Furosemide

Brand names

• Albert Furosemide
• Apo-Furosemide
• Fumide MD
• Furocot
• Furomide MD
• Furosemide
• Furoside
• Lasaject
• Lasimide
• Lasix
• Lasix Special
• Lo-Aqua
• Luramide
• Myrosemide
• Novo-Furosemide
• Novo-Semide
• Ro-Semide
• SK-Furosemide
• Uritol

Usage

To reduce fluid (salt and water) accumulation that leads to edema (swelling) and breathlessness in patients with heart disease, cirrhosis of the liver, and kidney disease. Furosemide is also sometimes used to help control high blood pressure.

How it works

Loop diuretics work on a specific portion of the kidney (the loop of Henle) to increase the excretion of water and sodium in urine.

Side effects

Serious

Skin rash, hives, intense itching, swelling of the mouth and throat, breathing difficulty, mood or mental changes, nausea and vomiting, unusual fatigue, black or tarry stools.

Common

Muscle cramps or pain. Potassium depletion may lead to heart palpitations and weakness. Fluid depletion may lead to dizziness, especially upon arising from a sitting or lying position, as well as thirst, dry mouth, and constipation.

Less common

Buzzing or ringing in ears, loss of hearing (particularly after intravenous treatment), diarrhea, loss of appetite, gout, increased blood sugar (a problem for diabetic patients).

Possible interactions

Other medicaments:

Furosemide may increase the effects of:

• other antihypertensive medicaments; dose adjustments may be necessary to prevent excessive lowering of blood pressure.
• digoxin (Lanoxin) and result in digoxin toxicity.
• lithium (Lithobid, others) and cause lithium toxicity.

Furosemide may decrease the effects of:



• oral antidiabetic medicaments (sulfonylureas); dose adjustments may be necessary for proper control of blood sugar.

Furosemide taken concurrently with:



• activated charcoal (various) will blunt absorption of oral furosemide.
• adrenocortical steroids may cause additive loss of potassium.
• amikacin, gentamicin, tobramycin or other aminoglycosides may cause hearing toxicity (ototoxicity).
• bepridil (Vascor) may lead to abnormal heart effects if potassium is low.
• cephalosporin antibiotics may increase risk of kidney problems (nephrotoxicity).
• cholestyramine (Questran) may cause loss of furosemide effectiveness.
• clofibrate (Atromid-S) may lead to muscle stiffness and increased diuretic effects.
• colestipol (Colestid) may cause loss of furosemide effectiveness.
• cortisone (various) may lead to excessive potassium loss.
• cyclosporine (Sandimmune) may cause elevated uric acid levels (hyperuricemia) and gout.
• digitalis preparations (digitoxin, digoxin) requires blood tests or dose changes to maintain potassium levels and avoid heart rhythm problems.
• lomefloxacin (Maxaquin) may increase lomefloxacin levels and lead to toxicity.
• metformin (Glucophage) may increase metformin and decrease furosemide effects.
• NSAIDs may cause loss of diuretic effectiveness.
• phenytoin (Dilantin) or fosphenytoin (Cerebyx) may decrease furosemide diuretic effects.

Foods:

Ask your doctor if it would benefit you to eat foods rich in potassium. Follow your physician's advice regarding the use of salt. Food decreases absorption of furosemide by up to 30%. Take this medicine 1 hour before or 2 hours after a meal.

Herbal medicines or minerals:

Ginseng may increase blood pressure, blunting the benefits of this medicine. Eleuthero root, hawthorn, saw palmetto, ma huang, goldenseal and licorice may also cause increased blood pressure. Couch grass may worsen edema due to heart or kidney problems. Indian snakeroot, calcium and garlic may help lower blood pressure. Caution: St. John's wort may also lead to photosensitivity. Magnesium levels should be checked and magnesium replaced if needed. Talk to your doctor before adding any herbal medicines or minerals.

Alcohol:

Use with caution-alcohol may exaggerate the blood-pressure-lowering effects of this medicament and cause orthostatic hypotension.

Exposure to sun:

Use caution-this medicament may cause photosensitivity.

Exposure to heat:

Avoid excessive perspiring, which could cause additional loss of salt and water from the body.

Heavy exercise or exertion:

Avoid exertion that produces light-headedness, excessive fatigue or muscle cramping. Ask your doctor for help about participation in exercise.

Occurrence of unrelated illness:

Vomiting or diarrhea can produce a serious imbalance of important body chemistry. Ask your doctor for guidance.

Discontinuation:

It may be best to discontinue this medicament 5 to 7 days before major surgery. Ask your physician, surgeon and/or anesthesiologist for guidance regarding dose adjustment or medicament withdrawal.