Lasix is a drug with a diuretic effect, which is used for acute and chronic heart failure, impaired kidney function. The main active ingredient is furosemide. It is prescribed with noticeable swelling of the tissues.
Diuretic Lasix affects the excretory system, allows you to get rid of excess fluid in the body, so that the patient's condition is greatly improved.
During prolonged use of the drug, additional medicinal products are additionally prescribed, which restore the water-electrolyte balance in the body.
Clinical and pharmacological group
"Loopback" diuretic.
Conditions of leave from pharmacies
It is released on prescription.
Price list
How much does Lasix cost? The average price in pharmacies is at the level of60 rubles.
.Form of issue and composition
The preparation is issued as:
- white tablets of 40 mg;
- a transparent, colorless solution for injection of 10 mg per 1 ml, with ampoules of dark glass 2 ml each. The package contains 10 ampoules;
- For children, granules are prepared for the preparation of a suspension, which is taken orally.
The active substance of the drug, furosemide, is a loop diuretic, a diuretic with a pronounced, rapidly advancing, short-term, strong action and a moderate decrease in pressure.
The tablet contains 40 mg of furosemide and other dry ingredients. The solution contains furosemide in the amount of 10 mg per 1 milliliter, sodium hydroxide and chloride, medical water.
Pharmacological effect
Lasix disrupts the processes of reabsorption of Na and Cl ions in the Henle loop, as a result of increased release Na ions, the excretion of water and increased secretion of K ions in the distal kidney tubule. In addition, because of the increased excretion of sodium chloride from the body and furosemide has an antihypertensive effect.
The onset of diuresis after taking the tablets is noted for an hour and persists for 6 to 8 hours. The peak of the diuretic effect is observed after taking the tablets in 1-2 hours. The effect after intravenous administration appears 5 minutes after the injection, the maximum it reaches in half an hour, and lasts about 2 hours.
In patients with heart failure, Lasix reduces preload on the heart, as it expands large veins. The diuretic effect of the drug depends on the dosage. Against the background of course therapy, there is no weakening of the effect. The drug does not change the rate of glomerular filtration and maintains its effectiveness when it is low.
Indications for use
Most often, Lasix is prescribed in the treatment of edema of various etiologies:
- pulmonary edema;
- puffiness caused by cirrhosis of the liver;
- puffiness of the brain during the elimination of the consequences of strokes and the removal of aneurysms;
- nephrotic edema, accompanied by partial or complete renal failure.
Minor drug functions are used in the treatment of the following diseases:
- Arterial hypertension - the drug quickly reduces blood pressure, but does not make it pathologically low.
- Hypertensive crisis - helps quickly and effectively reduce blood pressure, without compromising the cardiovascular system.
- Acute renal failure - allows to normalize the work of the kidneys, which have failed as a result of an acute infectious disease.
- Artificial diuresis - the drug helps to increase the flow of urine with extensive intoxication, allowing the body to recover quickly and without special losses after the harmful effects of toxic substances.
Contraindications
The drug is taken orally only as directed by a doctor. Before starting therapy, it is recommended that you carefully read the instructions for the tablets. Lasix is contraindicated in the following conditions:
- severe hyponatremia;
- hepatic precoma, coma;
- pronounced hypokalemia;
- allergic responses;
- pregnancy and breastfeeding;
- failure of the renal system in anuria, which does not respond to the introduction of Lasix;
- a pronounced violation of the urine flow in any pathology (including unilateral lesion of the urinary tract).
Relative contraindications:
- gout;
- arterial hypotension;
- hepatorenal syndrome;
- diabetes mellitus (latent, manifested);
- hearing loss;
- hypoproteinemia;
- diarrheal syndrome;
- pancreatitis;
- violation of urinary outflow (hydronephrosis, narrowing of the urethra, prostatic hyperplasia);
- systemic lupus erythematosus;
- myocardial infarction, acute stage (increased risk of cardiogenic shock);
- stenosing lesions of the cerebral, coronary arteries and other conditions in which excessive lowered blood pressure is extremely dangerous;
- ventricular arrhythmia.
In addition, the drug is not prescribed for premature infants because of the risk of deposition of Ca salts in the kidney parenchyma (nephrocalcinosis), because of the possibility of formation of calcium-containing stones in the renal system (nephrolithiasis).
Use in pregnancy and lactation
The indication for Lasix is pre-eclampsia of pregnant women - a serious condition, accompanied by swelling, high blood pressure, rapid weight gain, proteinuria.
The use of Lasix during the first 12 weeks of pregnancy is prohibited. In exceptional cases, the doctor may authorize the use of the drug after evaluating the "potential benefit to the mother and the possible risk to the fetus" ratio.
During lactation at the time of taking the drug, breast-feeding should be discontinued.
Dosage and route of administration
The instructions for use indicate: Laxix tablets are taken orally, before eating, without chewing, with a small amount of liquid.
The dosage of the drug is determined by the doctor on the basis of clinical indications, while it is recommended to prescribe the smallest doses that ensure the achievement of the desired effect. For adults, the maximum daily dose is recommended at a rate of 1500 mg, for children - at the rate of 2 mg per 1 kg of weight, but not more than 40 mg. An individual clinically effective dose is selected taking into account the diuretic response.
When appointing the dosing regimen in adults, you must adhere to the following recommendations for edematous syndrome against the background:
- Chronic heart failure - the initial daily dose is 20-80 mg in 2-3 doses;
- Chronic renal failure is the initial daily dose of 40-80 mg in 1-2 doses (because of the possible loss of fluid at the beginning of treatment to 2 kg of body weight per day selection of the dose is made with a gradual increase in order not to allow a sharp loss of fluid in the patient), the maintenance dose for hemodialysis is 250-1500 mg in day;
- Diseases of the liver - with inefficiency of monotherapy with aldosterone antagonists, Lasik is additionally prescribed in the initial dose of 20-80 mg per day, treatment should be accompanied by regular monitoring of fluid loss; nephrotic syndrome - the initial dose of 40-80 mg per day in 1-2 divided doses.
- With arterial hypertension, the drug is used in monotherapy and in combination with antihypertensive drugs in the form of a maintenance dose of 20-40 mg per day. Treatment of arterial hypertension in the background of chronic renal failure involves the appointment of higher doses.
In acute renal failure, the use of Lasix is indicated only after the elimination of hypovolemia, arterial hypotension and significant violations of the acid-base and electrolyte state.
Side effects
Against the backdrop of the application of Lasix, water-electrolyte disturbances are often developed, which are manifested by insufficient amounts of potassium, calcium, magnesium, chlorine in body, while the biochemical properties of the blood are violated, the level of creatinine, cholesterol, glucose, uric acid and other indicators in blood plasma.
Lasix can cause the following side effects:
- blood thickening;
- anaphylactic shock (extremely rare);
- skin allergic reactions: itching, dermatitis, erythema;
- on the part of the blood system: a decrease in the level of leukocytes, platelets, neutrophils, an increase in the number of eosinophils, and other hemolytic changes.
Overdose
The degree of overdose depends on the amount of fluid lost and electrolytes. As a result of an overdose of Lasix, dehydration, malfunction in heart rate and conduction, hypovolemia can be observed. Signs of excessive consumption of the drug are reduced blood pressure, thrombosis, apathy, flaccid paralysis, renal failure, confusion.
Treatment is directed to normalize the acid-alkaline and water-electrolyte balance of the body.
special instructions
Before you start using the drug, read the special instructions:
- The solution of Lasix should not be mixed in one syringe with other medicines.
- Before beginning treatment with Lasix it is necessary to exclude the presence of pronounced violations of the outflow of urine, even one-sided. Patients with partial impairment of urinary outflow should be carefully monitored.
- During the period of therapy, it is necessary to regularly monitor serum potassium, creatinine and sodium concentrations, especially in patients at high risk of developing electrolyte balance disorders caused by additional fluid and electrolyte losses, for example, due to diarrhea, vomiting, or intense sweating.
- Before and during the use of the drug should be monitored and, in case of development, to eliminate dehydration or hypovolemia, as well as clinically significant disorders of acid-base and / or electrolyte state. Sometimes this requires a short-term withdrawal of furosemide.
- During treatment, it is recommended to eat foods rich in potassium, for example, potatoes, meat, tomatoes, spinach, cauliflower, bananas, dried fruits. In some cases, additional potassium or potassium-sparing agents are prescribed.
- Selection of doses for patients with ascites, developed against cirrhosis of the liver, is carried out in the hospital, as violations of the water-electrolyte state can lead to hepatic coma.
- Premature infants require regular ultrasound examination of the kidneys and monitoring their function, there is a possibility of nephrolithiasis and nephrocalcinosis.
Some side effects (eg, symptoms accompanying a significant decrease in blood pressure) may violate the speed of reactions and the ability to concentrate, which can be dangerous when working with mechanisms and driving transport means. Especially it concerns the beginning of treatment and the period of increasing the dose, as well as cases of concurrent administration of antihypertensive drugs or alcoholic beverages.
Drug Interactions
When using the drug, it is necessary to take into account the interaction with other drugs:
- It is believed that furosemide similarly interacts with other NSAIDs.
- With simultaneous use with astemizole, the risk of arrhythmia increases.
- With simultaneous use with vancomycin, oto- and nephrotoxicity may be enhanced.
- There are reports of the development of hyponatremia with simultaneous use with carbamazepine.
- When used simultaneously with colestyramine, colestipol, the absorption and diuretic effect of furosemide decreases.
- With simultaneous application of lithium carbonate, lithium effects can be enhanced due to an increase in its concentration in the blood plasma.
- With simultaneous application with probenecid, the renal clearance of furosemide decreases.
- With simultaneous application with sotalol, hypokalemia and the development of ventricular arrhythmia such as "pirouette" are possible.
- With simultaneous application with theophylline, a change in the concentration of theophylline in the blood plasma is possible.
- With simultaneous use with phenytoin, the diuretic effect of furosemide is significantly reduced.
- After intravenous administration of furosemide against the background of chloral hydrate therapy, there may be an increase in sweating, a feeling of heat, instability of blood pressure, tachycardia.
- With simultaneous application with cisapride, hypokalemia may be increased.
- When used simultaneously with NSAIDs, which are selective inhibitors of COX-2, this interaction is expressed to a much lesser extent or practically absent.
- With the simultaneous use of aminoglycosides with antibiotics (including with gentamycin, tobramycin), nephro- and ototoxic effects may increase.
- It is suggested that furosemide may reduce the nephrotoxic effect of cyclosporine.
- Furosemide decreases the clearance of gentamicin and increases the concentration in the blood plasma of gentamicin, as well as tobramycin.
- With simultaneous use with antibiotics of the group of cephalosporins, which can cause renal dysfunction, there is a risk of increased nephrotoxicity.
- With simultaneous application with beta-adrenomimetics (including fenoterol, terbutaline, salbutamol) and with GCS, hypokalemia may be increased.
- When used simultaneously with hypoglycemic agents, insulin may reduce the effectiveness hypoglycemic agents and insulin; furosemide has the ability to increase the level of glucose in the plasma blood.
- With simultaneous use with ACE inhibitors, the antihypertensive effect is enhanced. Possible severe arterial hypotension, especially after taking the first dose of furosemide, apparently due to hypovolemia, which leads to transient enhancement of the hypotensive effect ACE inhibitors. Increased risk of renal dysfunction and the development of hypokalemia is not ruled out.
- With simultaneous use with digoxin, digitoxin, an increase in the toxicity of cardiac glycosides is possible, associated with the risk of hypokalemia in patients receiving furosemide.
- With simultaneous use with furosemid, the effects of nondepolarizing muscle relaxants are enhanced.
- When used simultaneously with indomethacin, other NSAIDs, a decrease in the diuretic effect is possible, presumably due to inhibition of synthesis prostaglandins in the kidneys and sodium retention in the body under the influence of indomethacin, which is a nonspecific inhibitor of COX; decrease antihypertensive action.
- With simultaneous application with cisplatinum, an increase in ototoxic effect is possible.
Reviews
We picked up some responses from people taking Lasix:
- Gennady. Lasix is a fairly good and powerful diuretic, which allows you to quickly cope with swelling, with intoxication and other pathologies. But this drug has one "but" is a potassium-sparing diuretic, which removes potassium from our body, that is not good, since potassium feeds the heart muscle, and with prolonged therapy with Lasix, we can exacerbate our condition. It is more often and more correctly to use a Lasik in the period of abundant intravenous infusions, for example, when you lie in a hospital and you are dripped with various solutions of preparations. So, it is better to use veroshpiron for long-term therapy.
- Natalia. I have been involved in sports all my life, there were no health problems, but apparently my age has taken its toll, last year I experienced the first hypertensive crisis. Fortunately, there was a daughter next to her, who quickly got her bearings and called for an ambulance. The ambulance doctor immediately injected Lasix intravenously, I was taken to the hospital and dripped for another 5 days, but with the help of a dropper. All this time I drank asparks and electrolyte to restore the potassium and magnesium levels in the body. Now constantly I am observed at the neurologist and the cardiologist, periodically I drink on their purpose or appointment Laziks in tablets. This drug really helped me.
- Martha. The doctor has forbidden me to take Lasix - says that he is too strong and can badly affect blood salts. Before, I often got rid of swelling with it. Now the doctor prescribed me another medicine, which is much more expensive ...
Analogues
Among drugs that can have a similar strong diuretic and weak hypotensive effect, these analogues stand out:
- Diffurex;
- Furosemide;
- Uriks;
- Florix;
- Furon;
- Fursemide;
- Novo-seven.
Before using analogues, consult your doctor.
Storage conditions and shelf life
The solution of Lasix is stored in a dark place at a temperature of no more than 25 degrees. Do not use after the expiration date (3 years).
Lasix tablets are stored for 4 years in a dark place at a temperature of no higher than 30 degrees.
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