FUROSEMIDE

Adults:

Dosage will vary from 1-3 tablets daily or on alternate days. The usual initial dose is 1 tablet (40 mg) daily which should be adjusted to achieve the effective dose. In mild oedema 1 tablet on alternate days or on three consecutive days of the week is recommended.

In patients with resistant oedema daily doses of 2 or 3 tablets may be required.

Children:

The dosage range is from 1 to 3 mg/kg of bodyweight daily.

Elderly:

Dosage should be titrated until the required response is achieved, because in the elderly Furosemide is generally eliminated more slowly.

Method of administration:

Oral

Side effects such as nausea, malaise and gastric upset occasionally occur but do not require cessation of treatment. Calcium depletion, hyponatraemia, hypokalaemia and hypomagnesaemia may occur. In commencing with other diuretics a transient rise in creatinine and urea levels have been reported.

As with other sulponamide-based diuretics, hyperuricaemia may occur and, in rare cases, clinical gout may be precipitated. g. skin rashes, are infrequent, treatment should be withdrawn when these occur. Aggravation of metabolic acidosis may occur.

As a rare complication bone marrow depression has been reported and may necessitate withdrawal of treatment. Other adverse effects include: hypochloraemic alkalosis, hypotension, temporary increase in plasma cholesterol and triglyceride concentrations and photosensitivity.

Tinnitus and deafness may occur but usually with large parenteral doses and rapid administration and in renal impairment.

Warnings:

There is an increased risk of developing acute retention in patients with prostatic hypertophy. It may be necessary to adjust the dosage of cardiac or anti-hypertensive agents which are taken concurrently. It will be necessary to correct hypotension or hypovolaemia before commencing treatment.

Concomitant administration of Furosemide may increase the toxic effects of nephrotoxic antibiotics. The insulin requirements of diabetic patients may increase. Latent diabetics may become manifest. May cause hypokalaemia and hyponatraemia.

May aggravate gout.

Precautions:

Observe caution in patients with a history of electrolyte deficiency, liver failure, prostatic enlargement and porphyria.

Frusid is contraindicated in anuria, renal failure, electrolyte deficiency and pre-comatose states associated with liver cirrhosis. Hypersensitivity to sulphonamides.