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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 diuretic recommended for use in all indications where a prompt and effective diuresis is required. 1) The treatment of oedema associated with congestive heart failure, cirrhosis of the liver and renal disease, including nephrotic syndrome and pulmonary oedema. 2) The treatment of peripheral oedema due…
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Adults and children over 12 years:
Oedema: Initially 40 mg daily in the morning; ordinarily a prompt diuresis ensues, and the starting dose can then be maintained or even reduced. Diuresis lasts for approximately four hours following administration and hence the time of administration can be adjusted to suit the patient's requirements.
Maintenance dose is 20mg daily or 40mg on alternate days, increased in resistant oedema to 80mg daily. Hypertension: 20-40mg twice daily; if 40mg twice daily does not lead to a clinically satisfactory response, the addition of other antihypertensive agents, rather than an increase in the dose of furosemide should be considered.
Children under 12 years:
A more suitable dosage form should be used in this age group.
Elderly:
Furosemide is generally eliminated more slowly. The dosage should be titrated until the required response is achieved. 4): Colestyramine and colestipol – Administer 2 to 3 hours apart.
Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000); Frequency not known (cannot be estimated from the available data). Uncommon: aplastic anaemia Rare: bone marrow depression (necessitates withdrawal of treatment), eosinophilia, leukopenia Blood and Lymphatic System disorders Very Rare: haemolytic anaemia, agranulocytosis, thrombocytopenia Very common: dehydration, hyponatraemia, hypochloremic metabolic alkalosis, hypocalcaemia, hypomagnesemia (incidences of the last three are reduced by triamterene), nephrocalcinosis in infants.
Common: hypovolaemia, hypochloraemia Uncommon: impaired glucose tolerance (by hypokalaemia) hyperuricaemia, gout, reduction of serum HDL-cholesterol, elevation of serum LDLcholesterol, elevation of serum triglycerides, hyperglycaemia Very Rare: tetany Metabolism and Nutritional disorders Frequency not known: aggravated pre-existing metabolic alkalosis (in decompensated cirrhosis of the liver), fluid and electrolyte disturbances, excretion of potassium increased* Psychiatric disorder: Rare: psychiatric disorder Rare: paraesthesia, confusion, headache, dizzinessNervous system disorders Eye disorders Uncommon: visual disturbance, blurred vision, yellow vision.
g. in nephritic syndrome) Cardio-Vascular disorders Uncommon: Orthostatic intolerance, Cardiac arrhythmias, increased risk or persistence of patent ductus arteriosus in premature infants. Very common: hypotension, (which, if pronounced may cause signs and symptoms such as impairment of concentration and reactions, light-headedness, sensations of pressure in the head, headache, drowsiness, weakness, disorders of vision, dry mouth, orthostatic intolerance).
Vascular Disorders:
Rare: Vasculitis, thrombosis, shock Uncommon: dry mouth, thirst, nausea, bowel motility disturbances, vomiting, diarrhoea, constipation.
3) • hypotension • hypovolaemia • severe electrolyte disturbances – particularly hypokalaemia, hyponatraemia and any acid-base disturbances. 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 and below – monitoring required) • diabetes mellitus (latent diabetes may become overt: insulin requirements in established diabetes may increase : stop furosemide before a glucose tolerance test) • elderly patients • difficulty with micturition/potential obstruction in the urinary tract including prostatic hypertrophy (increased risk of acute retention).
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.
8): Regular monitoring for • blood dyscrasias. If these occur, stop furosemide immediately • liver damage • idiosyncratic reactions In premature infants there is a risk of development of nephrocalcinosis/nephrolithiasis. Renal function must be monitored and renal ultrasonography performed.
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.
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.
6)
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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Gastrointestinal disorders Rare:
Acute Pancreatitis (in long-term diuretic treatment, including furosemide). Hepatobiliary disorders Rare: pure intrahepatic cholestasis (jaundice), hepatic function abnormal. Rare: rash, pruritus, photosensitivity, toxic epidermal necrolysis.
Skin and Subcutaneous tissue disorders Frequency not known: urticaria, erythema multiforme, purpura, exfoliative dermatitis, itching, allergic reactions, such as skin rashes, various forms of dermatitis including urticaria, bullous lesions, acute generalized exanthematous pustulosis (AGEP).
When these occur treatment should be withdrawn. Musculoskeletal, Connective tissue Uncommon: muscle cramps, muscle weakness. Uncommon: reduced diuresis, urinary incontinence, urinary obstruction (in patients with hyperplasia of the prostate, bladder inability to empty, urethral stricture unspecified).
Rare: nephrocalcinosis (in pre-term infants treated with furosemide), interstitial nephritis, acute renal failure. g. with shock).
Common: creatinine increased; blood urea increasedInvestigations:
Rare: Transaminases increased, blood *Potassium deficiency manifests itself in neuromuscular symptoms (muscular weakness, paralysis), intestinal symptoms (vomiting, constipation, meterorism), renal symptoms (polyuria) or cardiac symptoms.
Severe potassium depletion can result in paralytic ileus or confusion, which can result in coma. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
8 for details of electrolyte and metabolic abnormalities). • Renal function Frequent BUN in first few months of treatment, periodically thereafter. Longterm/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. • 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) magnesium, calcium, chloride, bicarbonate and uric acid should be regularly measured.
• serum electrolytes with replacement as appropriate Other alterations in lab values • Serum creatinine and urea levels tend to rise during treatment • Serum cholesterol and triglycerides may rise but usually return to normal within 6 months of starting furosemide • Furosemide should be discontinued before a glucose tolerance test This medicine contain lactose: Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.