Furosemide

Furosemide is a fast-acting diuretic used in the control of swelling of the respiratory and brain organs, as well as disorders of the circulatory system. It differs by rendering a rapid diuretic effect on the body.

As an active substance, the preparation contains furosemide in a dosage of 40 mg. The original preparation is Lasix, developed by Sanofi. Furosemide is one of the most powerful diuretics, while it is effective in both oral and parenteral form.

The therapeutic effect is observed after 5-10 minutes if the drug is used in the form of a solution for intravenous injection. In the case of a tablet formulation, the therapeutic effect is achieved within the first hour.

Clinical and pharmacological group

Diuretic.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does Furosemide cost in pharmacies? The average price is at the level of25 rubles.

Composition and form of release

Tablets: planocylindrical, round, with a bevel, white with a brownish or yellowish tinge, 10 pieces in a contour cell packaging from polyvinyl chloride film and paper with a polymer coating or aluminum foil. According to 1, 2, 3 or 5 cell contour packs in a cardboard box, 50 tablets in a dark glass bank of the BTS type or a polymer type BP bank, with a plastic pull-on lid. 1 bank in a cardboard box.

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Tablet composition:

active substance: furosemide - 40 mg;
auxiliary components: lactose monohydrate, potato starch, calcium stearate monohydrate.

Pharmacological effect

The active component of Furosemide has a diuretic effect, contributing to the enhanced excretion of water with a simultaneous increase in excretion of calcium and magnesium ions.

When Furosemide is used against a background of heart failure, there is a rapid decrease in preload on the heart caused by the expansion of large veins. After intravenous administration of Furosemide occurs quickly - after 5-10 minutes, after ingestion - an average of an hour.

The duration of the diuretic effect of taking Furosemide is two to three hours, and with reduced renal function, the drug can last up to eight hours.

Indications for use

What helps? Furosemide confidently copes with edema of various origins, therefore the range of its application is very wide. It is assigned with the following problems:

edema, the causes of which are kidney pathologies (including nephrotic syndrome), stage II or III CHF, or liver cirrhosis;
manifested in the form of edema of light acute heart failure;
hypertensive crisis (as a monotherapy or in combination with other drugs);
severe forms of hypertension;
edema of the brain;
hypercalcemia;
eclampsia.

Also, the drug is used to carry out forced diuresis during poisoning with chemicals that are excreted from the body by the kidneys in unchanged form.

With elevated blood pressure, which develops against the background of CRF, Furosemide is used if the patient has a contraindicated thiazide diuretics, and if Clcr does not exceed 30 ml per minute).

Can Furosemide be used to lose weight?

On the Internet, a lot of advice on the use of diuretics for weight loss. One of the most available drugs in this group is Furosemide.

What helps the medicine? According to the instructions, Furosemide is used in ascites, edematous syndrome, hypertension. Thus, the manufacturer does not say anything about the possibility of using diet pills. Nevertheless, many women note that with this tool they were able to quickly lose a few kilograms (in some cases, up to 3 kg per night). However, it is impossible to regard such weight loss as weight loss: the action of the drug is aimed at removing excess fluid, and not at splitting fat.

What is dangerous Furosemide?

The use of diuretics for weight loss can provoke serious health problems, as removing water, these drugs also disrupt the balance of electrolytes in the body. one of the most common side effects is hypokalemia. Deficiency of potassium in turn leads to the appearance of muscle cramps, weakness, visual impairment, sweating, loss of appetite, nausea, dizziness.

A very dangerous side effect is arrhythmia. SOLVD studies have shown that treatment with loop diuretics is accompanied by an increase in mortality among patients. At the same time, both the rates of general and cardiovascular mortality and the number of sudden deaths increase. Another danger, which can lead to uncontrolled use of diuretics for weight loss, is a violation of the kidneys. And the recovery of kidney function and lymphatic system can take more than a month.

Contraindications

Absolute contraindications:

hyperuricemia;
increased central venous pressure (more than 10 mm Hg. item);
idiopathic hypertrophic subaortic stenosis;
hepatic coma and precoma;
decompensated mitral or aortic stenosis;
disturbances in the outflow of urine of any etiology (including unilateral urinary tract damage);
hepatic failure in severe degree;
acute glomerulonephritis;
acute renal failure with anuria (the value of glomerular filtration is less than 3-5 ml / min);
violation of water-electrolyte metabolism, as well as acid-base balance (alkalosis, hypokalemia, hypovolemia, hyponatremia, hypomagnesemia, hypocalcemia, hypochloraemia);
digitalis intoxication;
increased sensitivity to any of the components of the drug.

Additionally for tablets:

acute myocardial infarction;
pancreatitis;
dehydration;
intolerance to galactose;
Precomatric conditions;
hyperglycaemic coma;
gout;
hypertrophic obstructive cardiomyopathy;
arterial hypotension;
Glucose-galactose malabsorption or lactase deficiency;
age up to 3 years.

In patients with allergies to sulfonylureas or sulfonamide antimicrobials, there is a risk of developing a cross-allergy to Furosemide.

Relative contraindications:

ventricular arrhythmia in the anamnesis;
hypoproteinemia (risk of development of ototoxicity);
diarrhea;
pancreatitis;
hearing loss;
systemic lupus erythematosus;
arterial hypotension - in the presence of conditions in which excessive reduction in blood pressure can be especially dangerous (stenosing lesions of the coronary or cerebral arteries);
acute myocardial infarction (due to an increased risk of developing cardiogenic shock);
manifested or latent diabetes mellitus (decreased glucose tolerance);
hepatorenal syndrome;
disturbances of urine outflow (hydronephrosis, narrowing of the urethra, benign prostatic hyperplasia);
gout;
prematurity in children (due to the risk of formation of calcium-containing stones in the kidneys and deposition of calcium salts in renal parenchyma requires constant monitoring of kidney function and regular ultrasound of the kidneys).

Additionally for tablets: stenosing lesions of the coronary or cerebral arteries.

Intended use for pregnancy and lactation

The drug penetrates the placental barrier, so it should not be administered during pregnancy. If you need Furosemide in pregnancy, you should evaluate the ratio of the benefits of using the drug for the mother at risk for the fetus.

Excreted in breast milk. If it is necessary to treat the drug, breastfeeding should be discontinued.

Dosage and route of administration

As indicated in the instructions for use Furosemide tablets should be taken on an empty stomach without chewing and drinking with a sufficient amount of liquid.

When administering Furosemide, it is recommended that its lowest doses be used to achieve the desired effect. The maximum daily intake for adults is 1500 mg. The initial single dose in children is determined from the calculation of 1-2 mg / kg body weight / day with a possible increase in the dose to a maximum of 6 mg / kg / day, subject to taking the drug no more than 6 hours later. The duration of treatment is determined by the doctor individually, depending on the indications.

Dosing regimen in adults:

Arterial hypertension. Furosemide can be used in monotherapy or in combination with other antihypertensive agents. The usual maintenance dose is a dose of 20-40 mg / day. When furosemide is added to already prescribed medications, their dose should be reduced 2 times. With arterial hypertension in combination with chronic renal failure may require the use of higher doses of the drug.
Edema with nephrotic syndrome. The initial dose is 40-80 mg / day. The necessary dose is selected depending on the diuretic response. The daily dose can be taken at one time or divided into several doses.
Edema syndrome with chronic heart failure. The initial dose is 20-80 mg / day. The necessary dose is selected depending on the diuretic response. It is recommended to divide the daily dose by 2-3 doses.
Edema syndrome with chronic renal failure. Patients with chronic renal failure require a careful dose selection, by gradually increasing it so that loss of fluid occurred gradually (at the beginning of treatment, a loss of fluid of up to about 2 kg of body weight / day is possible). The recommended initial dose is 40-80 mg / day. The necessary dose is selected depending on the diuretic response. The entire daily dose should be taken once or divided into two doses. In patients on hemodialysis, the usual maintenance dose is 250-1500 mg / day.
Edema syndrome with liver diseases. Furosemide is prescribed in addition to treatment with aldosterone antagonists in case of their insufficient effectiveness. To prevent the development of complications, such as a violation of orthostatic regulation of blood circulation or disturbance of the electrolyte or acid-base state, careful selection of the dose so that the loss of fluid occurs gradually (at the beginning of treatment, a loss of fluid up to about 0.5 kg of body weight / day is possible). The initial dose is 20-80 mg / day.

Adverse Reactions

Furosemide can cause the following side effects:.

Hemopoietic system: aplastic anemia, agranulocytosis, leukopenia and thrombocytopenia.
Water-electrolyte metabolism: hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, hypocalcemia, hypochloraemia, hypokalemia.
Metabolism: hyperglycemia, muscle weakness, convulsions, arterial hypotension, hyperuricemia and dizziness.
Cardiovascular system: lowering of arterial pressure, arrhythmia, tachycardia, orthostatic hypotension, collapse.
Nervous system: drowsiness, myasthenia gravis, apathy, weakness, lethargy, confusion, spasms of calf muscles, headache, paresthesia, adynamia.
Sense organs: hearing and vision impairment.
Gastrointestinal tract: dry mouth, nausea, exacerbation of pancreatitis, thirst, vomiting, decreased appetite, diarrhea or constipation, and cholestatic jaundice.
Genitourinary system: hematuria, interstitial nephritis, acute urinary retention, decreased potency
Allergic reactions: multi-form exudative erythema, photosensitivity, skin itch, exfoliative dermatitis, urticaria, vasculitis, purpura, fever, chills, necrotizing angiitis and anaphylactic shock.

Overdose

When the recommended dose is exceeded or for long uncontrolled use of Furosemide, the patients develop signs of overdose that are clinically manifested by an increase the side effects described above, paralysis, respiratory depression, cardiovascular system, development of coma, acute renal failure and shock.

Treatment of overdose consists in correction of water-electrolyte balance by diffuse infusion of drop isotonic sodium chloride solution, gastric lavage, replenishment of circulating blood volume, symptomatic treatment.

special instructions

Before you start using the drug, read the special instructions:

The use of furosemide slows the excretion of uric acid, which can provoke an exacerbation of gout.
Patients with increased sensitivity to sulfonamides and sulfonylureas may have cross-sensitivity to furosemide.
When azotemia and oliguria appear or increase in patients with severe progressive kidney disease, it is recommended to suspend treatment.
In patients with diabetes mellitus or with reduced glucose tolerance, periodic monitoring of the level of glucose in the blood and urine is required.
In patients with unconsciousness, with benign prostatic hyperplasia, narrowing of the ureters or hydronephrosis, monitoring of urinary excretion is necessary because of the possibility of acute urinary retention.
The drug contains lactose monohydrate, so patients with rare hereditary problems of intolerance to galactose, deficiency of lactase lapp or malabsorption of glucose-galactose, should not take this drug.
The composition of the drug includes wheat starch in an amount that is safe for use in patients with celiac disease (gluten enteropathy).
Patients with wheat allergy (other than celiac disease) should not use this drug.

Before starting therapy with Furosemide Sopharma, the presence of severe urine outflow disturbances should be excluded, patients with partial impairment of urine outflow should be closely monitored. Against the background of course treatment it is necessary to periodically monitor blood pressure, the content of electrolytes of blood plasma (including sodium, calcium, potassium, magnesium ions), acid-base condition, residual nitrogen, creatinine, uric acid, liver function and, if necessary, appropriate treatment correction.

Patients receiving high doses of furosemide, in order to avoid the development of hyponatremia and metabolic alkalosis, it is inappropriate to limit the intake of table salt. For the prevention of hypokalemia, simultaneous administration of potassium and potassium-sparing diuretics is recommended, as well as adherence to a diet rich in potassium. Selection of the dosing regimen for patients with ascites against the background of cirrhosis of the liver should be done in a stationary setting (violations of the water-electrolyte balance may lead to the development of the hepatic coma). This category of patients shows regular control over the content of plasma electrolytes.

Compatibility with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

Furosemide may increase the risk of nephropathy after the administration of radiopaque substances.
The combination of the drug with cardiac glycosides increases the risk of developing digitalis intoxication.
The effect of Furosemide decreases with simultaneous use with phenobarbital and phenytoin.
The drug is able to increase the concentration of cephalosporin antibiotics and levomycetin. At the same time, it increases the risk of developing their nephro- and ototoxic effects. The elimination of antibiotics of the aminoglycoside group slows down when combined with Furosemide, which also increases the likelihood of intoxication.
Elderly patients often have to take Furosemide and drugs from the group of non-steroidal anti-inflammatory drugs. With this combination, you should be careful, as it leads to a decrease in the effectiveness of Furosemide. If salicylates are chosen as NSAIDs, Furosemide may exacerbate their toxic effects.
Weakening of the effect of Furosemide is observed with simultaneous administration with sucralfate. Increased activity - when combined with other diuretics or antihypertensive agents, especially ACE inhibitors.

Reviews

We offer you to get acquainted with the opinions of people who used Furosemide:

Eve. I have lowered the pressure from furosemide, and of course immediately my head starts spinning, in general, my side effects are very clearly manifested. Diuretic drugs do not really like my body, it seems to me that everything necessary for urine begins to be excreted in the urine, therefore it is better not to abuse such medicines.
Olga. My great-grandmother has hypertension for about 20 years. She is constantly in search of a good diuretic, because age is already over 80 and tolerability of drugs is bad enough (I turned to a friend, she is a doctor, she recommended furosemide. I bought it and brought it to my great-grandmother. She took about a week and she approached. She feels wonderful! So if you have elderly relatives with hypertension, try furosemide! Maybe help me, as my great-grandmother.
Hope. At mum with the years there was a dyspnea or short wind and a pressing pain in a breast. In addition to her diagnosis of angina pectoris, she was also given hydropericardia (fluid around the heart). After in-patient treatment, my mother began on an empty stomach to take furosemide, she felt better with the heart, but often a cramp in her legs often began to suffice. This turned out to be a side effect of furosemide, since this drug displays potassium. You have to take supplemental medicines containing potassium.

Analogues

If the appointment and use of Furosemide for one reason or another is not possible, it is recommended to use one of the following analogues of this drug:

Lasix is a diuretic drug based on furosemide. Produced in the form of tablets (45 pcs. Each). in the package) and injection solutions in ampoules with volumes of 2 ml (10 pcs. packaged). The active substance content in one ampoule is 20 mg, and in one tablet - 40 mg. The average cost of the tablet form is 55 rubles, and the injection solution is 90 rubles per packing.
Diver is a diuretic drug whose main active substance is represented by torasemide. Produced in the form of tablets of 20 and 60 pcs. packaged. The dosage of torasemide reaches 5 and 10 mg. The drug is produced by the pharmaceutical company Teva from Israel and the minimum cost is 685 rubles (60 tablets with a dosage of torasemide 5 mg).
Torasemide is a drug that is a "loop" diuretic. Torasemide, to a lesser degree than furosemide, causes hypokalemia, while it exhibits greater activity and its effect is more prolonged. The main active substance of the drug is represented by torasemide. It is available in the form of tablets with an active substance content of 2.5, 5, 10 and 20 mg. The average price of 60 tablets in a dosage of 5 mg is 330 rubles, in a dosage of 10 mg - 235 rubles.
Trigrim is a diuretic drug based on torasemide. Produced in the form of tablets with a content of the main component of 2.5, 5 or 10 mg. The average cost of 30 tablets in the minimum dosage is 220 rubles (Polpharma, Poland).

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

Keep the package with tablets in a place protected from children, away from moisture sources, at a temperature of no higher than 25 degrees. The shelf life of the drug is indicated on the package and is 4 years from the date of manufacture.

Do not use the drug at the end of the expiration date.