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FUROSEMIDE is a brand name for Furosemide (also known as Frusemide). The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Furosemide is a potent diuretic with rapid action. Furosemide tablets are indicated for: 1) The treatment of fluid retention associated with heart failure, including left ventricular failure, cirrhosis of the liver and renal disease, including nephrotic syndrome. 2) The treatment of mild to moderate hypertension…
Verbatim from this product's MHRA label. Tap a section to expand.
It is recommended that Furosemide tablets are taken on an empty stomach, and with plenty of liquid.
Adults:
The initial adult dose is 40mg daily, reduced to 20mg daily or 40mg on alternative days. In some patients daily doses of 80mg or higher (given in divided doses) may be required. 4).
Method of Administration:
For oral administration
The frequencies are derived from data from the literature which refer to studies. In the case where the frequency category for the same side effect was different, the highest frequency category was chosen. The evaluation of adverse reactions is based on the following definition of frequency: Very common: > 1/10 Common: > 1/100, < 1/10 Uncommon: > 1/1000, < 1/100 Rare: > 1/10000, < 1/1000 Very rare: < 1/10000, including isolated reports Not known: frequency cannot be estimated from the available data Blood and lymphatic system disorders Common: hemoconcentration Uncommon: thrombocytopenia Rare: eosinophilia, leukopenia, bone marrow depression (necessitates withdrawal of treatment).
The haemopoietic status should therefore be regularly monitored. g. with shock). Not known: exacerbation or activation of systemic lupus erythematosus. Eye disorders Uncommon: visual disturbance Metabolism and nutrition disorders Very Common: electrolyte abnormalities (including symptomatic), dehydration and hypovolaemia, especially in elderly patients, increased blood creatinine and triglyceride levels.
Common: hyponatremia, hypochloraemia, hypokalaemia, increased blood cholesterol levels, increased blood uric acid levels and gout attacks. Uncommon: decrease in glucose tolerance. Latent diabetes mellitus can become manifest. See. 4 "Special warnings and precautions for use".
Not known: hypocalcaemia, hypomagnesaemia, increased blood urea, metabolic alkalosis, pseudo-Bartter syndrome in the context of misuse and/or long-term use of furosemide. 3 “Contraindications”). Therefore, regular monitoring of diuresis and electrolytes and correction of any disturbances are required.
Not known:
Dizziness, fainting and loss of consciousness (caused by symptomatic hypotension), headache. Ear and labyrinth disorders Rare: syrigmus (tinnitus aurium) can occur. g. nephrotic syndrome) and/or when furosemide is administered intravenously very quickly.
2) • difficulty with micturition including prostatic hypertrophy (increased risk of urinary retention: consider lower dose). Closely monitor patients with partial occlusion of the urinary tract • patients where latent diabetes may become manifest or the insulin requirements of diabetic patients may increase.
Stop furosemide before a glucose tolerance test. 6) • patients with gout. Serum uric acid levels tend to rise during treatment with Furosemide and an acute attack of gout may occasionally be precipitated. • patients with hepatorenal syndrome.
g. associated with nephritic syndrome (the effect of furosemide may be weakened and its ototoxicity potentiated). Cautious dose titration is required. • acute hypercalcaemia (dehydration results from vomiting and diuresis - correct before giving furosemide).
Treatment of hypercalcaemia with a high dose of furosemide results in fluid and electrolyte depletion - meticulous fluid replacement and correction of electrolyte required. • Patients who are at risk from a pronounced fall in blood pressure • Premature infants (possible development nephrocalcinosis/nephrolithiasis; renal function must be monitored and renal ultrasonography performed).
• Symptomatic hypotension leading to dizziness, fainting or loss of consciousness can occur in patients treated with furosemide, particularly in the elderly, patients on other medications which can cause hypotension and patients with other medical conditions that are risks for hypotension.
3) • hypotension • hypovolemia • Severe electrolyte disturbances - particularly hypokalaemia, hyponatraemia and acid-base disturbances. Furosemide is not recommended • In patients at high risk for radiocontrast nephropathy - it should not be used for diuresis as part of the preventative measures against radiocontrast-induced nephropathy.
5 for other interactions • concurrent NSAIDs should be avoided - if not possible diuretic effect of furosemide may be attenuated • ACE-inhibitors & Angiotensin II receptor antagonists - severe hypotension may occur - dose of furosemide should be reduced/stopped (3 days) before starting or increasing the dose of these Laboratory monitoring requirements: • Serum sodium Particularly in the elderly or in patients liable to electrolyte deficiency • Serum potassium The possibility of hypokalaemia should be taken into account, in particular in patients with cirrhosis of the liver, those receiving concomitant treatment with corticosteroids, those with an unbalanced diet and those who abuse laxatives.
1. • Hypersensitivity to amiloride, sulphonamides or sulphonamide derivatives (because of cross-sensitivity between sulphonamides and furosemide). 4) • Anuria, or renal failure with anuria not responding to furosemide. • Renal failure as a result of poisoning by nephrotoxic or hepatotoxic agents or renal failure associated with hepatic coma.
4) • Severe hypokalaemia, severe hyponatraemia. 4). 4). • Children and adolescents under 18 years of age (safety in this age group has not yet been established). 5). 5). • Porphyria
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Furosemide in United Kingdom.
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Cases of deafness (sometimes irreversible) have been reported following administration of furosemide orally or intravenously. 4 “Special warnings and precautions for use”). Rare: vasculitis Not known: thrombosis Skin and subcutaneous tissue disorders Uncommon: itching, hives, rashes, bullous dermatitis, erythema multiforme, pemphigoid, exfoliative dermatitis, purpura, photosensitivity reactions.
Not known:
Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis (AGEP) and drug rash with eosinophilia and systemic symptoms (DRESS), Lichenoid reactions. 3). These are predominantly manifested as impairment of concentration and reactions, light headedness, sensations of pressure in the head, vertigo, drowsiness, dysopia, xerostomia and thirst, and orthostatic dysregulation.
Dehydration and - as a consequence of hypovolaemia - circulatory collapse and haemoconcentration may occur as a result of excessive diuresis. As a result of haemoconcentration, there may be an increased risk of thrombosis, particularly in elderly patients.
General disorders and administration site conditions Uncommon:
Fatigue Rare: Malaise Xanthopsia, thrombophlebitis. hyperuricemia, azotemia; Also common, especially in the elderly and summer months, is dehydration. Gastrointestinal disorders Uncommon: dry mouth, thirst, nausea, bowel motility disturbances, constipation.
Gastro-intestinal disorders such as nausea, or gastric upset (vomiting or diarrhoea) and constipation may occur but not usually severe enough to necessitate withdrawal of treatment.
Rare:
Diarrhoea, vomiting Very rare: Acute Pancreatitis Renal and urinary disorders Common: Increased urine volume Uncommon: serum creatinine and urea levels can be temporarily elevated during treatment with furosemide. Rare: interstitial nephritis of the urinary tubules, acute renal failure.
4 "Special warnings and precautions for use"). 4 "Special warnings and precautions for use"). 5 "Interactions with other medicinal products and other forms of interaction"). Pregnancy, puerperium and perinatal conditions In premature infants with respiratory distress syndrome, administration of Furosemide Tablets in the initial weeks after birth entails an increased risk of a persistent patent ductus arteriosus.
In premature infants, furosemide can be precipitated as nephrocalcinosis/kidney stones. Rare complications may include minor psychiatric disturbances.
Congenital and familial/genetic disorders Not known:
Increased risk of ductus arteriosus open if furosemide is administered to premature infants during the first weeks of life. Reporting of suspected adverse reactions Reporting of suspected adverse reactions after the marketing authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are […]
Regular monitoring of the potassium, and if necessary, treatment with a potassium supplement, is recommended in all cases, but is essential at higher doses and in patients with impaired renal function. 5). A potassium-rich diet is recommended during long-term use.
8 for details of electrolyte and metabolic abnormalities). • Renal function Frequent BUN in first few months of treatment, periodically thereafter. Long- term/high-dose BUN should regularly be measured. Marked diuresis can cause reversible impairment of kidney function in patients with renal dysfunction.
Adequate fluid intake is necessary in such patients. Serum creatinine and urea levels tend to rise during treatment. The outflow of urine should be ensured. In patients with partial obstruction of the outflow of urine (for example, in patients with disorders in the emptying of the bladder, prostatic hyperplasia or narrowing of the urethra), increased urine output can cause or aggravate these conditions.
Thus, these patients require careful monitoring, especially during the initial stages of treatment. • Glucose Adverse effect on carbohydrate metabolism - exacerbation of existing carbohydrate intolerance or diabetes mellitus. Regular monitoring of blood glucose levels is desirable.
• Other electrolytes Patients with hepatic failure/alcoholic cirrhosis are particularly at risk of hypomagnesia (as well as hypokalaemia). During long-term therapy (especially at high doses) it is recommended to carefully and regularly check the electrolytes and especially potassium, magnesium, calcium, chloride, bicarbonate, uric acid and fluid balance.
Regular testing of creatinine and urea in the blood is also necessary. Carbohydrate metabolism should also be controlled. g. due to vomiting, diarrhea or profuse sweating). Hypovolemia or dehydration as well as any significant disturbance of electrolytes and acid-base balance should be restored.
This may require transient discontinuation of furosemide. 8): Regular monitoring for • blood dyscrasias. If these occur, stop furosemide immediately • liver damage • idiosyncratic reactions Other alterations in lab values […]