Furosemide

Generic Name: Furosemide

Brand Names:

Availability: Available with Prescription

Drug Class: loop diuretics

Therapeutic action

  • Loop diuretic

Indications

  • Oedema associated with renal, hepatic or congestive heart failure

Forms and strengths

  • 20 mg and 40 mg tablets

Dosage

  • Adult: start with 20 mg once daily. Increase, if necessary, according to clinical response up to 80 mg once daily or 2 times daily (max. 160 mg daily). Once oedema decrease, reduce to 20 to 40 mg once daily.

Duration

  • According to clinical response

Contra-indications, adverse effects, precautions

  • Do not administer to patients with dehydration, severe hypokalaemia and hyponatraemia. 
  • May cause:
    • dehydration, hypotension, hypokalaemia, hyponatraemia, hyperuricemia; 
    • renal impairment, deafness, photosensitivity.
  • Avoid or monitor combination with NSAIDs, ACE inhibitors (risk of renal impairment); ototoxicdrugs (e.g. aminoglycosides, quinine); lithium (increased plasma concentrations of lithium).
  • Monitor combination with:
    • drugs that provoke hypotension (e.g. haloperidol, amitriptyline) and antihypertensive drugs (risk of hypotension);
    • potassium-depleting drugs(e.g. corticosteriods, laxatives, amphotericin B), sodium-depleting drugs (e.g. SSRI, carbamazepine);
    • oral antidiabetics and insulin(risk of hyperglycaemia).
  • Pregnancy: administer only if clearly needed
  • Breast-feeding: CONTRA-INDICATED (excreted in milk and reduces milk production)

Remarks

  • Preferably take in the morning.
  • A potassium-rich diet (dates, bananas, mangoes, oranges, tomatoes, etc.) is recommended during treatment. If potassium level is < 3.5 mmol/litre, administer a sustained-release potassium supplement.
  • Diuretics are not indicated in the treatment of nutritional oedema or oedema associated with pre- eclampsia.

Storage

- Below 25 °C