Lasix 20mg Tablets

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, and potassium. It also has a direct vasodilatory effect.

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: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, 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: mood changes, confusion, muscle pain or weakness, abnormal heartbeat, severe dizziness or fainting, increased thirst, seizures, feeling extremely tired or weak, decreased appetite, inability to urinate or changes in urine output, dry mouth, dry eyes, or severe nausea and vomiting.
Signs of liver problems: dark urine, fatigue, decreased appetite, stomach pain or nausea, light-colored stools, vomiting, or yellowing of the skin and eyes.
Signs of kidney problems: inability to urinate, changes in urine output, blood in the urine, or sudden weight gain.
Signs of pancreatitis (pancreas problem): severe stomach pain, severe back pain, or severe nausea and vomiting.
Severe dizziness or fainting.
Abnormal sensations such as burning, numbness, or tingling.
Blurred vision.
Restlessness.

Severe Skin Reactions

This medication may cause severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. These reactions can be life-threatening and may also affect internal organs. Seek immediate medical help if you experience:

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
Swollen glands

Other Possible Side Effects

Like all medications, this drug may cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:

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

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult 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. Describe the allergic reaction you experienced, including the symptoms that occurred.
If you have difficulty urinating or are unable to pass urine.
If you are dehydrated or have electrolyte imbalances.
If you have a history of liver problems or low blood pressure.
* If you are currently taking any of the following medications: chloral hydrate, ethacrynic acid, or lithium.

This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your existing health conditions and medications. Do not initiate, discontinue, or modify 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.

Caution with Daily Activities
Avoid driving and performing tasks that require alertness until you understand how this medication affects you. To minimize the risk of dizziness or fainting, stand up slowly after sitting or lying down, and be cautious when climbing stairs.

Managing Diabetes
If you have diabetes, 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.

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

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

Potential Side Effects
High cholesterol and triglyceride levels have been associated with this medication. If you have high cholesterol or triglycerides, consult your doctor. You may also require additional potassium; discuss this with your doctor.

Interactions with Other Substances
Before using alcohol, marijuana or other forms of cannabis, or prescription or OTC medications that may cause drowsiness, consult your doctor.

Sun Sensitivity
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.

Other Potential Risks
Be aware of the possibility of gout attacks. If you have lupus, this medication may exacerbate your condition; report any new or worsening symptoms to your doctor immediately.

Hearing and Blood Cell Problems
Hearing problems, including decreased hearing and hearing loss, have been reported 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 immediately. Additionally, low blood cell counts have been associated with this medication, which can lead to bleeding problems, infections, or anemia. Seek medical attention if you have signs of infection, such as fever, chills, or sore throat; unexplained bruising or bleeding; or if you feel extremely tired or weak.

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

Pregnancy and Breastfeeding
Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Discuss the benefits and risks of this medication with your doctor to ensure the best possible outcome for you and your baby.

• Ethacrynic acid (increased risk of ototoxicity)

• Aminoglycosides (increased risk of ototoxicity and nephrotoxicity)
• Cisplatin (increased risk of ototoxicity)
• Lithium (increased serum lithium levels and toxicity due to reduced renal clearance)
• NSAIDs (may reduce diuretic and antihypertensive effects, increased risk of nephrotoxicity)
• Digoxin (hypokalemia induced by furosemide can potentiate digoxin toxicity)
• ACE inhibitors/ARBs (increased risk of severe hypotension and renal dysfunction, especially with initial doses)
• Sucralfate (may reduce furosemide absorption)
• Chloral hydrate (flushing, sweating, blood pressure changes)

• Corticosteroids (increased risk of hypokalemia)
• Amphotericin B (increased risk of hypokalemia)
• Muscle relaxants, non-depolarizing (potentiated effect)
• Antidiabetic agents (may decrease hypoglycemic effect)
• Phenytoin (may reduce furosemide effect)
• Probenecid (may reduce furosemide secretion)
• Salicylates (may compete for renal excretion, increased risk of toxicity)

• Alcohol (additive hypotensive effect)
• Barbiturates (additive hypotensive effect)
• Opioids (additive hypotensive effect)

• Dizziness or lightheadedness (especially when standing up)
• Muscle cramps or weakness
• Excessive thirst or dry mouth
• Nausea or vomiting
• Unusual tiredness or weakness
• Irregular heartbeat
• Hearing changes (tinnitus, hearing loss)
• Signs of dehydration (decreased urination, sunken eyes)
• Signs of gout (joint pain, swelling)

Furosemide is Pregnancy Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown adverse effects, and there are no adequate and well-controlled studies in pregnant women.

Furosemide is excreted in breast milk and may suppress 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. Pediatric patients, especially neonates and infants, are more susceptible to fluid and electrolyte imbalances. Close monitoring of fluid status, electrolytes, and renal function is essential. Dosing must be carefully titrated based on weight and response.

Elderly patients may be more susceptible to the hypotensive and electrolyte-depleting effects of furosemide, particularly hypokalemia and hyponatremia. They are also at higher risk for renal impairment. Lower initial doses and careful titration are recommended. Monitor closely for dehydration, orthostatic hypotension, and renal function.

• Advise patients to take furosemide in the morning to avoid nocturia (waking up to urinate at night). If a second dose is needed, take it in the early afternoon.
• Furosemide can cause significant potassium loss. Many patients will require potassium supplementation or dietary modifications (e.g., potassium-rich foods) to prevent hypokalemia.
• Monitor for signs of dehydration and orthostatic hypotension, especially in the elderly or those on concomitant antihypertensive medications.
• The bioavailability of oral furosemide is variable; if a rapid or more predictable effect is needed, IV administration may be preferred.
• In patients with severe renal impairment, higher doses of furosemide may be required, but monitor closely for ototoxicity (hearing loss, tinnitus), which is more common with rapid IV administration or high doses in renal failure.
• Patients with sulfa allergies may have a cross-reactivity with furosemide, although this is rare and often overstated. Use with caution.

• Other loop diuretics (e.g., bumetanide, torsemide)
• Thiazide diuretics (e.g., hydrochlorothiazide, chlorthalidone) for hypertension or mild edema
• Potassium-sparing diuretics (e.g., spironolactone, eplerenone, amiloride, triamterene) often used in combination with loop diuretics to counteract potassium loss or for specific indications like heart failure with reduced ejection fraction.
• Vasodilators (e.g., nitrates) for acute heart failure
• Ultrafiltration for refractory fluid overload

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.