Furosemide: instructions for use. Furosemide instructions for use, contraindications, side effects, reviews Furosemide dose

Furosemide, what do these pills help with? The drug is well known for its diuretic properties, allowing you to remove puffiness. The diuretic "Furosemide" instruction for use prescribes to take with edema, heart failure, hypertension.

Composition and form of release

The drug is produced in the form of tablets for internal use, as well as a solution for injection. The active element of the drug "Furosemide", from which it helps with edema, is the substance of the same name. Diuretic tablets include 0.04 g of the active substance, injections contain 10 mg / ml.

Tablets are packed in blister packs, 50 pieces each with detailed instructions attached.

Injections are supplied in 2 ml ampoules. Auxiliary components contribute to better absorption of the drug, the list of which depends on the form of release: starch, silicon dioxide, sodium hydroxide, magnesium stearate, sodium chloride, povidone and other components.

Pharmacological properties

Diuretic tablets "Furosemide", from which the medicine helps with kidney diseases, intensively remove water and magnesium and calcium ions from the body. Thus, the diuretic effect of the active element is manifested. When using the remedy for heart failure, the load on the myocardium decreases.

This occurs as a result of the expansion of arteries and veins. The action of the drug is observed after 5 minutes with intravenous injection and an hour later when using tablets. The therapeutic effect lasts for 2-3 hours. With a deterioration in kidney function, the drug acts for 6-8 hours.

The drug "Furosemide": what helps

The drug is prescribed for various types of edematous syndrome. Indications for the use of the drug "Furosemide" include the following diseases and conditions:

heart asthma;
excess calcium in the body;
pulmonary edema;
hypertensive crisis;
heart failure;
eclampsia;
swelling of the brain;
complicated arterial hypertension;
nephrotic syndrome;
cirrhosis of the liver.

The drug is also used when performing forced diuresis.

What helps "Furosemide" in ampoules

The instruction explains that the indications for the use of the injection form are similar to tablets. However, injections work faster. To the question: “What is the Furasemide solution for?”, Physicians answer that intravenous administration can quickly reduce pressure and preload on the myocardium. This plays an important role in emergency conditions of the patient.

Medicine "Furosemide": instructions for use

The treatment regimen is determined by a specialist depending on the clinical picture of the pathology. Tablets are taken in a volume of 20 to 80 mg per day. The dosage can be gradually increased, bringing the daily use of the drug to 0.6 g. The amount of the drug "Furosemide" for children is calculated based on body weight 1-2 mg per kg, not more than 6 mg per kg.

Instructions for the use of injections "Furosemide"

The volume of intramuscular or intravenous injections should not exceed 0.04 g per day. Doubling the dose is possible. Doctors recommend injecting the drug into a vein infectiously for 2 minutes. It is possible to inject injections into muscle tissue only if it is impossible to use tablets and intravenous injections.

Contraindications

The drug "Furosemide" instructions for use prohibits the use of:

hypersensitivity to the active element;
stenosis of the urethra;
arterial hypotension;
digitalis intoxication;
pancreatitis;
acute glomerulonephritis;
hypokalemia;
diabetic coma;
increased venous pressure;
acute kidney failure;
hepatic coma;
gout;
cardiomyopathy;
urinary tract stones;
liver failure in a complex form;
hyperglycemic coma;
hyperuricemia;
aortic stenosis;
alkalosis;
precomatose states;
acute myocardial infarction.

Caution when using the product should be observed by persons aged, with diabetes mellitus, prostate hyperplasia, hypoproteinemia, atherosclerosis. Furosemide during pregnancy and breastfeeding can only be used as an emergency aid under the supervision of a physician.

In acute conditions, injections into the muscle are contraindicated.

Drug interaction

The combined use of the drug "Furosemide" and other drugs can cause negative reactions of the body. The combination of the drug with hypoglycemic drugs, cephalosporins, aminoglycosides, indomethacin, NSAIDs, insulin is unacceptable. Do not take the drug together with digitoxin, astemizole, digoxin, ACE inhibitors, cisplatin, cholestyramine, cisapride, phenytoin, colestipol, lithium carbonate.

Side effects

The drug "Furosemide", reviews and instructions confirm this, it can cause negative reactions in the body. Side effects include:

tachycardia, dizziness, hearing impairment;
anorexia, oliguria, exfoliative dermatitis;
aplastic anemia, dehydration, thrombophlebitis;
orthostatic hypotension, muscle weakness;
visual disturbances, dry mouth;
interstitial nephritis, urticaria;
thrombocytopenia, metabolic acidosis;
kidney calcification (in newborns);
arrhythmia, headache, cholestatic jaundice;
hematuria, pruritus, hypochloremia;
low blood pressure, tetany, stool disorders;
urinary retention, purpura, leukopenia;
hyponatremia, collapse, apathy;
nausea or vomiting, lethargy, impotence;
necrotizing angiitis, agranulocytosis;
hypovolemia, confusion;
exacerbation of pancreatitis, vasculitis;
anaphylactic shock, weakness, drowsiness, erythema.

Price and analogues

"Furosemide" can be replaced by the following drugs - analogues: "", "", "Trigrim", "Furosemide Sopharma". You can buy Furosemide tablets for 16-20 rubles, the price of injections is 25 rubles.

Vacation and storage conditions

Released by prescription.

Store in places protected from light and out of reach of children, at room temperature. The shelf life of the tablets is 2 years, the solution for intramuscular and intravenous injections is 2 years.

Opinions of patients and doctors

The drug "Furosemide", reviews of experts confirm this fact, is a key tool for the treatment of edematous syndrome in people with heart failure. This is a fast acting drug. Patients say that in addition to helping with edema and hypertension, the medication has side effects and is addictive (it is undesirable to use it for a long time).

Many women use the medicine "Furosemide" for weight loss. This tool allows you to quickly get rid of 3 - 5 kg of excess weight. However, for weight loss, doctors do not advise taking the drug, because it does not break down excess fat, but removes water and other necessary substances. Women claim that when taking more than 2 capsules per week, side effects and addiction appear.

On the forums you can meet the question: Which is better - "Lasix" or "Furosemide"? The pharmacists explain that the drugs are identical and their choice depends on price and availability.

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Characteristics of the substance Furosemide

Loop diuretic. White or almost white crystalline powder, practically insoluble in water, sparingly soluble in ethanol, freely soluble in dilute alkali solutions and insoluble in dilute acid solutions.

Pharmacology

pharmachologic effect- diuretic, natriuretic.

It acts throughout the thick segment of the ascending limb of the loop of Henle and blocks the reabsorption of 15-20% of filtered Na + ions. Secreted into the lumen of the proximal renal tubules. Increases the excretion of bicarbonates, phosphates, Ca 2+ , Mg 2+ , K + ions, increases urine pH. It has secondary effects due to the release of intrarenal mediators and the redistribution of intrarenal blood flow. It is quickly and completely absorbed by any route of administration. Bioavailability when taken orally is usually 60-70%. Plasma protein binding - 91-97%. T 1 / 2 0.5-1 h. In the liver undergoes biotransformation with the formation of inactive metabolites (mainly glucuronide). It is excreted by 88% by the kidneys and by 12% with bile.

The diuretic effect is characterized by significant severity, short duration and depends on the dose. After oral administration, it occurs after 15–30 minutes, reaches a maximum after 1–2 hours and lasts 6–8 hours. ions Na + increases significantly, however, after its termination, the rate of excretion of Na + ions decreases below the initial level (the phenomenon of "rebound" or recoil). The phenomenon is due to a sharp activation of renin-angiotensin and other antinatriuretic neurohumoral regulation in response to massive diuresis. Stimulates the arginine vasopressin and sympathetic systems, reduces the level of atrial natriuretic factor in plasma, causes vasoconstriction. Due to the "rebound" phenomenon, when taken once a day, it may not have a significant effect on the daily excretion of Na + ions. Effective in heart failure (both acute and chronic), improves the functional class of heart failure, because. reduces the filling pressure of the left ventricle. Reduces peripheral edema, pulmonary congestion, pulmonary vascular resistance, pulmonary capillary wedge pressure in the pulmonary artery and right atrium. It remains effective at a low glomerular filtration rate, therefore it is used to treat arterial hypertension in patients with renal insufficiency.

Updating information

Furosemide Carcinogenicity Data

Furosemide has been tested for oral carcinogenicity in a single strain of mice and rats. A small but statistically significant increase in the incidence of breast carcinoma was noted in female mice at a dose 17.5 times higher than the maximum allowable for human use. There was also a slight increase in the incidence of rare tumors in male rats when using furosemide at a dose of 15 mg/kg (slightly higher than the maximum dose allowed for use in humans), but this effect was not observed when the drug was administered at a dose of 30 mg/kg.

[Updated 27.12.2011 ]

Furosemide mutagenicity data

Data on the mutagenicity of furosemide are ambiguous. A number of studies report the absence of mutagenic activity. Thus, there is evidence that there is no induction of sister chromatid exchange in human cells. in vitro, however, other studies of chromosome aberrations have yielded conflicting results. A study in Chinese hamster cells found the induction of chromosomal damage, while the positive data obtained for the presence of sister chromatid exchange were questionable. The results of studies of the induction of chromosome aberrations in mice treated with furosemide were inconclusive.

[Updated 27.12.2011 ]

Impact on fertility

It has been shown that furosemide does not reduce the level of fertility in rats of both sexes at a dose of 100 mg/kg, which provides the most effective diuresis in mice (8 times the maximum allowable for use in humans - 600 mg/day).

[Updated 30.12.2011 ]

Application of the substance Furosemide

Inside: edematous syndrome of various origins, incl. in chronic heart failure, chronic renal failure, liver disease (including cirrhosis of the liver), edematous syndrome in nephrotic syndrome (with nephrotic syndrome, the treatment of the underlying disease is in the forefront), acute renal failure (including that in pregnancy and burns, to maintain fluid excretion ), arterial hypertension.

Parenterally: edematous syndrome in chronic heart failure stage II-III, acute heart failure, nephrotic syndrome, liver cirrhosis; pulmonary edema, cardiac asthma, cerebral edema, eclampsia, severe arterial hypertension, some forms of hypertensive crisis, hypercalcemia; conducting forced diuresis, incl. in case of poisoning with chemical compounds excreted by the kidneys unchanged.

Contraindications

Hypersensitivity (including to sulfonylurea derivatives, sulfonamides), renal failure with anuria, severe liver failure, hepatic coma and precoma, severe electrolyte imbalance (including severe hypokalemia and hyponatremia), hypovolemia (with arterial hypotension or without it) or dehydration, a pronounced violation of the outflow of urine of any etiology (including unilateral lesions of the urinary tract), digitalis intoxication, acute glomerulonephritis, decompensated mitral or aortic stenosis, increased pressure in the jugular vein over 10 mm Hg. Art., hypertrophic obstructive cardiomyopathy, hyperuricemia, children under 3 years of age (for tablets).

Application restrictions

arterial hypotension; conditions in which an excessive decrease in blood pressure is especially dangerous (stenosing lesions of the coronary and / or cerebral arteries), acute myocardial infarction (increased risk of developing cardiogenic shock), diabetes mellitus or impaired carbohydrate tolerance, gout, hepatorenal syndrome, hypoproteinemia (for example, with nephrotic syndrome - the risk of developing ototoxicity of furosemide), impaired urinary outflow (prostatic hypertrophy, narrowing of the urethra or hydronephrosis), systemic lupus erythematosus, pancreatitis, diarrhea, history of ventricular arrhythmia.

Use during pregnancy and lactation

During pregnancy, it is possible only for a short time and only if the intended benefit to the mother outweighs the potential risk to the fetus (passes through the placental barrier). In the case of the use of furosemide during pregnancy, careful monitoring of the fetus is necessary.

At the time of treatment, it is necessary to stop breastfeeding (furosemide passes into breast milk, and can also suppress lactation).

Updating information

The use of furosemide during pregnancy

FDA category - C. The use of furosemide during pregnancy should take into account the ratio of potential risk and benefit to the fetus. The use of furosemide during pregnancy must be accompanied by monitoring of fetal growth.

Sufficient and well-controlled studies in pregnant women have not been conducted.

[Updated 15.12.2011 ]

Furosemide use in pregnancy: evidence from in vivo studies

The effects of furosemide on the development of the embryo, fetus and pregnant female have been studied in mice, rats and rabbits. The results of studies in mice and one study in rabbits suggest that the use of furosemide in pregnant females resulted in an increase in the frequency and severity of hydronephrosis (dilation of the renal pelvis and, in some cases, the ureter) in fetuses of females treated with furosemide, compared with the fetuses of the control group of pregnant animals.

[Updated 15.12.2011 ]

Additional information about the use of furosemide during pregnancy

The use of furosemide in pregnant female rabbits at doses of 25, 50 and 100 mg/kg (respectively 2, 4 and 8 times the maximum allowable human dose of 600 mg/day) led to unexplained death of females and abortions in rabbits. In another study, with the introduction of furosemide in the period from 12 to 17 days of gestation at a dose exceeding the maximum allowable in humans by 4 times (50 mg / kg), abortions and death of females were also noted. The third study showed that none of the female rabbits survived when furosemide was administered at a dose of 100 mg/kg.

[Updated 26.12.2011 ]

Side effects of Furosemide

decrease in blood pressure, incl. orthostatic hypotension, collapse, tachycardia, arrhythmia, decreased BCC, leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia.

From the side of water-electrolyte metabolism: hypovolemia, hypokalemia, hypomagnesemia, hyponatremia, hypochloremia, hypocalcemia, hypercalciuria, metabolic alkalosis, impaired glucose tolerance, hyperglycemia, hypercholesterolemia, hyperuricemia, gout, increased LDL cholesterol (at high doses), dehydration (risk of thrombosis and thromboembolism, more often in elderly patients).

From the digestive tract: loss of appetite, dryness of the oral mucosa, thirst, nausea, vomiting, constipation / diarrhea, cholestatic jaundice, pancreatitis (exacerbation).

dizziness, headache, paresthesia, apathy, adynamia, weakness, lethargy, drowsiness, confusion, muscle weakness, calf muscle cramps (tetany), inner ear damage, hearing loss, blurred vision.

oliguria, acute urinary retention (in patients with prostatic hypertrophy), interstitial nephritis, hematuria, reduced potency.

Allergic reactions: purpura , photosensitivity, urticaria, pruritus, exfoliative dermatitis, erythema multiforme, vasculitis, necrotizing angiitis, anaphylactic shock.

Others: chills, fever; with intravenous administration (optional) - thrombophlebitis, kidney calcification in premature babies.

Updating information

Violation of water and electrolyte balance in patients taking furosemide

Patients who are prescribed furosemide should be warned about the possible development of symptoms associated with excessive loss of fluid and / or electrolytes. There is a possibility of developing orthostatic arterial hypotension. At the same time, a slow change in body position can, to a certain extent, prevent a decrease in blood pressure when moving from a horizontal to a vertical position. The addition of potassium preparations during therapy with furosemide and / or adherence to a certain dietary regimen (meal rich in potassium) is necessary to prevent the development of hypokalemia.

[Updated 21.12.2011 ]

Additions to Known Side Effects of Furosemide

From the digestive tract: hepatic encephalopathy in patients with hepatic cell failure syndrome, intrahepatic cholestatic jaundice, increased activity of liver enzymes; anorexia, irritation of the oral mucosa and stomach, colic.

Allergic reactions: systemic hypersensitivity reactions

From the genitourinary system: interstitial nephritis.

[Updated 26.12.2011 ]

From the nervous system and sensory organs: tinnitus, hearing loss: blurred vision, xanthopsia.

From the side of the cardiovascular system and blood (hematopoiesis, hemostasis): orthostatic hypotension, which may be aggravated by alcohol or drugs, hemolytic anemia, eosinophilia.

Others: bullous pemphigoid, in premature infants, the use of furosemide in the first weeks of life, in addition to the risk of developing nephrocalcinosis and nephrolithiasis, there is a risk of non-closure of the Botallian duct.

[Updated 27.12.2011 ]

Interaction

Aminoglycosides, ethacrynic acid and cisplatin increase ototoxicity (especially with impaired renal function). Increases the risk of kidney damage against the background of amphotericin B. When prescribing high doses of salicylates, the risk of developing salicylism (competitive renal excretion), cardiac glycosides - hypokalemia and associated arrhythmia, corticosteroids - electrolyte imbalance increases. Reduces the muscle relaxant activity of tubocurarine, potentiates the effect of succinylcholine. Reduces renal clearance (and increases the likelihood of intoxication) of lithium. Under the influence of furosemide, the effect of ACE inhibitors and antihypertensive drugs, warfarin, diazoxide, theophylline increases, and the effect of antidiabetic drugs, noradrenaline is weakened. Sucralfate and indomethacin (due to inhibition of PG synthesis, impaired plasma renin levels and aldosterone excretion) reduce efficacy. Probenecid increases serum concentration (blocks excretion).

Updating information

Further information on drug interactions between furosemide and NSAIDs

The combination of furosemide and acetylsalicylic acid temporarily reduces creatinine clearance in patients with chronic renal failure. Cases of an increase in the concentration of blood urea nitrogen, serum creatinine and potassium and an increase in body weight have been reported while taking furosemide and NSAIDs. In patients receiving furosemide and salicylates, toxic effects may develop due to the presence of competition in renal excretion and, consequently, a delay in the excretion of salicylates.

[Updated 21.12.2011 ]

Further information on drug interactions between furosemide and indomethacin

There are literature data indicating a weakening of the antihypertensive and natriuretic effects of furosemide when taken simultaneously with indomethacin, due to inhibition of prostaglandin synthesis. Indomethacin can also alter plasma renin levels, its profile, and aldosterone excretion. Patients receiving both indomethacin and furosemide should be carefully examined to assess whether the antihypertensive and/or diuretic effects of furosemide have been achieved.

[Updated 26.12.2011 ]

Simultaneous use of furosemide and drugs excreted by the kidneys

Probenecid, methotrexate, and other drugs that, like furosemide, are excreted by the renal tubules, may reduce the effectiveness of furosemide. On the other hand, furosemide is able to suppress the excretion of these drugs and thus reduce the rate of their elimination. The use of large doses of furosemide and the above drugs can lead to an increase in serum concentrations of both the diuretic and drugs competitively excreted by the renal tubules, and, consequently, to an increased risk of developing toxic effects.

[Updated 26.12.2011 ]

Further Information on Furosemide Drug Interactions

The simultaneous use of furosemide and chloral hydrate is not recommended. Intravenous furosemide within 24 hours of taking chloral hydrate may cause flushing (flushing), sweating, restlessness, nausea, high blood pressure, and tachycardia.

It is possible to potentiate the action of ganglioblockers and adrenoblockers.

Patients receiving both furosemide and cyclosporine are at high risk of developing gouty arthritis due to the induction of hyperuricemia by furosemide and the inhibition of renal urate excretion by cyclosporine.

[Updated 22.02.2012 ]

Overdose

Symptoms: hypovolemia, dehydration, hemoconcentration, severe hypotension, decrease in BCC, collapse, shock, cardiac arrhythmias and conduction disorders (including AV blockade, ventricular fibrillation), acute renal failure with anuria, thrombosis, thromboembolism, drowsiness, confusion, flaccid paralysis, apathy.

Treatment: correction of water and electrolyte balance and acid-base balance, replenishment of BCC, symptomatic therapy, maintenance of vital functions. The specific antidote is unknown.

Routes of administration

Inside, in / m, in / in.

Precautions Substance Furosemide

In the presence of ascites without peripheral edema, it is recommended to use in doses that provide additional diuresis in a volume of not more than 700-900 ml / day in order to avoid the development of oliguria, azotemia and electrolyte disturbances. In order to exclude the phenomenon of "rebound" in the treatment of arterial hypertension, it is prescribed at least 2 times a day. It should be borne in mind that long-term use can lead to weakness, fatigue, a decrease in blood pressure and cardiac output, and excessive diuresis in myocardial infarction with congestion in the pulmonary circulation can contribute to the development of cardiogenic shock. Temporary cancellation (for several days) is necessary before the appointment of ACE inhibitors. In order to avoid the development of hypokalemia, it is advisable to combine furosemide with potassium-sparing diuretics, and also to prescribe potassium preparations at the same time. A diet rich in potassium is always recommended during treatment with furosemide.

Against the background of course treatment, it is recommended to control blood pressure, electrolyte levels (especially potassium), CO 2 , creatinine, urea nitrogen, uric acid, periodic determination of liver enzymes, calcium and magnesium levels, blood glucose and urine (in diabetes mellitus). Patients with hypersensitivity to sulfonylurea derivatives and sulfonamides may have cross-sensitivity to furosemide. If oliguria persists for 24 hours, furosemide should be discontinued.

Composition and form of release

Pharmacological properties

The drug "Furosemide": what helps

The drug is prescribed for various types of edematous syndrome. Indications for the use of the drug "Furosemide" include the following diseases and conditions:

heart asthma; excess calcium in the body; pulmonary edema; hypertensive crisis; heart failure; eclampsia; swelling of the brain; complicated arterial hypertension; nephrotic syndrome; cirrhosis of the liver.

The drug is also used when performing forced diuresis.

What helps "Furosemide" in ampoules

Contraindications

The drug "Furosemide" instructions for use prohibits the use of:

hypersensitivity to the active element; stenosis of the urethra; arterial hypotension; digitalis intoxication; pancreatitis; acute glomerulonephritis; hypokalemia; diabetic coma; increased venous pressure; acute kidney failure; hepatic coma; gout; cardiomyopathy; urinary tract stones; liver failure in a complex form; hyperglycemic coma; hyperuricemia; aortic stenosis; alkalosis; precomatose states; acute myocardial infarction.

Medicine "Furosemide": instructions for use

Instructions for the use of injections "Furosemide"

In acute conditions, injections into the muscle are contraindicated.

Drug interaction

Side effects

The drug "Furosemide", reviews and instructions confirm this, it can cause negative reactions in the body. Side effects include:

tachycardia, dizziness, hearing impairment; anorexia, oliguria, exfoliative dermatitis; aplastic anemia, dehydration, thrombophlebitis; orthostatic hypotension, muscle weakness; visual disturbances, dry mouth; interstitial nephritis, urticaria; thrombocytopenia, metabolic acidosis; kidney calcification (in newborns); arrhythmia, headache, cholestatic jaundice; hematuria, pruritus, hypochloremia; low blood pressure, tetany, stool disorders; urinary retention, purpura, leukopenia; hyponatremia, collapse, apathy; nausea or vomiting, lethargy, impotence; necrotizing angiitis, agranulocytosis; hypovolemia, confusion; exacerbation of pancreatitis, vasculitis; anaphylactic shock, weakness, drowsiness, erythema.

Price and analogues

Furasemide can be replaced by the following drugs - analogues: Lasix, Torasemide, Trigrim, Furosemide Sopharma. You can buy Furosemide tablets for 16-20 rubles, the price of injections is 25 rubles.

Opinions of patients and doctors

On the forums you can meet the question: Which is better - "Lasix" or "Furosemide"? The pharmacists explain that the drugs are identical and their choice depends on price and availability.

Stagnation, swelling of soft tissues are quite common disorders that occur in many diseases of various organ systems. It is possible to improve the outflow and exit of fluid from the body with the help of drugs, of which there are a huge variety today. And quite often, doctors recommend the drug "Furosemide" to their patients. What does he help? What properties does it have? Are there any contraindications to treatment? Is it possible for side effects to occur? The answers to these questions are of interest to every patient.

The composition and form of release of the drug

The diuretic "Furosemide" is available in the form of tablets, as well as a solution for intravenous or intramuscular administration. There are also granules for the preparation of a suspension - this form of medicine is more suitable for the treatment of children.

The main active substance of the drug is furosemide. One tablet contains 40 mg of this component. In the pharmacy you can buy packs of 20 or 50 tablets. In some cases (especially when it comes to severe edema), it is advisable to use an injection solution - it is sold in 2 ml glass ampoules with a furosemide concentration of 1%. To date, packages of 10, 25 and 50 ampoules are sold.

In fact, in almost every pharmacy you can easily buy the drug "Furosemide". A prescription from a doctor for pills is not needed in this case, although some pharmacies have sales restrictions.

Main pharmacological properties

In modern medicine, the medicine "Furosemide" is very often used. Its use in some cases is simply necessary. This is a fast-acting diuretic that inhibits the reabsorption of chloride and sodium ions in the proximal and distal tubules of the kidney, which accelerates the process of excretion of their body fluid. The drug does not affect glomerular filtration in any way, so it is prescribed even in the presence of renal failure. Furosemide also dilates peripheral vessels, which reduces blood pressure.

After taking the pill, the effect, as a rule, begins to appear after 30-50 minutes. If we are talking about intravenous administration, then an increase in the volume of urine released begins after 15-20 minutes. The effect of the drug lasts about 3-4 hours.

The drug "Furosemide": what is it taken from? Indications for therapy

Everyone experiences health problems from time to time. So in what cases is it advisable to take the drug "Furosemide"? What does he help? The main indication for admission is edematous syndrome. In turn, edema can be a symptom of a variety of diseases.

Of course, often the stagnation of fluid indicates the presence of problems with the kidneys. In such cases, doctors often prescribe Furosemide. Indications for use - edema that has arisen against the background of chronic renal failure, nephrotic syndrome, hypercalcemia. In addition, the drug helps with hypertension, chronic heart failure, eclampsia, cardiac asthma. Also, the medicine helps fight swelling, which is associated with liver diseases. Indications also include pulmonary and cerebral edema.

The drug "Furosemide": instructions

These tablets, as mentioned earlier, can be freely bought at the pharmacy. If you have any problems, however, you should first consult a doctor. Only a specialist can prescribe you the drug "Furosemide". How to take pills, what is the maximum daily dose, how long will the treatment last - you will find answers to all these questions from your doctor. The instructions for use contain only general recommendations.

As a rule, the initial dose of the drug for adults is 40 mg of furosemide (one tablet). If there are no changes after taking the medicine, the doctor can increase the dose by 80-120 mg every 6-8 hours until a normal diuretic effect appears. However, there are some restrictions. No more than four tablets (160 mg) can be taken at a time. The maximum daily dose is 300 mg, but in such quantities the drug cannot be used for maintenance therapy, only as an emergency measure.

Often, patients suffering from edema and arterial hypertension are prescribed the drug Furosemide. How to take it in such cases? Most often, doctors recommend drinking one tablet twice a day. The duration of therapy is determined individually. As soon as the swelling begins to disappear, the dose of the drug is gradually reduced.

Intravenous and intramuscular administration is advisable only for persistent edema, and also in cases where oral administration is not possible. If we are talking about the treatment of children, then the daily dose is 1-2 mg of furosemide per kilogram of weight.

Doctors often prescribe Furosemide (tablets) to their patients. The instructions for use contain some specific recommendations. Against the background of a long-term course of taking the drug, it is very important to control blood pressure all the time, as well as monitor the concentration of electrolytes in the plasma. Also, some patients are advised to take potassium supplements and eat a diet rich in this and other minerals.

Are there contraindications?

Many people are interested in the question of whether all categories of patients are allowed to take the drug "Furosemide" (tablets). Instructions for use confirms that there are some contraindications in this case. Each patient should familiarize themselves with their list even before the start of therapy.

To begin with, it is worth saying that the drug is not prescribed to a patient with hypokalemia, since the tablets can further reduce the level of potassium in the blood, which will affect the work of the whole organism, especially the cardiovascular system. Contraindications also include hypersensitivity to any of the components of the drug, lactose intolerance, lactase deficiency and wheat allergy.

The drug should not be prescribed in the presence of severe renal or hepatic insufficiency, hepatic coma. Also, contraindications include acute glomerulonephritis, in which there is a violation of the outflow of urine. The drug should not be taken by patients with impaired water and electrolyte balance, decompensated aortic and mitral stenosis, increased venous pressure, hypertrophic obstructive cardiomyopathy. The tablets are not intended for the treatment of children under the age of three.

Many people need to take the drug Furosemide. Indications for therapy are most often puffiness, and it is no secret to anyone that many pregnant women face a similar problem. It is immediately worth noting that taking this medication in the first trimester is strictly prohibited. In the second half of pregnancy, therapy is possible, but only under medical supervision. By the way, during lactation, the drug affects the functioning of the mammary glands, causing a decrease in the amount of milk (due to the removal of fluid). If therapy is still necessary, then it is better to stop breastfeeding for the duration of treatment.

Main Side Effects

Many people are interested in questions about what Furosemide is, what it is used for, etc. But no less important aspect is the presence of side effects. Statistical studies have shown that complications in most cases are the result of incorrect or too long medication. If you follow all the doctor's recommendations, the likelihood of side effects is minimal.

Against the background of therapy, hypotension, interstitial nephritis may develop. It is also possible to reduce the level of potassium in the blood, increase the level of glucose and uric acid, which is associated with increased diuresis. Sometimes there are reactions from the digestive (nausea, vomiting) and nervous systems (dizziness, headaches, fatigue, depression, confusion). It is also possible the appearance of strong thirst, dryness of the mucous membranes. Some patients develop allergic skin reactions.

Interaction with other drugs

Diuretic "Furosemide" is not recommended to be taken together with cephalosporins, ethacrynic acid, amphotericins and other drugs that have a nephrotoxic effect. This drug also increases the activity of theophylline and diazoxide, reduces the effect of allopurinol, non-depolarizing muscle relaxants. Be sure to tell your doctor about all medications you are taking. During therapy, it is strictly forbidden to drink alcohol.

Overdose and its consequences

Today, many patients are faced with the need to take the drug "Furosemide". Indications for its use are swelling and stagnation of fluid, which, alas, some people encounter very often. Unfortunately, too high doses of this drug can lead to dangerous consequences, in particular, hypovolemia, a condition that is accompanied by a decrease in circulating blood volume. Against the background of such a disorder, a sharp decrease in blood pressure is possible, as well as orthostatic collapse. The patient after an overdose urgently needs to be taken to the hospital. First of all, he needs to enter an electrolyte solution in order to restore blood volume. If necessary, further symptomatic therapy is carried out.

How much does the medicine cost?

So, we found out what the instruction tells about the drug "Furosemide". Tablets, their composition and properties are certainly very interesting. But no less important factor for many is the price of the medicine.

So how much will the drug cost? In fact, Furosemide stands out among other diuretics not only for its high efficiency, but also for its affordable cost. A package of 50 tablets with a dose of the active substance of 40 mg costs about 30-40 rubles. But 10 ampoules of this medicine will cost 25-30 rubles, which, you see, is not so much. Of course, the figure may vary depending on the city of residence of the patient, the pharmacy, the services of which he decided to use, and many other factors.

Drug analogues

In some cases, for a number of reasons, this or that medicine is not suitable for patients. Therefore, many are interested in whether it is possible to replace Furosemide with something. Analogues of this drug, of course, exist. The modern pharmaceutical market offers a huge selection of diuretics.

For example, Lasix is considered a pretty good substitute. Also, the doctor may recommend taking drugs such as Furon or Frusemide. These are structural analogues that contain the same active substance and, accordingly, have a similar effect.

There are other diuretics that contain different ingredients but provide the same effect. Doctors often prescribe to their patients drugs such as "Urea", "Mannitol", "Trifas", "Clopamide", "Uregit". These are quite strong drugs that help to quickly solve the problem with edema. There are milder agents, the list of which includes Cyclomethiazide, Hypothiazid, Pterofen, Diakarb, Veroshpiron.

In any case, it should be understood that you cannot independently look for a substitute for the drug Furosemide. Analogues can only be selected by the attending physician, since everything here depends on the patient's state of health, his age, the characteristics of the disease and individual needs. Uncontrolled intake of diuretics can lead to dangerous consequences.

loop diuretics.

Composition Furosemide

The active substance is furosemide.

Manufacturers

Biologists Italy Laboratories S.R.L. (Italy), Biomed (Russia), Biosintez OJSC (Russia), Biochemist OJSC (Russia), Borisov Plant of Medical Preparations (Belarus), Dalchimpharm (Russia), Ipka Laboratories Ltd (India), Life Pharma (Italy), Moscow Endocrine Plant (Russia), Moskhimfarmpreparaty im. ON THE. Semashko (Russia), Novosibkhimfarm (Russia), Pilot Plant "GNTSLS" (Ukraine), Polpharma Pharmaceutical Plant (Poland), Samson (Russia), Samson-Med (Russia), Ufavita (Russia), Quinoin (Hungary)

pharmachologic effect

Diuretic, natriuretic.

It acts throughout the thick segment of the ascending limb of the loop of Henle and blocks the reabsorption of 15-20% of filtered sodium ions.

Secreted into the lumen of the proximal renal tubules.

Increases the excretion of bicarbonates, phosphates, calcium, magnesium and potassium, increases the pH of the urine.

It has secondary effects due to the release of intrarenal mediators and the redistribution of intrarenal blood flow.

It is quickly and completely absorbed by any route of administration.

The half-life is 0.5-1 hour.

It is excreted by 88% by the kidneys and by 12% with bile.

The diuretic effect is characterized by significant severity, short duration and depends on the dose.

After oral administration, it occurs in 15-30 minutes, reaches a maximum after 1-2 hours and lasts 6-8 hours.

With intravenous injection, it appears after 5 minutes, the peak is after 30 minutes, the duration is 2 hours.

During the period of action, the excretion of sodium ions increases significantly, but after its termination, the rate of excretion of sodium ions decreases below the initial level (the "rebound" or recoil phenomenon).

The phenomenon is due to a sharp activation of renin-angiotensin and other antinatriuretic neurohumoral regulation in response to massive diuresis.

Stimulates the arginine-vasopressin and sympathetic systems, reduces the level of atrial natriuretic factor in plasma, causes vasoconstriction.

Due to the “rebound” phenomenon, when taken once a day, it may not have a significant effect on the daily excretion of sodium ions.

Effective in heart failure (both acute and chronic), improves the functional class of heart failure, because. reduces the filling pressure of the left ventricle.

Reduces peripheral edema, pulmonary congestion, pulmonary vascular resistance, pulmonary capillary wedge pressure in the pulmonary artery and right atrium.

It remains effective at a low glomerular filtration rate, therefore it is used to treat arterial hypertension in patients with renal insufficiency.

Side effects of Furosemide

Hypotension, incl. postural, collapse, thromboembolism, thrombophlebitis (mainly in the elderly), hypokalemia, hypomagnesemia, hyponatremia, impaired glucose tolerance, hyperuricemia, gout, increased LDL cholesterol (at high doses), impaired acid-base balance (hypochloremic alkalosis), hypercalciuria, impaired liver function , intrahepatic cholestasis, pancreatitis, diarrhea, constipation, nausea, vomiting, anorexia, inner ear damage, hearing loss, blurred vision, confusion, nervousness, headache, dizziness, paresthesia, weakness, muscle spasm, bladder spasm, chills, fever , thrombocytopenia, aplastic anemia, leukopenia, systemic vasculitis, interstitial nephritis, hematuria, necrotizing angiitis, exfoliative dermatitis, erythema multiforme, impotence, photosensitivity, urticaria, pruritus.

Indications for use

Chronic heart failure, pulmonary edema, hypertensive crisis, edematous-ascitic syndrome in liver cirrhosis, renal failure, nephrotic syndrome, severe hypernatremia, hypercalcemia and hypermagnesemia.

Contraindications Furosemide

Hypersensitivity (including to sulfonamides), hepatic coma, severe electrolyte imbalance, hypokalemia, severe liver and kidney failure, oliguria for more than 24 hours, anuria, gout, hyperuricemia, diabetes mellitus or impaired carbohydrate tolerance, decompensated mitral or aortic stenosis, increased pressure in the jugular vein over 10 mm Hg, hypertrophic cardiomyopathy with left ventricular outflow tract obstruction, hypotension, myocardial infarction, systemic lupus erythematosus, pancreatitis, metabolic alkalosis.

Method of application and dosage

Intramuscularly or intravenously - once, 20-40 mg (if necessary, increase the dose by 20 mg every 2 hours).

Jet intravenous administration is carried out slowly, over 1-2 minutes.

In high doses (80-240 mg or more) administered intravenously, at a rate not exceeding 4 mg/min.

The maximum daily dose is 600 mg.

Overdose

Symptoms:

hypotension,
decrease in OC,
hypokalemia and hypochloremic alkalosis.

Treatment:

maintenance of vital functions.

Interaction

Aminoglycosides, ethacrynic acid and cisplatin increase ototoxicity (especially with impaired renal function).

Increases the risk of kidney damage against the background of amphotericin B.

When prescribing high doses of salicylates, the risk of developing salicylism, cardiac glycosides - hypokalemia and associated arrhythmia, corticosteroids - electrolyte imbalance increases.

Reduces the muscle relaxant activity of tubocurarine, potentiates the effect of succinylcholine.

Reduces renal clearance of lithium.

Under the influence of furosemide, the effect of ACE inhibitors and antihypertensive drugs, warfarin, diazoxide, theophylline increases, and the effect of antidiabetic drugs, noradrenaline is weakened.

Sucralfate and indomethacin reduce efficacy.

Probenecid increases serum concentration.

special instructions

In order to exclude the phenomenon of "rebound" in the treatment of arterial hypertension, it is prescribed at least 2 times a day.

It should be borne in mind that long-term use can lead to weakness, fatigue, a decrease in blood pressure and cardiac output, and excessive diuresis in myocardial infarction with congestion in the pulmonary circulation can contribute to the development of cardiogenic shock.

A temporary cancellation (for several days) is necessary before the appointment of ACE inhibitors.

During the first months of treatment, it is recommended to control blood pressure, electrolyte levels (especially potassium), CO2, creatinine, urea nitrogen, uric acid, periodic determination of liver enzymes, calcium and magnesium levels, blood glucose and urine (in diabetes mellitus).

If oliguria persists for 24 hours, furosemide should be discontinued.

It should not be used during work by drivers of vehicles and people whose profession is associated with increased concentration of attention.

Furosemide diuretic tablets are prescribed to eliminate edema of various etiologies. This drug is aimed at removing excess fluid from the body and increasing the production of urine. To avoid undesirable negative consequences in the treatment of Furosemide, it is necessary to take a diuretic as prescribed by a doctor, in strictly prescribed dosages.

"Furosemide" is prescribed for edema of various nature.

general information

The "loop" diuretic "Furosemide" contains in its composition the following elements:

furosemide - 40;
milk sugar;
food emulsifier E572;
corn starch.

The diuretic "Furosemide" activates the kidneys to excrete a large volume of fluid and salts in the urine. This effect of the drug allows patients to get rid of edema that has arisen for various reasons. But, unfortunately, along with the excreted urine, potassium and magnesium ions leave the body. That is why specialized experts recommend drinking potassium-sparing drugs with Furosemide. The severity of the diuretic effect of the described drug depends on the dosage taken by patients, but in any case, this diuretic is more powerful than thiazide-like diuretics.

Simultaneously with the drug, it is advisable to take potassium-sparing drugs

After taking the Furosemide tablet, the diuretic effect appears in the first 60 minutes, and after the injection, the therapeutic effect is observed after 5 minutes. The disadvantage of this medication is the rapid cessation of the diuretic action. Furosemide is prescribed for edema of renal and cardiac origin, as well as for edema of hepatic etiology, but only in complex therapy, which includes a potassium-sparing diuretic. Specialists define potassium-sparing diuretics as drugs whose mechanism of action is aimed at preventing the excretion of potassium from the body. It should be borne in mind that the diuretic effect of "Furosemide" under the influence of theophylline is reduced, while the effect of theophylline is enhanced, which is dangerous for the development of negative consequences.

Contraindications and side effects

Furosemide should not be used in patients who have the following pathologies:

oliguria;
allergic reactions to the components of the described diuretic;
dehydration;
hypokalemia;
hyponatremia;
glomerulonephritis in the acute phase;
gout;
the threat of renal coma;
diabetes;
low blood pressure;
diarrhea;
pancreatitis;
violation of the outflow of urine.

In the process of treatment with this pharmaceutical preparation, the following side effects often occur:

Side effects of "Furosemide" will affect the patient's well-being and heart function.

cardiopalmus;
dryness in the mouth;
nausea;
drowsiness;
a sharp decrease in urination;
dizziness;
gagging;
weakness;
thirst.

Instructions for use and dosage

Attached to the pharmaceutical product "Furosemide" is an instruction for use, which indicates the dosage depending on the indications, the severity of the disease, the age of the patient and other factors that the doctor takes into account before prescribing the medicine to the patient. For adults, the dosage of the drug in tablet form is 20-80 mg, drunk once or divided into several doses per day. The dose for injection is 20-240 mg. If necessary, the dosage can be revised by the attending physician and increased.

How to drink with edema?

Drinking "Furosemide" should be with edema that has arisen against the background of dysfunction of the heart muscle, cirrhosis, high blood pressure, as well as renal failure. Taking the diuretic drug "Furosemide", the patient needs to eat right. The therapeutic diet should be dominated by foods containing large amounts of potassium and magnesium. Based on this, it is recommended to include dried apricots in the menu both as a whole and in the form of compotes. It is useful to combine the described diuretic with baked apples, which, like dried apricots, are able to saturate the body with potassium and magnesium.

At elevated pressure

To normalize blood pressure, patients often require complex treatment, which includes not only antihypertensive drugs, but also diuretics. Furosemide is effective in the fight against hypertension. In most cases, it is prescribed at 20-40 mg per day, but at the same time, the dose of other medications taken is reduced by 2 times.

Diuretic for weight loss

Many use the described diuretic in the fight against excess weight. However, specialized doctors argue that it is not advisable to use Furosemide for weight loss. Its diuretic action is aimed at removing excess fluid from the body, which has nothing to do with body fat. This drug with a diuretic effect, which many people mistakenly use to reduce body weight, with prolonged use leads to a breakdown, low blood pressure, problems with urination and disruption of water and electrolyte balance in the blood.

With impaired renal and hepatic function

Furosemide is also prescribed for liver failure.

Diuretics are used, in particular, Furosemide for edematous syndrome caused by renal and hepatic dysfunction. Patients with these pathologies require an individual selection of dosage with its subsequent increase. This treatment regimen is used to provide the patient with a gradual loss of fluid. In the first days of therapy for renal dysfunction, the dosage is 40-80 mg per day, which should be drunk once or divided into 2 doses.

In renal pathologies, "Furosemide" with a diuretic effect is used as an additional remedy for the ineffectiveness of aldosterone antagonists. The dosage of the medication is selected carefully for each patient individually in order to prevent sudden weight loss. On the first day of treatment, fluid loss of up to 0.5 kg of body weight is allowed. Initially, the daily dosage is 20-80 mg.