Furosemide – when should it be used? Dosage and side effects

Proven content

Edema as well as arterial hypertension require the use of specialized medicinal preparations. Furosemide is used very often in such diseases. What are the properties of this preparation? What’s in the leaflet? What opinions does this drug have? Here is some information.

Moreover, the increased excretion of sodium is accompanied by the increased excretion of magnesium, potassium and calcium. In addition, Furosemide probably contributes to vasodilation and minimizes vascular resistance. Thanks to which it lowers blood pressure.

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This substance is also called a loop diuretic because it acts within the nephron loop. In addition, Furosemide allows blood vessels to widen and reduces vascular resistance.

The drug can be used in the treatment of children and adults who struggle with congestive heart failure and in people with kidney disease, cirrhosis and other conditions that require the use of diuretics. Furosemide works quickly and the effects can be noticed after 30-60 minutes.

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In adults, it can also be used as part of the treatment of high blood pressure. The preparation is also given in the form of intramuscular injections, which should be administered by medical personnel.

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Furosemide – indications for use

The indications for the use of Furosemide are:

1. treatment of edema caused by congestive heart failure, as well as edema of renal or hepatic origin,
2. treatment of arterial hypertension – monotherapy or combined treatment with other preparations.

1. renal dysfunction along with anuria;
2. hepatic coma and pre-coma;
3. obstruction of the urinary tract;
4. electrolyte deficiencies;
5. pregnancy and breastfeeding.

The dosage of Furosemide is as follows:

1. Adults – at the beginning, 40-80 mg of the drug is used once a day in the morning – over time, if necessary, the doctor may increase the dose or lower it. The maintenance dose should be taken as prescribed by your doctor, i.e. 1-2 times a day, every 2 days or for 2-4 consecutive days each week. In case of sWhen taking Furosemide over a long period of time, the maintenance dose is 40-80 mg per day. However, for the treatment of severe edema, the maximum dose may be as high as 600 mg per day. This dose is divided into 3-4 doses. In the case of chronic renal failure, high doses of up to 1,5 g per day are administered;
2. dzieci – do not use the drug in infants and children who cannot swallow a tablet. Each case is assessed individually by a doctor who determines the dose. Most often it is 1-3 mg per kg of the child’s weight given once a day. For children, the maximum daily dose is 40 mg a day – it is not affected by the weight of the child. Children who are treated for long periods should take the lowest effective dose possible.

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In the event of an overdose with Furosemide, the most important thing is to replenish the electrolyte deficiency and increase the volume of circulating blood. Hemodialysis does not accelerate Furosemide.

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1. other possible side effects include: metabolic alkalosis, increased blood urea levels, hematological disorders, hepatic encephalopathy, paresthesia, head disorders, fainting, loss of consciousness, headaches, restlessness, yellow vision, noise, deafness, hypotension, thrombosis, nausea, vomiting, diarrhea, appetite disorders, cholestasis, acute pancreatitis, urinary glucose excretion, pollakiuria, hypersensitivity reactions, possible anaphylactic and anaphylactoid reactions, exacerbation or activation of systemic lupus erythematosus and other autoimmune diseases.

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Furosemide – precautions

Particular caution should be exercised when taking Furasemide in the case of certain diseases and other circumstances that may constitute a contraindication for taking or may be a reason to change the dosage of the preparation. Sometimes it may be necessary to perform check-ups.

People should be particularly careful when using Furosemide:

1. with too low blood pressure;
2. suffering from overt or latent diabetes – in this group of patients it is necessary to periodically test the level of glucose in the blood;
3. struggling with gout – in this group of patients it is necessary to determine the level of uric acid;
4. with urination disorders resulting from the enlargement of the prostate gland or narrowing of the urethra – the drug should be taken only when urination is unimpeded, because urinary retention may occur and the bladder may expand too much;
5. with hypoproteinemia, which may lead to an increase in side effects, therefore it is necessary to carefully adjust the dose level;
6. struggling with hepatorenal syndrome, which means a combination of liver cirrhosis and renal dysfunction;
7. with severe drops in blood pressure which could lead to a stroke or heart attack.

The use of Furosemide is associated with the risk of dizziness, fainting or loss of consciousness, especially in the elderly, who are also taking other medications that may lower blood pressure. It should also be remembered that these people may be at risk of developing hypotension for other health reasons.

Furosemide works quickly and intensively and therefore may lead to dehydration manifested by dizziness and light-headedness. The drug can be used to lower blood pressure only in people with normal kidney function and after individual assessment of the patient’s condition and the risk associated with the use of the preparation.

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Due to increased urination, Furosemide may lead to fluid and electrolyte imbalances. Therefore, it is imperative to control the level of electrolytes and the acid-base balance, as well as the concentration of creatinine, urea, glucose and uric acid. People using the drug should also have regular blood counts.

People who are at risk of electrolyte disturbances and additional fluid loss, e.g. during vomiting, require special control. In certain situations, your doctor may recommend that you temporarily stop taking the drug.

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In adults, passing urine more frequently should not lead to weight loss of more than 1 kg per day. It should be remembered that excessive dehydration can lead to cardiovascular collapse and complications of thromboembolism.

To avoid hypokalemia, be mindful of a potassium-rich diet. Moreover, the simultaneous use of NSAIDs may lead to the development of acute renal failure.

Increased urine output can also lead to a deficiency of thiamine, or vitamin B1. It may lead to heart problems, therefore these deficiencies should be supplemented. When using the drug, it should also be remembered that it may aggravate or activate systemic lupus erythematosus.

Furosemide contains lactose, therefore the drug should not be used by people with galactose intolerance, lactase deficiency or malabsorption of glucose-galactose. In addition, the drug may have a negative impact on psychophysical abilities and interfere with the ability to drive and use machines.

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So far, no data have been collected regarding the negative effect of Furosemide on the fetus and that the preparation increases the risk of birth defects in the child. Therefore, it is not recommended to use the preparation during pregnancy to ensure maximum safety for the baby. The drug is not recommended especially in the first trimester, and also in the third trimester, when the use of Furosemide may increase the risk of haemolytic anemia in a child.

Furosemide and breastfeeding

The active substance of Furosemide passes into breast milk. The drug may inhibit lactation, therefore it is contraindicated during breastfeeding. If administration is necessary, the woman should consider weaning the child.

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Furosemide is alcohol

You should not consume alcohol while taking Furosemide, as it can make your blood pressure lower and lower it even more. This can lead to headaches, dizziness and even fainting.

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Furosemide – interactions with other drugs

Before starting to use Furosemide, inform your doctor about all medications you are taking, including those without a prescription. Keep in mind that:

1. other diuretics increase urination too much;
2. potassium-sparing diuretics used together with Furosemide to prevent hypokalemia;
3. the preparation may lead to a decrease in blood potassium levels, which increases the toxicity of concomitantly used cardiac glycosides and increases the risk of heart problems;
4. Furosemide affects the action of the neuromuscular blocking drugs you are taking;
5. the drug increases the effect of theophylline;
6. reduces the effect of catecholamines on the arterial muscle;
7. a combination drug with corticosteroids can make the body retain sodium;
8. drug combined with corticosteroids, corticotropin; carbenoxolone, licorice, beta2-sympathomimetics, amphotericin B, reboxetine and laxatives increase the risk of hypokalemia and its symptoms;
9. Furosemide reduces the excretion of lithium, thus increasing its toxic effect – the simultaneous use of lithium salts should be avoided;
10. Furosemide reduces the effectiveness of diabetes drugs and insulin;
11. Furosemide may enhance the antihypertensive effect of antihypertensive drugs;
12. Furosemide used concomitantly with angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists may increase the risk of severe hypotension and renal failure;
13. NSAIDs may reduce the diuretic and antihypertensive effects;
14. Furosemide may increase the effect of salicylates – it may lead to salicylate poisoning;
15. Furosemide may increase the toxic effects of aminoglycoside antibiotics, ethacrynic acid and other ototoxic drugs – permanent hearing impairment may occur;
16. Furosemide increases the toxic effects of cephalosporins or other antibiotics on the kidneys;
17. Furosemide increases the toxic effect of cisplatin;
18. Furosemide, when used concomitantly with cyclosporine, may increase the risk of arthritis in gout;
19. Furosemide should not be used in people at high risk of nephropathy as a result of the administration of contrast agents, i.e. contrast during radiographic examinations.

Furosemide – side effects

Because Furosemide is excreted in the urine via the kidneys. Most patients are not seriously affected by overdose, but patients with kidney problems are at greater risk. This group of patients may include:

1. dizziness;
2. headaches;
3. nausea;
4. anemia;
5. skin reactions.

Furosemide – opinion

Opinions about Furosemide vary – with a predominance of positive statements. People using this medicinal preparation praise it for its quick and effective action.