Drug information of Furosemide

Furosemide

Drug group:

Furosemide is a loop diuretic (water pill) that prevents your body from absorbing too much salt. This allows the salt to instead be passed in your urine. Furosemide is used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. Furosemide is also used to treat high blood pressure (hypertension).

Mechanism of effect

Furosemide, a loop diuretic, inhibits water reabsorption in the nephron by blocking the sodium-potassium-chloride cotransporter (NKCC2) in the thick ascending limb of the loop of Henle.

Pharmacodynamic

Furosemide, a sulfonamide-type loop diuretic structurally related to bumetanide, is used to manage hypertension and edema associated with congestive heart failure, cirrhosis, and renal disease, including the nephrotic syndrome.

Pharmacokinetics

60% absorbed in patients with normal renal function. 95% bound to plasma proteins. Only a small amount is hepatically metabolized to the defurfurylated derivative. Furosemide is excreted in urine. Half life:2 hours.

Dosage

Usual Adult Dose for Hypertension
Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.
Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.
Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.
Usual Pediatric Dose for Edema
Infants and Children: Oral: 2 mg/kg once daily; if ineffective, may increase in increments of 1 to 2 mg/kg/dose every 6 to 8 hours; not to exceed 6 mg/kg/dose.
IM or IV: 1 to 2 mg/kg/dose every 6 to 12 hours
Continuous infusion: 0.05 mg/kg/hour; titrate dosage to clinical effect

Alerts

Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dose and dose schedule must be adjusted to the individual patient’s needs

Points of recommendation

Avoid alcohol. Avoid excess salt/sodium unless otherwise instructed by your physician. Increase potassium intake; add a banana or orange juice; unless instructed otherwise. Take with food to reduce irritation.

Pregnancy level

C


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