faithfully,
Administrators
admin
Sergei, Thank you. I try for you.
Guests
Diana
Prompt, at a liquid delay in an organism before a menses it is expedient to apply a preparation? Thank you in advance.
Administrators
admin
DianaFurosemide is a strong enough drug to use it without prescribing a doctor. It is better to go to the doctor and be examined. Perhaps your condition is associated with a violation of the kidneys and start more appropriately with potassium-sparing diuretics (the same Veroshpirona, Spironolactone, for example).
Guests
vova
Fight with excess weight can be?
Administrators
admin
vovaTo combat obesity or obesity, Furosemide is useless. It is a diuretic that removes excess water from the body and all its pohudatelny effect will last while this medicine will be taken.After cancellation, the water will return and the weight will again be dialed to the previous values. To reduce weight, it is better to contact the endocrinologist and nutritionist and already with these specialists to decide what causes obesity - hormonal causes or disorders in nutrition.
Guests
is given
In the morning I drank 2 tablets. The whole day I ran to the toilet, and by the evening I felt very cold and sweating.
Guests
Irina
I drank 2 tablets of furosemide and without asparks. Excess water left the body, but the whole body began to itch, hives appeared and the face became bloated.
Guests
Allat
In tablets I took, I really liked. Now I want to make a lotion of furasemide in ampoules. Can?
Administrators
admin
AllatAbsolutely useless. I hesitate to ask where do you want to do lotion with Furosemide, in order to get some effect and who has impressed you on this heresy?
Visitors
milla
Tell or say swell very strongly the reasons are unknown Whether there is a sense to drink the given preparation or all taki it is better to pass or take placeexamination? This drug saw very well helps, but I'm afraid that the body will get used and without this drug will not function .. request
Administrators
admin
milla, Sometimes the cause of puffiness is difficult to establish, so many patients take diuretic drugs for a long time (controlling the level of salts in the body, donating blood) and this is normal. Of course, it is better to be examined before starting treatment, because if the cause can be established, then therapy can be quite different drugs, more effective in a particular case.
Guests
Farid
Farid, Postponed your feedback to the drug Veroshpiron, where it is more appropriate.
admin
Guests
Галина, 70 years old
I was prescribed this drug in 1999 with neuritis of the facial nerve. Very strong diuretic effect. I have a long problem with the kidneys. The urologist told me that I should not get carried away with vegetables, because my body works on the production of salts and they clog all channels, and in vegetables there are many mineral salts.But I want, for example, cabbage. And I know that I can not do it. The "crane" closes, I swell and creep out of my eyes. Here again cabbage indulged and swelled strongly. Blood pressure = 167/105. I remembered about furosemide. I drank 1 tablet and the "cock" opened. Running hours. 3. Edemas are gone and even coughing has stopped. Head "brightened". Blood pressure = 122/89. After three hours, the blood pressure rose again to 162/102. And there were such strong convulsions in the legs, especially at night. Neither a needle or a cold floor helped me. Somehow I stumbled into the kitchen, drank hot tea and at the same time asparks. The spasms passed. I do not know if it's related to furosemide or not, but I've had (never before) strong, sharp pains in the middle fingers. With relaxing movements they pass, but then come back again.

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