Furosemide

💊 What is Furosemide used for?

• •Edema (swelling from extra fluid) linked to heart failure
• •Edema linked to cirrhosis of the liver
• •Edema linked to kidney disease, including nephrotic syndrome
• •Acute pulmonary edema (sudden fluid build-up in the lungs), as added (adjunctive) therapy

How it works

The label describes furosemide as a diuretic, which means it increases urine output so the body loses extra fluid. The label does not describe its mechanism in more detail.

How it is usually taken

• •This medicine is given by a healthcare professional, not taken at home. It may be injected into a muscle or into a vein. The label says an intravenous dose should be given slowly, over about 1 to 2 minutes. The label says the dose is individualized based on how the patient responds. Before use, the solution should be checked visually for particles and discoloration.

Comes as

• •Injection solution: 20 mg per 2 mL (10 mg per mL) in a single-dose vial
• •Sterile, colorless solution, preservative free

⚠️ Furosemide side effects

🛑 Who should not take Furosemide, and who should be careful

The label says not to take it if

• 🚨You have anuria (the label says furosemide is contraindicated in patients with anuria).
• 🚨You have had a hypersensitivity (allergic reaction) to furosemide in the past.

Tell your doctor before taking it if

• •The label says you may have symptoms from excessive fluid or electrolyte loss.
• •The label says low blood pressure when standing can usually be managed by getting up slowly.
• •The label says potassium supplements or diet changes may be needed to control or avoid low potassium (hypokalemia).
• •The label says furosemide may raise blood glucose and can affect urine glucose tests.
• •Your skin may be more sensitive to sunlight while using this medicine.
• •If you have high blood pressure, the label advises avoiding medicines that may raise blood pressure, including over-the-counter products for appetite suppression and cold symptoms.
• •The label says your blood levels of electrolytes, CO2, BUN, creatinine, glucose, and uric acid should be monitored.
• •The label says that in patients with cirrhosis and ascites, treatment is best started in the hospital with small doses and careful monitoring.
• •The label says people with severe urinary retention symptoms, such as from prostate enlargement, need careful monitoring, especially at the start of treatment.

🔀 Furosemide with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Aminoglycoside antibiotics: may increase the risk of ear damage (ototoxicity). The label says to avoid this combination except in life-threatening situations.
• •Ethacrynic acid: risk of ototoxicity. The label says to avoid this combination.
• •Salicylates: may cause salicylate toxicity at lower doses. The label says to monitor for symptoms.
• •Cisplatin and other nephrotoxic drugs: risk of ear and kidney toxicity.
• •Paralytic agents such as tubocurarine and succinylcholine: may change their muscle effects. The label says to monitor.
• •Lithium: furosemide reduces lithium clearance and raises the risk of lithium toxicity. The label says to avoid this combination.
• •Angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers: may lead to severe low blood pressure and kidney problems, including kidney failure. The label says to monitor and adjust doses if needed.
• •Other blood pressure medicines: may add to their effect. The label says to monitor blood pressure and adjust doses if needed.
• •Adrenergic blocking drugs and drugs cleared through kidney tubular secretion: the label notes a risk of increased effects or toxicity.

Alcohol and food

The label does not say.

🤰 Furosemide in pregnancy and breastfeeding

Pregnancy

The label says published studies, case reports, and decades of use have not shown a drug-associated risk of major birth defects, miscarriage, or other adverse outcomes with furosemide during pregnancy. The label also says untreated congestive heart failure and cirrhosis can lead to adverse outcomes for the mother and fetus. In animal studies, oral furosemide caused maternal deaths and abortions in rabbits, which the label attributes to volume depletion. Pregnant people should discuss use with their healthcare provider.

Breastfeeding

The label does not say.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at room temperature, between 20°C and 25°C (68°F and 77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). Protect from light. Discard any unused portion. Do not use if the solution is discolored or contains particles.

If a dose is missed

The label does not say.

If too much is taken

The label says the main signs of overdose are dehydration, reduced blood volume, low blood pressure, electrolyte imbalance, low potassium, and low chloride with alkalosis. Treatment is supportive and includes replacing lost fluid and electrolytes, with frequent checks of electrolytes, carbon dioxide level, and blood pressure. Hemodialysis does not speed up furosemide removal, according to the label.

🗒️ Questions to ask about Furosemide

• Why am I receiving this medicine, and is it an injection or a tablet for me?
• How will you check my electrolytes, kidney function, and blood sugar while I am on this medicine?
• Could this medicine affect my hearing, and what should I tell you if I notice changes?
• Should I get up slowly to reduce dizziness or low blood pressure?
• Do I need potassium or diet changes during treatment?
• Are any of my other medicines, including over-the-counter products, likely to interact with furosemide?
• How should I protect my skin from sunlight while using this medicine?

❓ Furosemide: frequently asked questions