Lasix 80mg Tablets
WARNING: This drug is a strong fluid-lowering drug (diuretic). Sometimes too much water and electrolytes (like potassium) in the blood may be lost. This can lead to severe health problems. Your doctor will follow you closely to change the dose to match your body's needs. @ COMMON USES: It is used to get rid of extra fluid. It is used to treat high blood pressure.
Drug Class
Diuretic
Pharmacologic Class
Loop Diuretic
Pregnancy Category
C
FDA Approved
Jun 1966
DEA Schedule
Not Controlled
Overview
What is this medicine?
Furosemide is a 'water pill' (diuretic) that helps your body get rid of extra salt and water. This helps to reduce swelling (edema) and can lower high blood pressure. It works by making your kidneys remove more fluid from your body.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. This medication may increase your urine production, so try to avoid taking it too close to bedtime to minimize sleep disturbances.
Important Interactions and Precautions
Do not take sucralfate within 2 hours before or after taking this medication. If the product changes color, do not take it.
Storing and Disposing of Your Medication
Store your medication at room temperature, protected from light and moisture. Keep it in a dry place, away from the bathroom. Ensure all medications are kept in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best disposal method, and consider participating in local drug take-back programs.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. This medication may increase your urine production, so try to avoid taking it too close to bedtime to minimize sleep disturbances.
Important Interactions and Precautions
Do not take sucralfate within 2 hours before or after taking this medication. If the product changes color, do not take it.
Storing and Disposing of Your Medication
Store your medication at room temperature, protected from light and moisture. Keep it in a dry place, away from the bathroom. Ensure all medications are kept in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on the best disposal method, and consider participating in local drug take-back programs.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Take this medication exactly as prescribed, usually once or twice a day. If taking once daily, take it in the morning to avoid waking up at night to urinate.
- If taking twice daily, take the second dose in the late afternoon, not too close to bedtime.
- Monitor your weight daily at the same time, wearing similar clothing. Report any sudden weight changes (e.g., more than 2-3 pounds in a day) to your doctor.
- Follow your doctor's recommendations for salt intake. A low-salt diet is often advised.
- Avoid alcohol, as it can increase the risk of dizziness and dehydration.
- Be careful when standing up quickly, as you may feel dizzy or lightheaded (orthostatic hypotension).
- Discuss potassium-rich foods or potassium supplements with your doctor, as furosemide can cause potassium loss.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Edema: 20 to 80 mg as a single dose, then 20 to 40 mg every 6 to 8 hours as needed. Hypertension: 40 mg twice daily.
Dose Range:
20 - 600 mg
Condition-Specific Dosing:
Edema:
Initial: 20-80 mg single dose. Maintenance: 20-40 mg every 6-8 hours. Max: 600 mg/day.
Hypertension:
Initial: 40 mg twice daily. Adjust based on response.
Pediatric Dosing
Neonatal:
0.5 to 2 mg/kg/dose every 12 to 24 hours. Max 6 mg/kg/day.
Infant:
1 to 2 mg/kg/dose every 6 to 12 hours. Max 6 mg/kg/day.
Child:
1 to 2 mg/kg/dose every 6 to 12 hours. Max 6 mg/kg/day.
Adolescent:
Same as adult dosing, 20 to 80 mg as a single dose, then 20 to 40 mg every 6 to 8 hours as needed.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment, monitor response and electrolytes closely.
Moderate:
May require higher doses or more frequent administration; monitor closely for efficacy and adverse effects. Consider starting at lower end of dosing range.
Severe:
Dose adjustments are necessary. Max dose may be limited to 80-160 mg/day. Monitor closely for fluid and electrolyte balance. Furosemide may be less effective with GFR < 30 mL/min/1.73m².
Dialysis:
Furosemide is not significantly removed by dialysis. Dosing should be individualized based on residual renal function and fluid status. Higher doses may be needed in anuric patients to achieve diuresis.
Hepatic Impairment:
Mild:
No specific adjustment, monitor for electrolyte imbalances.
Moderate:
Use with caution. Increased risk of electrolyte disturbances and hepatic encephalopathy. Lower doses may be appropriate.
Severe:
Use with extreme caution. Increased risk of hepatic coma. Avoid if possible, or use lowest effective dose with careful monitoring of fluid, electrolytes, and mental status.
Pharmacology
Mechanism of Action
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.
Pharmacokinetics
Absorption:
Bioavailability:
40-70% (highly variable)
Tmax:
1-2 hours (oral)
FoodEffect:
Food may delay absorption and decrease peak plasma concentrations, but generally does not significantly affect the total amount absorbed.
Distribution:
Vd:
0.1-0.2 L/kg
ProteinBinding:
>95% (primarily to albumin)
CnssPenetration:
Limited
Elimination:
HalfLife:
1-2 hours (normal renal function); prolonged in renal impairment (up to 20 hours)
Clearance:
Approximately 100-200 mL/min
ExcretionRoute:
Renal (primarily unchanged drug), some biliary/fecal excretion
Unchanged:
60-80% (renal)
Pharmacodynamics
OnsetOfAction:
30-60 minutes (oral)
PeakEffect:
1-2 hours (oral)
DurationOfAction:
6-8 hours (oral)
Safety & Warnings
BLACK BOX WARNING
Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dosing must be individualized according to the patient's needs.
Side Effects
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 nausea
+ Light-colored stools or vomiting
+ Yellowing of the 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 nausea or vomiting
Severe dizziness or fainting
Abnormal sensations, such as burning, numbness, or tingling
Blurred vision
Restlessness
Severe Skin Reactions: Seek Immediate Medical Help
This medication can cause severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. These conditions can be life-threatening and may also affect other organs. If you experience any of the following symptoms, seek immediate medical attention:
Red, swollen, blistered, or peeling skin
Red or irritated eyes
Sores in the mouth, throat, nose, eyes, genitals, or skin
Fever or chills
Body aches or shortness of breath
Swollen glands
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people 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 symptoms that bother you or do not go away, contact your doctor:
Dizziness or headache
Constipation, diarrhea, stomach upset, vomiting, or decreased appetite
Stomach cramps
Reporting Side Effects
If you have questions or concerns about side effects, 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.
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 nausea
+ Light-colored stools or vomiting
+ Yellowing of the 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 nausea or vomiting
Severe dizziness or fainting
Abnormal sensations, such as burning, numbness, or tingling
Blurred vision
Restlessness
Severe Skin Reactions: Seek Immediate Medical Help
This medication can cause severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. These conditions can be life-threatening and may also affect other organs. If you experience any of the following symptoms, seek immediate medical attention:
Red, swollen, blistered, or peeling skin
Red or irritated eyes
Sores in the mouth, throat, nose, eyes, genitals, or skin
Fever or chills
Body aches or shortness of breath
Swollen glands
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people 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 symptoms that bother you or do not go away, contact your doctor:
Dizziness or headache
Constipation, diarrhea, stomach upset, vomiting, or decreased appetite
Stomach cramps
Reporting Side Effects
If you have questions or concerns about side effects, 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.
Seek Immediate Medical Attention If You Experience:
- Signs of dehydration: excessive thirst, dry mouth, decreased urination, dark urine, severe dizziness.
- Signs of electrolyte imbalance: muscle cramps, weakness, irregular heartbeat, confusion, nausea, vomiting, unusual tiredness.
- Hearing problems: ringing in the ears (tinnitus) or hearing loss.
- Allergic reaction: rash, itching, swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reactions you have 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 determine if it is safe to take this medication with your existing treatments and health conditions.
Remember, do not start, stop, or change the dosage of any medication without first consulting your doctor.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reactions you have 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 determine if it is safe to take this medication with your existing treatments and health conditions.
Remember, do not start, stop, or change the dosage of any medication without first consulting your doctor.
Precautions & Cautions
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
Until you know how this medication affects you, avoid driving and other tasks that require alertness. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and be cautious when climbing stairs.
Managing Diabetes
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.
Dietary Considerations
If you are on a low-salt 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 potential for 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, such as decreased hearing or 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 promptly. Additionally, low blood cell counts have been associated 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.
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. Your doctor will discuss the benefits and risks of this medication with you and your baby.
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
Until you know how this medication affects you, avoid driving and other tasks that require alertness. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and be cautious when climbing stairs.
Managing Diabetes
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.
Dietary Considerations
If you are on a low-salt 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 potential for 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, such as decreased hearing or 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 promptly. Additionally, low blood cell counts have been associated 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.
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. Your doctor will discuss the benefits and risks of this medication with you and your baby.
Overdose Information
Overdose Symptoms:
- Severe dehydration
- Profound electrolyte imbalances (especially hypokalemia, hyponatremia)
- Hypotension (very low blood pressure)
- Cardiovascular collapse
- Acute renal failure
- Dizziness, confusion, weakness, fainting
What to Do:
Seek immediate medical attention. Call 911 or your local emergency number. For poison control, call 1-800-222-1222. Treatment involves supportive care, fluid and electrolyte replacement, and monitoring of vital signs and renal function.
Drug Interactions
Major Interactions
- Aminoglycosides (e.g., gentamicin, tobramycin): Increased risk of ototoxicity.
- Ethacrynic acid: Increased risk of ototoxicity.
- Lithium: Decreased renal clearance of lithium, leading to increased lithium levels and toxicity.
- NSAIDs (e.g., ibuprofen, naproxen): May reduce diuretic and antihypertensive effects of furosemide; increased risk of renal impairment.
- Digoxin: Increased risk of digoxin toxicity due to furosemide-induced hypokalemia.
- Cisplatin: Increased risk of ototoxicity and nephrotoxicity.
- Phenytoin: May reduce the diuretic effect of furosemide.
Moderate Interactions
- ACE inhibitors/ARBs: Increased risk of severe hypotension and renal dysfunction, especially with initial doses.
- Corticosteroids: Increased risk of hypokalemia.
- Amphotericin B: Increased risk of hypokalemia.
- Sucralfate: May reduce the absorption of furosemide; administer 2 hours apart.
- Antidiabetic agents: Furosemide may decrease the hypoglycemic effect of these agents.
- Muscle relaxants (nondepolarizing): May enhance the effect of muscle relaxants.
Minor Interactions
- Probenecid: May reduce the diuretic effect of furosemide.
- Salicylates (high dose): May compete for renal tubular secretion, increasing salicylate toxicity.
Monitoring
Baseline Monitoring
Serum Electrolytes (Sodium, Potassium, Chloride, Magnesium, Calcium)
Rationale: To establish baseline levels and identify pre-existing imbalances, as furosemide can cause significant electrolyte disturbances.
Timing: Prior to initiation of therapy.
Renal Function (BUN, Serum Creatinine, eGFR)
Rationale: To assess baseline kidney function, which influences dosing and risk of adverse effects.
Timing: Prior to initiation of therapy.
Blood Pressure
Rationale: To establish baseline and monitor for excessive hypotension.
Timing: Prior to initiation of therapy.
Fluid Status (Weight, Edema, Urine Output)
Rationale: To assess baseline hydration status and guide initial dosing.
Timing: Prior to initiation of therapy.
Routine Monitoring
Serum Electrolytes (Potassium, Sodium, Magnesium)
Frequency: Daily to weekly initially, then monthly to quarterly depending on patient stability and dose.
Target: Potassium: 3.5-5.0 mEq/L; Sodium: 135-145 mEq/L; Magnesium: 1.7-2.2 mg/dL
Action Threshold: Potassium < 3.5 mEq/L or > 5.5 mEq/L; Sodium < 130 mEq/L or > 150 mEq/L; Magnesium < 1.5 mg/dL. Requires intervention (supplementation, dose adjustment, or discontinuation).
Renal Function (BUN, Serum Creatinine)
Frequency: Weekly initially, then monthly to quarterly.
Target: Within patient's baseline range.
Action Threshold: Significant increase in BUN or creatinine (e.g., >25% above baseline or absolute values indicating acute kidney injury). Requires investigation and possible dose adjustment.
Blood Pressure (Orthostatic)
Frequency: Daily initially, then regularly at clinic visits.
Target: Individualized target.
Action Threshold: Symptomatic hypotension or significant orthostatic drop (>20 mmHg systolic or >10 mmHg diastolic). Requires dose adjustment or fluid management.
Fluid Status (Daily Weight, Edema, Urine Output)
Frequency: Daily (for hospitalized patients or those with severe edema); weekly (for stable outpatients).
Target: Stable weight, resolution of edema, adequate urine output.
Action Threshold: Rapid weight loss (>2-3 lbs/day), signs of dehydration (dry mucous membranes, decreased skin turgor), or persistent edema. Requires assessment and intervention.
Blood Glucose
Frequency: Periodically, especially in diabetic patients.
Target: Individualized target.
Action Threshold: Significant hyperglycemia. May require adjustment of antidiabetic medications.
Symptom Monitoring
- Dizziness or lightheadedness (especially when standing)
- Muscle cramps or weakness
- Excessive thirst or dry mouth
- Nausea or vomiting
- Unusual tiredness or fatigue
- Irregular heartbeat
- Decreased urination
- Confusion or lethargy
- Hearing changes (tinnitus, hearing loss)
Special Patient Groups
Pregnancy
Furosemide is Pregnancy Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. There are no adequate and well-controlled studies in pregnant women. Animal studies have shown some adverse effects at high doses.
Trimester-Specific Risks:
First Trimester:
Limited data, but generally avoided unless absolutely necessary due to potential for fluid/electrolyte shifts.
Second Trimester:
May be used cautiously for severe edema or hypertension if other options are ineffective and benefit outweighs risk.
Third Trimester:
Use with caution. May reduce placental perfusion and cause fetal/neonatal electrolyte disturbances (e.g., hypokalemia, hyponatremia, thrombocytopenia). May also inhibit lactation.
Lactation
Furosemide is excreted in breast milk and may inhibit lactation. The American Academy of Pediatrics considers it compatible with breastfeeding, but caution is advised due to potential for infant dehydration and electrolyte imbalance, and suppression of milk production.
Infant Risk:
Low to moderate. Monitor breastfed infant for signs of dehydration, poor feeding, and electrolyte disturbances. Consider alternative if possible, or use lowest effective dose and monitor milk supply.
Pediatric Use
Dosing is weight-based. Pediatric patients, especially neonates and infants, are more susceptible to fluid and electrolyte imbalances. Close monitoring is essential. Ototoxicity risk may be higher in neonates.
Geriatric Use
Elderly patients are more susceptible to the hypotensive and electrolyte-depleting effects of furosemide, particularly hypokalemia and dehydration. Lower initial doses and careful titration are recommended. Monitor renal function and fluid status closely.
Clinical Information
Clinical Pearls
- Furosemide is a potent diuretic; initiate with caution and individualize dosing.
- Administer in the morning to avoid nocturia, or split doses with the last dose in the late afternoon.
- Monitor electrolytes (especially potassium, sodium, magnesium) and renal function frequently, particularly during initiation and dose adjustments.
- Educate patients on signs of dehydration and electrolyte imbalance.
- Caution with concomitant use of NSAIDs, aminoglycosides, and lithium due to significant interactions.
- Patients with sulfa allergy may have cross-reactivity, though rare and often tolerated.
Alternative Therapies
- Other loop diuretics (e.g., torsemide, bumetanide)
- Thiazide diuretics (e.g., hydrochlorothiazide, chlorthalidone) for hypertension or mild edema
- Potassium-sparing diuretics (e.g., spironolactone, amiloride) often used in combination with loop diuretics to mitigate potassium loss
- Aldosterone antagonists (e.g., spironolactone, eplerenone) for heart failure with reduced ejection fraction
- Vasodilators (e.g., nitrates, hydralazine) for heart failure or hypertension
- Beta-blockers, ACE inhibitors, ARBs, calcium channel blockers for hypertension or heart failure
Cost & Coverage
Average Cost:
$10 - $30 per 30 tablets (generic 80mg)
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure your safety, 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. If you have any questions or concerns about this medication, don't hesitate to discuss them with 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 reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.