Furosemide 10mg/ml Inj, 4ml

Furosemide is a loop diuretic that inhibits the Na+-K+-2Cl- cotransporter in the thick ascending limb of the loop of Henle. This inhibition prevents the reabsorption of sodium, potassium, and chloride, leading to increased excretion of water, sodium, chloride, magnesium, and calcium. It also has a direct vasodilatory effect on renal vasculature, increasing renal blood flow.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
Signs of fluid and electrolyte problems, including:
+ Mood changes or confusion
+ Muscle pain or weakness
+ Abnormal or rapid heartbeat
+ Severe dizziness or fainting
+ Increased thirst or seizures
+ Feeling extremely tired or weak
+ Decreased appetite or inability to urinate
+ Changes in urine production or dry mouth and eyes
+ Severe stomach upset or vomiting
Signs of liver problems, such as:
+ Dark urine
+ Fatigue or decreased appetite
+ Stomach pain or upset
+ Light-colored stools or vomiting
+ Yellow skin or eyes
Signs of kidney problems, including:
+ Inability to urinate or changes in urine production
+ Blood in the urine or significant weight gain
Signs of pancreatitis (pancreas problems), such as:
+ Severe stomach or back pain
+ Severe stomach upset or vomiting
Severe dizziness or fainting
Abnormal burning, numbness, or tingling sensations
Blurred vision
Restlessness
Severe skin reactions, including:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other serious reactions that may affect body organs and be life-threatening
+ Symptoms may include: red, swollen, blistered, or peeling skin; red or irritated eyes; sores in the mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands

Other Possible Side Effects

Like all medications, this drug may cause side effects in some people. While many individuals may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:

Dizziness or headache
Constipation, diarrhea, stomach upset, vomiting, or decreased appetite
* Stomach cramps

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you have difficulty urinating.
If you are dehydrated or have electrolyte imbalances.
If you have a history of liver problems or low blood pressure.

Additionally, tell your doctor if you are taking any of the following medications:
Chloral hydrate
Ethacrynic acid
* Lithium

Please note that this is not an exhaustive list of all potential interactions. It is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. This will help ensure that it is safe to take this medication in combination with your other medications and health conditions.

Remember, do not start, stop, or change the dosage of any medication without first consulting your doctor.

Important Warnings and Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

To ensure your safety, avoid driving and other activities that require alertness until you understand how this medication affects you. When changing positions, rise slowly from sitting or lying down to minimize the risk of dizziness or fainting. Be cautious when using stairs.

If you have diabetes (high blood sugar), closely monitor your blood sugar levels. Be aware of signs of high blood sugar, such as confusion, drowsiness, increased thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath. Report these symptoms to your doctor.

If you follow a low-salt or salt-free diet, consult your doctor. Additionally, if you have high blood pressure and are taking this medication, discuss the use of over-the-counter (OTC) products that may increase blood pressure with your doctor. These products include cough and cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

Regularly check your blood pressure as instructed by your doctor. Also, have your blood work checked as directed by your doctor and discuss the results with them.

Be aware that this medication may cause increased cholesterol and triglyceride levels. If you have high cholesterol or triglycerides, consult your doctor. You may require additional potassium supplements; discuss this with your doctor.

Before using alcohol, marijuana or other cannabis products, or prescription or OTC medications that may cause drowsiness, consult your doctor.

This medication may increase your risk of sunburn. Take precautions when exposed to the sun, and inform your doctor if you experience easy sunburning while taking this medication.

Monitor yourself for gout attacks. If you have lupus, this medication may exacerbate your condition or cause a flare-up. Immediately report any new or worsening symptoms to your doctor.

Hearing problems, including decreased hearing or hearing loss, have been associated with this medication. These effects may be temporary or permanent. If you experience ringing in the ears, changes in your hearing, or a feeling of fullness in your ears, contact your doctor promptly.

Low blood cell counts have been reported with this medication, which can increase the risk of bleeding, infections, or anemia. If you experience signs of infection (fever, chills, sore throat), unexplained bruising or bleeding, or feel extremely tired or weak, contact your doctor immediately.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the benefits and risks of this medication with your doctor.

• Anuria
• Hepatic coma or precoma (if electrolyte depletion is present)

• Aminoglycosides (increased ototoxicity)
• Ethacrynic acid (increased ototoxicity)
• Lithium (decreased renal clearance of lithium, leading to toxicity)
• NSAIDs (may reduce diuretic and antihypertensive effects, risk of renal impairment)
• Chloral hydrate (flushing, sweating, blood pressure changes)
• Cisplatin (increased ototoxicity and nephrotoxicity)
• Phenytoin (reduced diuretic effect of furosemide)

• ACE inhibitors/ARBs (risk of severe hypotension and renal impairment, especially with initial doses)
• Corticosteroids (increased risk of hypokalemia)
• Digoxin (increased risk of digoxin toxicity due to hypokalemia)
• Hypotensive agents (additive hypotensive effects)
• Neuromuscular blockers (potentiated effect due to electrolyte imbalance)
• Sucralfate (reduced absorption of furosemide if given concurrently)
• Probenecid (reduced renal clearance of furosemide)
• Salicylates (reduced renal excretion of salicylates, increased risk of toxicity)

• Antidiabetic agents (may decrease hypoglycemic effect)
• Theophylline (may alter clearance)

• Signs of dehydration (dry mouth, thirst, decreased skin turgor, dizziness, lightheadedness, confusion)
• Symptoms of electrolyte imbalance (muscle weakness, cramps, fatigue, irregular heart beat, nausea, vomiting, confusion, seizures)
• Ototoxicity (tinnitus, hearing loss, vertigo)
• Hypotension (dizziness, lightheadedness, syncope)
• Gout flares (joint pain, swelling, redness)
• Allergic reactions (rash, itching, swelling, severe dizziness, trouble breathing)

Category C. Use only if the potential benefit justifies the potential risk to the fetus. Furosemide can cause fetal or neonatal jaundice, thrombocytopenia, and other adverse reactions seen in adults. In animal studies, furosemide caused maternal deaths and abortions at high doses.

Furosemide is excreted in breast milk. It may inhibit lactation. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Use with caution. Neonates, especially premature infants, may have prolonged half-life and increased sensitivity to effects. Risk of nephrocalcinosis/nephrolithiasis, especially in premature infants. Close monitoring of fluid and electrolytes is crucial.

Elderly patients may be more sensitive to the effects of furosemide, particularly hypotension and electrolyte disturbances. Start with lower doses and titrate carefully. Increased risk of dehydration and falls.

• Furosemide is a potent diuretic; always start with the lowest effective dose and titrate carefully.
• Administer IV furosemide slowly (over 1-2 minutes) to minimize the risk of ototoxicity, especially with higher doses or in patients with renal impairment.
• Monitor electrolytes (especially potassium, sodium, magnesium, calcium) frequently, as imbalances are common and can be severe.
• Consider potassium supplementation or co-administration with a potassium-sparing diuretic to prevent hypokalemia.
• Be vigilant for signs of dehydration and orthostatic hypotension, particularly in elderly patients or those on concomitant antihypertensives.
• Furosemide can cause photosensitivity; advise patients to use sun protection.
• In patients with severe renal impairment, higher doses may be needed, but monitor for ototoxicity and ensure no anuria is present.
• Avoid concurrent use with aminoglycosides due to increased risk of ototoxicity.

• Bumetanide (another loop diuretic, often more potent on a mg-for-mg basis)
• Torsemide (another loop diuretic, longer half-life)
• Ethacrynic acid (loop diuretic, used in patients with sulfonamide allergy)
• Hydrochlorothiazide (thiazide diuretic, less potent, different site of action)
• Metolazone (thiazide-like diuretic, often used in combination with loop diuretics for refractory edema)
• Spironolactone (potassium-sparing diuretic, often used in combination)

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, do not flush medications down the toilet or pour them down the drain. If you are unsure about the proper disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken to ensure prompt and effective treatment.