Drugs Details

Drugs Info of Lasix
Drugs Details
  • Drugs Type  : FDA
  • Date : 12th Feb 2015 04:04 am
  • Brand Name : Lasix
  • Generic Name : furosemide (Pronunciation: fur OH se mide)
Descriptions

LASIX® is a diuretic which is an anthranilic acid derivative. LASIX tablets for oral administration contain furosemide as the active ingredient and the following inactive ingredients: lactose monohydrate NF, magnesium stearate NF, starch NF, talc USP, and colloidal silicon dioxide NF. Chemically, it is 4-chloro-N-furfuryl-5-sulfamoylanthranilic acid. LASIX is available as white tablets for oral administration in dosage strengths of 20, 40 and 80 mg. Furosemide is a white to off-white odorless crystalline powder. It is practically insoluble in water, sparingly soluble in alcohol, freely soluble in dilute alkali solutions and insoluble in dilute acids.

The CAS Registry Number is 54-31-9.

The structural formula is as follows:

 

LASIX® (furosemide) Structural Formula Illustration

What are the possible side effects of furosemide

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using furosemide and call your doctor at once if you have a serious side effect such as:

  • ringing in your ears, hearing loss;
  • itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • severe pain in your upper stomach spreading to your back, nausea and vomiting;
  • weight loss, body aches, numbness;
  • swelling, rapid weight gain, urinating less than...

Read All Potential Side Effects and See Pictures of Lasix »

What are the precautions when taking furosemide (Lasix)?

Before taking furosemide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, inability to make urine, gout, lupus.

If you have diabetes, furosemide may affect your blood sugar level. Check your blood sugar level regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication or diet.

Furosemide may reduce the potassium level in your blood. Your doctor may instruct you to add potassium-rich foods to...

Read All Potential Precautions of Lasix »

This monograph has been modified to include the generic and brand name in many instances.

Indications

Edema

LASIX is indicated in adults and pediatric patients for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome. LASIX is particularly useful when an agent with greater diuretic potential is desired.

Hypertension

Oral LASIX may be used in adults for the treatment of hypertension alone or in combination with other antihypertensive agents. Hypertensive patients who cannot be adequately controlled with thiazides will probably also not be adequately controlled with LASIX alone.

Dosage Administration

Edema

Therapy should be individualized according to patient response to gain maximal therapeutic response and to determine the minimal dose needed to maintain that response.

Adults

The usual initial dose of LASIX is 20 to 80 mg given as a single dose. Ordinarily a prompt diuresis ensues. If needed, the same dose can be administered 6 to 8 hours later or the dose may be increased. The dose may be raised by 20 or 40 mg and given not sooner than 6 to 8 hours after the previous dose until the desired diuretic effect has been obtained. The individually determined single dose should then be given once or twice daily (eg, at 8 am and 2 pm). The dose of LASIX may be carefully titrated up to 600 mg/day in patients with clinically severe edematous states.

Edema may be most efficiently and safely mobilized by giving LASIX on 2 to 4 consecutive days each week.

When doses exceeding 80 mg/day are given for prolonged periods, careful clinical observation and laboratory monitoring are particularly advisable. (See PRECAUTIONS: Laboratory Tests.)

Geriatric Patients

In general, dose selection for the elderly patient should be cautious, usually starting at the low end of the dosing range (see PRECAUTIONS: Geriatric Use).

Pediatric Patients

The usual initial dose of oral LASIX in pediatric patients is 2 mg/kg body weight, given as a single dose. If the diuretic response is not satisfactory after the initial dose, dosage may be increased by 1 or 2 mg/kg no sooner than 6 to 8 hours after the previous dose. Doses greater than 6 mg/kg body weight are not recommended. For maintenance therapy in pediatric patients, the dose should be adjusted to the minimum effective level.

Hypertension

Therapy should be individualized according to the patient's response to gain maximal therapeutic response and to determine the minimal dose needed to maintain the therapeutic response.

Adults

The usual initial dose of LASIX for hypertension is 80 mg, usually divided into 40 mg twice a day. Dosage should then be adjusted according to response. If response is not satisfactory, add other antihypertensive agents.

Changes in blood pressure must be carefully monitored when LASIX is used with other antihypertensive drugs, especially during initial therapy. To prevent excessive drop in blood pressure, the dosage of other agents should be reduced by at least 50 percent when LASIX is added to the regimen. As the blood pressure falls under the potentiating effect of LASIX, a further reduction in dosage or even discontinuation of other antihypertensive drugs may be necessary.

Geriatric patients

In general, dose selection and dose adjustment for the elderly patient should be cautious, usually starting at the low end of the dosing range (see PRECAUTIONS: Geriatric Use).

How Supplied

LASIX (furosemide) Tablets 20 mg are supplied as white, oval, monogrammed tablets in Bottles of 100 (NDC 0039-0067-10) and 1000 (NDC 0039-0067-70). The 20 mg tablets are imprinted with “Lasix®” on one side.

LASIX Tablets 40 mg are supplied as white, round, monogrammed, scored tablets in Bottles of 100 (NDC 0039-0060-13), 500 (NDC 0039-0060-50), and 1000 (NDC 0039-0060-70). The 40 mg tablets are imprinted with “Lasix® 40” on one side.

LASIX Tablets 80 mg are supplied as white, round, monogrammed, facetted edge tablets in Bottles of 50 (NDC 0039-0066-05) and 500 (NDC 0039-0066-50). The 80 mg tablets are imprinted with “Lasix® 80” on one side.

Note: Dispense in well-closed, light-resistant containers. Exposure to light might cause a slight discoloration. Discolored tablets should not be dispensed.

Tested by USP Dissolution Test 2

Store at 25° C (77° F); excursions permitted to 15 - 30° C (59 - 86° F). [See USP Controlled Room Temperature.]

sanofi-aventis U.S. LLC Bridgewater, NJ 08807. Revised August 2011

This monograph has been modified to include the generic and brand name in many instances.

Side Effects

Adverse reactions are categorized below by organ system and listed by decreasing severity.

Gastrointestinal System Reactions

  1. hepatic encephalopathy in patients with hepatocellular insufficiency
  2. pancreatitis
  3. jaundice (intrahepatic cholestatic jaundice)
  4. increased liver enzymes
  5. anorexia
  6. oral and gastric irritation
  7. cramping
  8. diarrhea
  9. constipation
  10. nausea
  11. vomiting

Systemic Hypersensitivity Reactions

  1. Severe anaphylactic or anaphylactoid reactions (e.g. with shock)
  2. systemic vasculitis
  3. interstitial nephritis
  4. necrotizing angiitis

Central Nervous System Reactions

  1. tinnitus and hearing loss
  2. paresthesias
  3. vertigo
  4. Dizziness
  5. Headache
  6. blurred vision
  7. xanthopsia

Hematologic Reactions

  1. aplastic anemia
  2. thrombocytopenia
  3. agranulocytosis
  4. hemolytic anemia
  5. Leucopenia
  6. Anemia
  7. Eosinophilia

Dermatologic-Hypersensitivity Reactions

  1. toxic epidermal necrolysis
  2. Stevens-Johnson Syndrome
  3. erythema multiforme
  4. drug rash with eosinophilia and systemic symptoms
  5. acute generalized exanthematous pustulosis
  6. exfoliative dermatitis
  7. bullous pemphigoid
  8. Purpura
  9. Photosensitivity
  10. Rash
  11. Pruritis
  12. Urticaria

Cardiovascular Reaction

  1. Orthostatic hypotension may occur and be aggravated by alcohol, barbiturates or narcotics.
  2. Increase in cholesterol and triglyceride serum levels

Other Reactions

  1. hyperglycemia
  2. glycosuria
  3. hyperuricemia
  4. muscle spasm
  5. weakness
  6. Restlessness
  7. urinary bladder spasm
  8. Thrombophlebitis
  9. fever

Whenever adverse reactions are moderate or severe, LASIX dosage should be reduced or therapy withdrawn.

Read the Lasix (furosemide) Side Effects Center for a complete guide to possible side effects

Learn More »

Interactions

LASIX may increase the ototoxic potential of aminoglycoside antibiotics, especially in the presence of impaired renal function. Except in life-threatening situations, avoid this combination.

LASIX should not be used concomitantly with ethacrynic acid because of the possibility of ototoxicity. Patients receiving high doses of salicylates concomitantly with LASIX, as in rheumatic disease, may experience salicylate toxicity at lower doses because of competitive renal excretory sites.

There is a risk of ototoxic effects if cisplatin and LASIX are given concomitantly. In addition, nephrotoxicity of nephrotoxic drugs such as cisplatin may be enhanced if LASIX is not given in lower doses and with positive fluid balance when used to achieve forced diuresis during cisplatin treatment.

LASIX has a tendency to antagonize the skeletal muscle relaxing effect of tubocurarine and may potentiate the action of succinylcholine.

Lithium generally should not be given with diuretics because they reduce lithium's renal clearance and add a high risk of lithium toxicity.

LASIX combined with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers may lead to severe hypotension and deterioration in renal function, including renal failure. An interruption or reduction in the dosage of LASIX, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers may be necessary.

Potentiation occurs with ganglionic or peripheral adrenergic blocking drugs.

LASIX may decrease arterial responsiveness to norepinephrine. However, norepinephrine may still be used effectively.

Simultaneous administration of sucralfate and LASIX tablets may reduce the natriuretic and antihypertensive effects of LASIX. Patients receiving both drugs should be observed closely to determine if the desired diuretic and/or antihypertensive effect of LASIX is achieved. The intake of LASIX and sucralfate should be separated by at least two hours.

In isolated cases, intravenous administration of LASIX within 24 hours of taking chloral hydrate may lead to flushing, sweating attacks, restlessness, nausea, increase in blood pressure, and tachycardia. Use of LASIX concomitantly with chloral hydrate is therefore not recommended.

Phenytoin interferes directly with renal action of LASIX. There is evidence that treatment with phenytoin leads to decrease intestinal absorption of LASIX, and consequently to lower peak serum furosemide concentrations.

Methotrexate and other drugs that, like LASIX, undergo significant renal tubular secretion may reduce the effect of LASIX. Conversely, LASIX may decrease renal elimination of other drugs that undergo tubular secretion. High-dose treatment of both LASIX and these other drugs may result in elevated serum levels of these drugs and may potentiate their toxicity as well as the toxicity of LASIX.

LASIX can increase the risk of cephalosporin-induced nephrotoxicity even in the setting of minor or transient renal impairment.

Concomitant use of cyclosporine and LASIX is associated with increased risk of gouty arthritis secondary to LASIX-induced hyperurecemia and cyclosporine impairment of renal urate excretion.

One study in six subjects demonstrated that the combination of furosemide and acetylsalicylic acid temporarily reduced creatinine clearance in patients with chronic renal insufficiency. There are case reports of patients who developed increased BUN, serum creatinine and serum potassium levels, and weight gain when furosemide was used in conjunction with NSAIDs.

Literature reports indicate that coadministration of indomethacin may reduce the natriuretic and antihypertensive effects of LASIX (furosemide) in some patients by inhibiting prostaglandin synthesis. Indomethacin may also affect plasma renin levels, aldosterone excretion, and renin profile evaluation. Patients receiving both indomethacin and LASIX should be observed closely to determine if the desired diuretic and/or antihypertensive effect of LASIX is achieved.

Read the Lasix Drug Interactions Center for a complete guide to possible interactions

Learn More »

This monograph has been modified to include the generic and brand name in many instances.

Warnings

In patients with hepatic cirrhosis and ascites, LASIX therapy is best initiated in the hospital. In hepatic coma and in states of electrolyte depletion, therapy should not be instituted until the basic condition is improved. Sudden alterations of fluid and electrolyte balance in patients with cirrhosis may precipitate hepatic coma; therefore, strict observation is necessary during the period of diuresis. Supplemental potassium chloride and, if required, an aldosterone antagonist are helpful in preventing hypokalemia and metabolic alkalosis.

If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, LASIX should be discontinued.

Cases of tinnitus and reversible or irreversible hearing impairment and deafness have been reported. Reports usually indicate that LASIX ototoxicity is associated with rapid injection, severe renal impairment, the use of higher than recommended doses, hypoproteinemia or concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs. If the physician elects to use high dose parenteral therapy, controlled intravenous infusion is advisable (for adults, an infusion rate not exceeding 4 mg LASIX per minute has been used). (See PRECAUTIONS: DRUG INTERACTIONS)

Precautions

General

Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in elderly patients. As with any effective diuretic, electrolyte depletion may occur during LASIX therapy, especially in patients receiving higher doses and a restricted salt intake. Hypokalemia may develop with LASIX, especially with brisk diuresis, inadequate oral electrolyte intake, when cirrhosis is present, or during concomitant use of corticosteroids, ACTH, licorice in large amounts, or prolonged use of laxatives. Digitalis therapy may exaggerate metabolic effects of hypokalemia, especially myocardial effects.

All patients receiving LASIX therapy should be observed for these signs or symptoms of fluid or electrolyte imbalance (hyponatremia, hypochloremic alkalosis, hypokalemia, hypomagnesemia or hypocalcemia): dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Increases in blood glucose and alterations in glucose tolerance tests (with abnormalities of the fasting and 2-hour postprandial sugar) have been observed, and rarely, precipitation of diabetes mellitus has been reported.

In patients with severe symptoms of urinary retention (because of bladder emptying disorders, prostatic hyperplasia, urethral narrowing), the administration of furosemide can cause acute urinary retention related to increased production and retention of urine. Thus, these patients require careful monitoring, especially during the initial stages of treatment.

In patients at high risk for radiocontrast nephropathy LASIX can lead to a higher incidence of deterioration in renal function after receiving radiocontrast compared to high-risk patients who received only intravenous hydration prior to receiving radiocontrast.

In patients with hypoproteinemia (e.g., associated with nephrotic syndrome) the effect of LASIX may be weakened and its ototoxicity potentiated.

Asymptomatic hyperuricemia can occur and gout may rarely be precipitated.

Patients allergic to sulfonamides may also be allergic to LASIX. The possibility exists of exacerbation or activation of systemic lupus erythematosus.

As with many other drugs, patients should be observed regularly for the possible occurrence of blood dyscrasias, liver or kidney damage, or other idiosyncratic reactions.

Laboratory Tests

Serum electrolytes (particularly potassium), CO2, creatinine and BUN should be determined frequently during the first few months of LASIX therapy and periodically thereafter. Serum and urine electrolyte determinations are particularly important when the patient is vomiting profusely or receiving parenteral fluids. Abnormalities should be corrected or the drug temporarily withdrawn. Other medications may also influence serum electrolytes.

Reversible elevations of BUN may occur and are associated with dehydration, which should be avoided, particularly in patients with renal insufficiency.

Urine and blood glucose should be checked periodically in diabetics receiving LASIX, even in those suspected of latent diabetes.

LASIX may lower serum levels of calcium (rarely cases of tetany have been reported) and magnesium. Accordingly, serum levels of these electrolytes should be determined periodically.

In premature infants LASIX may precipitate nephrocalcinosis/nephrolithiasis, therefore renal function must be monitored and renal ultrasonography performed. (See PRECAUTIONS: Pediatric Use)

Carcinogenesis, Mutagenesis, Impairment of Fertility

Furosemide was tested for carcinogenicity by oral administration in one strain of mice and one strain of rats. A small but significantly increased incidence of mammary gland carcinomas occurred in female mice at a dose 17.5 times the maximum human dose of 600 mg. There were marginal increases in uncommon tumors in male rats at a dose of 15 mg/kg (slightly greater than the maximum human dose) but not at 30 mg/kg.

Furosemide was devoid of mutagenic activity in various strains of Salmonella typhimurium when tested in the presence or absence of an in vitro metabolic activation system, and questionably positive for gene mutation in mouse lymphoma cells in the presence of rat liver S9 at the highest dose tested. Furosemide did not induce sister chromatid exchange in human cells in vitro, but other studies on chromosomal aberrations in human cells in vitro gave conflicting results. In Chinese hamster cells it induced chromosomal damage but was questionably positive for sister chromatid exchange. Studies on the induction by furosemide of chromosomal aberrations in mice were inconclusive. The urine of rats treated with this drug did not induce gene conversion in Saccharomyces cerevisiae.

LASIX (furosemide) produced no impairment of fertility in male or female rats, at 100 mg/kg/day (the maximum effective diuretic dose in the rat and 8 times the maximal human dose of 600 mg/day).

Pregnancy

Pregnancy Category C

Furosemide has been shown to cause unexplained maternal deaths and abortions in rabbits at 2, 4 and 8 times the maximal recommended human dose. There are no adequate and well-controlled studies in pregnant women. LASIX should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Treatment during pregnancy requires monitoring of fetal growth because of the potential for higher birth weights.

The effects of furosemide on embryonic and fetal development and on pregnant dams were studied in mice, rats and rabbits.

Furosemide caused unexplained maternal deaths and abortions in the rabbit at the lowest dose of 25 mg/kg (2 times the maximal recommended human dose of 600 mg/day). In another study, a dose of 50 mg/kg (4 times the maximal recommended human dose of 600 mg/day) also caused maternal deaths and abortions when administered to rabbits between Days 12 and 17 of gestation. In a third study, none of the pregnant rabbits survived a dose of 100 mg/kg. Data from the above studies indicate fetal lethality that can precede maternal deaths.

The results of the mouse study and one of the three rabbit studies also showed an increased incidence and severity of hydronephrosis (distention of the renal pelvis and, in some cases, of the ureters) in fetuses derived from the treated dams as compared with the incidence in fetuses from the control group.

Nursing Mothers

Because it appears in breast milk, caution should be exercised when LASIX is administered to a nursing mother.

LASIX may inhibit lactation.

Pediatric Use

In premature infants LASIX may precipitate nephrocalcinosis/nephrolithiasis. Nephrocalcinosis/nephrolithiasis has also been observed in children under 4 years of age with no history of prematurity who have been treated chronically with LASIX. Monitor renal function, and renal ultrasonography should be considered, in pediatric patients receiving LASIX.

If LASIX is administered to premature infants during the first weeks of life, it may increase the risk of persistence of patent ductus arteriosus

Geriatric Use

Controlled clinical studies of LASIX did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for the elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection and it may be useful to monitor renal function. (See PRECAUTIONS: General and DOSAGE AND ADMINISTRATION.)

This monograph has been modified to include the generic and brand name in many instances.

OverDose

The principal signs and symptoms of overdose with LASIX are dehydration, blood volume reduction, hypotension, electrolyte imbalance, hypokalemia and hypochloremic alkalosis, and are extensions of its diuretic action.

The acute toxicity of LASIX has been determined in mice, rats and dogs. In all three, the oral LD50 exceeded 1000 mg/kg body weight, while the intravenous LD50 ranged from 300 to 680 mg/kg. The acute intragastric toxicity in neonatal rats is 7 to 10 times that of adult rats.

The concentration of LASIX in biological fluids associated with toxicity or death is not known.

Treatment of overdosage is supportive and consists of replacement of excessive fluid and electrolyte losses. Serum electrolytes, carbon dioxide level and blood pressure should be determined frequently. Adequate drainage must be assured in patients with urinary bladder outlet obstruction (such as prostatic hypertrophy).

Hemodialysis does not accelerate furosemide elimination.

ContrainDications

LASIX is contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide.

This monograph has been modified to include the generic and brand name in many instances.

Clinical Pharamacology

Investigations into the mode of action of LASIX have utilized micropuncture studies in rats, stop flow experiments in dogs and various clearance studies in both humans and experimental animals. It has been demonstrated that LASIX inhibits primarily the absorption of sodium and chloride not only in the proximal and distal tubules but also in the loop of Henle. The high degree of efficacy is largely due to the unique site of action. The action on the distal tubule is independent of any inhibitory effect on carbonic anhydrase and aldosterone.

Recent evidence suggests that furosemide glucuronide is the only or at least the major biotransformation product of furosemide in man. Furosemide is extensively bound to plasma proteins, mainly to albumin. Plasma concentrations ranging from 1 to 400 μg/mL are 91 to 99% bound in healthy individuals. The unbound fraction averages 2.3 to 4.1% at therapeutic concentrations.

The onset of diuresis following oral administration is within 1 hour. The peak effect occurs within the first or second hour. The duration of diuretic effect is 6 to 8 hours.

In fasted normal men, the mean bioavailability of furosemide from LASIX Tablets and LASIX Oral Solution is 64% and 60%, respectively, of that from an intravenous injection of the drug. Although furosemide is more rapidly absorbed from the oral solution (50 minutes) than from the tablet (87 minutes), peak plasma levels and area under the plasma concentration-time curves do not differ significantly. Peak plasma concentrations increase with increasing dose but times-topeak do not differ among doses. The terminal half-life of furosemide is approximately 2 hours.

Significantly more furosemide is excreted in urine following the IV injection than after the tablet or oral solution. There are no significant differences between the two oral formulations in the amount of unchanged drug excreted in urine.

Geriatric Population

Furosemide binding to albumin may be reduced in elderly patients. Furosemide is predominantly excreted unchanged in the urine. The renal clearance of furosemide after intravenous administration in older healthy male subjects (60-70 years of age) is statistically significantly smaller than in younger healthy male subjects (20-35 years of age). The initial diuretic effect of furosemide in older subjects is decreased relative to younger subjects. (See PRECAUTIONS: Geriatric Use.)

This monograph has been modified to include the generic and brand name in many instances.

Patient Information

Patients receiving LASIX should be advised that they may experience symptoms from excessive fluid and/or electrolyte losses. The postural hypotension that sometimes occurs can usually be managed by getting up slowly. Potassium supplements and/or dietary measures may be needed to control or avoid hypokalemia.

Patients with diabetes mellitus should be told that furosemide may increase blood glucose levels and thereby affect urine glucose tests. The skin of some patients may be more sensitive to the effects of sunlight while taking furosemide.

Hypertensive patients should avoid medications that may increase blood pressure, including over-the-counter products for appetite suppression and cold symptoms.

This monograph has been modified to include the generic and brand name in many instances.

Consumer Overview Uses

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

 

FUROSEMIDE - ORAL

 

(fyou-ROW-seh-mide)

 

COMMON BRAND NAME(S): Lasix

 

WARNING: Furosemide is a very potent medication. Using too much of this drug can lead to serious water and salt/mineral loss. Therefore, it is important that you are closely monitored by your doctor while taking this medication. Tell your doctor right away if you become very thirsty or confused, or develop muscle cramps/weakness. See also Side Effects section.

 

USES: Furosemide is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen.

This drug is also used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

Furosemide is a "water pill" (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt.

 

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to decrease a high level of calcium in the blood (hypercalcemia).

 

HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking furosemide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, with or without food, usually once or twice daily. It is best to avoid taking this medication within 4 hours of your bedtime to prevent having to get up to urinate.

Dosage is based on your medical condition, age, and response to treatment. For children, the dose is also based on weight. Older adults usually start with a lower dose to decrease the risk of side effects. Do not increase your dose or take it more often than directed.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) of the day as directed. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

Sucralfate, cholestyramine, and colestipol can decrease the absorption of furosemide. If you are taking any of these drugs, separate the timing of each dose from furosemide by at least 2 hours.

Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase).

Consumer Overview Side Effect

SIDE EFFECTS: Dizziness, lightheadedness, headache, or blurred vision may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may cause a serious loss of body water (dehydration) and salt/minerals. Tell your doctor right away if you have any of these unlikely but serious side effects: muscle cramps, weakness, unusual tiredness, confusion, severe dizziness, fainting, drowsiness, unusual dry mouth/thirst, nausea, vomiting, fast/irregular heartbeat, unusual decrease in the amount of urine.

Tell your doctor right away if any of these unlikely but serious side effects occur: numbness/tingling/pain/redness/swelling of the arms/legs, hearing changes (such as ringing in the ears, temporary or permanent decreased hearing/deafness), stomach/abdominal pain, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

 

Read the Lasix (furosemide) Side Effects Center for a complete guide to possible side effects

Learn More »

PRECAUTIONS: Before taking furosemide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, inability to make urine, gout, lupus.

If you have diabetes, furosemide may affect your blood sugar level. Check your blood sugar level regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication or diet.

Furosemide may reduce the potassium level in your blood. Your doctor may instruct you to add potassium-rich foods to your diet (such as bananas, orange juice) or prescribe potassium supplements to prevent potassium loss. Ask your doctor for more details.

This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.

This drug may make you dizzy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

Severe sweating, diarrhea, or vomiting can increase the risk of dehydration. Report prolonged diarrhea or vomiting to your doctor. Follow your doctor's instructions about the amount of fluids you can drink.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Babies born early (premature infants) and children may be more sensitive to certain effects of this drug, such as kidney stones.

Older adults may be more sensitive to the effects of this drug, especially dizziness and water/mineral loss.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk and may affect milk production. Consult your doctor before breast-feeding.

Consumer Overview Missed Dose

DRUG INTERACTIONS: See also the How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: ethacrynic acid, lithium.

Check the labels on all your medicines (such as cough-and-cold products, diet aids, or NSAIDs such as ibuprofen, naproxen) because they may contain ingredients that could increase your blood pressure or worsen swelling (edema). Ask your pharmacist for more details.

 

OVERDOSE: If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fainting, severe weakness, a severe decrease in the amount of urine.

 

NOTES: Do not share this medication with others.

Lifestyle changes that may help this medication work better include exercising, stopping smoking, reducing stress, and changing your diet. Consult your doctor for more details.

Laboratory and/or medical tests (such as kidney tests, blood mineral levels such as potassium) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

 

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

 

STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

 

Information last revised February 2014. Copyright(c) 2014 First Databank, Inc.

Patient Detailed Side Effect

Brand Names: Lasix

Generic Name: furosemide (Pronunciation: fur OH se mide)

  • What is furosemide (Lasix)?
  • What are the possible side effects of furosemide
  • What is the most important information I should know about furosemide (Lasix)?
  • What should I discuss with my healthcare provider before taking furosemide (Lasix)?
  • How should I take furosemide (Lasix)?
  • What happens if I miss a dose (Lasix)?
  • What happens if I overdose (Lasix)?
  • What should I avoid while taking furosemide (Lasix)?
  • What other drugs will affect furosemide (Lasix)?
  • Where can I get more information?

What is furosemide (Lasix)?

Furosemide is a loop diuretic (water pill) that prevents your body from absorbing too much salt, allowing the salt to instead be passed in your urine.

Furosemide treats fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure (hypertension).

Furosemide may also be used for purposes not listed in this medication guide.

Furosemide 20 mg-GG

round, white, imprinted with GG 21

What are the possible side effects of furosemide

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using furosemide and call your doctor at once if you have a serious side effect such as:

  • ringing in your ears, hearing loss;
  • itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • severe pain in your upper stomach spreading to your back, nausea and vomiting;
  • weight loss, body aches, numbness;
  • swelling, rapid weight gain, urinating less than usual or not at all;
  • chest pain, new or worsening cough with fever, trouble breathing;
  • pale skin, bruising, unusual bleeding, feeling light-headed, rapid heart rate, trouble concentrating;
  • low potassium (confusion, uneven heart rate, leg discomfort, muscle weakness or limp feeling);
  • low calcium (tingly feeling around your mouth, muscle tightness or contraction, overactive reflexes);
  • headache, feeling unsteady, weak or shallow breathing; or
  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • diarrhea, constipation, stomach pain;
  • dizziness, spinning sensation; or
  • mild itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the Lasix (furosemide) Side Effects Center for a complete guide to possible side effects

Learn More »

What is the most important information I should know about furosemide (Lasix)?

You should not use this medication if you are unable to urinate.

Before using this medication, tell your doctor if you have kidney disease, enlarged prostate, urination problems, cirrhosis or other liver disease, an electrolyte imbalance, high cholesterol, gout, lupus, diabetes, or an allergy to sulfa drugs.

Tell your doctor if you have recently had an MRI (magnetic resonance imaging) or any type of scan using a radioactive dye that is injected into your veins.

Do not take more of this medication than is recommended. High doses of furosemide may cause irreversible hearing loss.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Side Effects Centers
  • Lasix

Patient Detailed How Take

What should I discuss with my healthcare provider before taking furosemide (Lasix)?

You should not use this medication if you are unable to urinate.

To make sure you can safely take furosemide, tell your doctor if you have any of these other conditions:

  • kidney disease;
  • enlarged prostate, bladder obstruction or other urination problems;
  • cirrhosiss or other liver disease;
  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
  • high cholesterol or triglycerides (a type of fat in the blood);
  • gout;
  • lupus;
  • diabetes; or
  • an allergy to sulfa drugs.

Tell your doctor if you have recently had an MRI (magnetic resonance imaging) or any type of scan using a radioactive dye that is injected into your veins.

FDA pregnancy category C. It is not known whether furosemide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Furosemide can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take furosemide (Lasix)?

Take exactly as prescribed by your doctor. Do not take more of this medication than is recommended. High doses of furosemide may cause irreversible hearing loss. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Furosemide will make you urinate more often and you may get dehydrated easily. Follow your doctor's instructions about using potassium supplements or getting enough salt and potassium in your diet.

While using furosemide, you may need blood tests at your doctor's office. Visit your doctor regularly.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store at room temperature away from moisture, heat, and light. Furosemide liquid medicine should be used within 60 to 90 days after opening the bottle. Ask your pharmacist how many days your medicine is good for. Throw away any unused liquid after that time has passed.

Side Effects Centers
  • Lasix

Patient Detailed Avoid Taking

What happens if I miss a dose (Lasix)?

Furosemide is sometimes used only once, so you may not be on a dosing schedule. If you are using the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Lasix)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include feeling very thirsty or hot, heavy sweating, or hot and dry skin.

What should I avoid while taking furosemide (Lasix)?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid becoming dehydrated. Follow your doctor's instructions about the type and amount of liquids you should drink while you are taking furosemide.

What other drugs will affect furosemide (Lasix)?

If you take sucralfate (Carafate), take it at least 2 hours before or after you take furosemide.

Tell your doctor about all other medicines you use, especially:

  • cisplatin (Platinol);
  • cyclosporine (Neoral, Gengraf, Sandimmune);
  • ethacrynic acid (Edecrin);
  • lithium (Eskalith, Lithobid);
  • methotrexate (Rheumatrex, Trexall);
  • phenytoin (Dilantin);
  • an antibiotic such as amikacin (Amikin), cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Mycifradin, Neo Fradin, Neo Tab), streptomycin, tobramycin (Nebcin, Tobi);
  • heart or blood pressure medication such as amiodarone (Cordarone, Pacerone), benazepril (Lotensin), candesartan (Atacand), eprosartan (Teveten), enalapril (Vasotec), irbesartan (Avapro, Avalide), lisinopril (Prinivil, Zestril), losartan (Cozaar, Hyzaar), olmesartan (Benicar), quinapril (Accupril), ramipril (Altace), telmisartan (Micardis), valsartan (Diovan), and others;
  • a laxative (Metamucil, Milk of Magnesia, Colace, Dulcolax, Epsom salts, senna, and others)
  • salicylates such as aspirin, Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others; or
  • steroids (prednisone and others).

This list is not complete and other drugs may interact with furosemide. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about furosemide.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2013 Cerner Multum, Inc. Version: 13.01. Revision date: 8/10/2012.

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