Furosemide

Furosemide is a prescription medication used to treat edema (tissue swelling) associated with congestive heart failure, cirrhosis of the liver, and kidney disease. It also treats high blood pressure. Furosemide belongs to a group of drugs called diuretics, also known as “water pills.” These work by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

This medication comes in tablet and oral (by mouth) solution forms and is taken once or twice a day, with or without food.

This medication is available in an injectable form to be given directly into a vein (IV) or the muscle (IM) by a healthcare professional.

Common side effects of furosemide include diarrhea, constipation, cramping, and ringing in the ears. Furosemide can also cause dizziness. Do not drive or operate heavy machinery until you know how furosemide affects you.

Furosemide is a prescription medication used to treat edema (tissue swelling) associated with congestive heart failure, cirrhosis of the liver, and kidney disease. It also treats high blood pressure.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Furosemide may be found in some form under the following brand names:

• Diaqua-2

• Disal

• Lasix

• Lo-Aqua

• Salix - substance

Serious side effects have been reported with furosemide. See the “Drug Precautions” section.

Common side effects of furosemide include the following:

• diarrhea
• constipation
• cramping
• ringing in the ears
• high blood sugar levels
• high sugar levels in the urine
• weakness
• rash
• dizziness

This is not a complete list of furosemide side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

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

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• aminoglycoside antibiotics such as tobramycin (Nebcin, Tobi), gentamicin, or amikacin (Amikin),
• ethacrynic acid (Edecrin)
• aspirin (Ecotrin)
• bismuth subsalicylate (Pepto-Bismol)
• succinylcholine (Anectine, Quelicin)
• lithium (Eskalith, Lithobid)
• angiotensin-converting enzyme (ACE) blockers such as
  • benazepril (Lotensin, Lotensin HCT)
  • captopril (Capoten, Capozide)
  • enalapril (Vasotec, Vaseretic)
  • fosinopril (Monopril, Monopril HCT)
  • lisinopril (Prinivil, Prinzide, Zestril, Zestoretic)
  • moexipril (Univasc, Uniretic)
  • quinapril (Accupril, Accuretic, Quinaretic)
  • ramipril (Altace)
  • trandolapril (Mavik, Tarka)
• angiotensin receptor II blockers such as
  • azilsartan (Edarbi)
  • candesartan (Atacand)
  • irbesartan (Avapro)
  • losartan (Cozaar)
  • olmesartan (Benicar)
  • telmisartan (Micardis, Twynsta)
  • valsartan (Diovan)
• diuretics such as
  • acetazolamide (Diamox)
  • amiloride (Midamor)
  • Bumex
  • chlorothiazide (Diuril)
  • chlorthalidone (Thalitone)
  • furosemide (Lasix)
  • hydrochlorothiazide (Microzide, HCTZ)
  • metolazone (Zaroxolyn)
  • torsemide (Demadex)
  • triamterene (Dyrenium)
• beta blockers such as
  • metoprolol (Toprol XL, Lopressor)
  • carvedilol (Coreg)
  • bisoprolol (Zebeta)
  • betaxolol (Kerlone)
  • nebivolol (Bystolic)
  • propranolol (Inderal)
• calcium channel blockers such as
  • nifedipine (Adalat, Nifedical, Procardia)
  • amlodipine (Norvasc)
  • verapamil (Calan, Isoptin, Covera, Verelan)
  • diltiazem (Cardizem)
• sucralfate (Carafate)
• indomethacin (Indocin)

This is not a complete list of furosemide drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with furosemide including the following:

• Ototoxicity. Ototoxicity may occur with too high of a dose of furosemide, if you have severe kidney dysfunction, of if you take other medications that are also known to cause ototoxicity. Tell your healthcare provider right away if you experience symptoms of ototoxicity such as
  • hearing disturbances (such as ringing in the ears)
  • if you feel as if your head is “spinning”
  • if you have trouble keeping your balance
• Loss of electrolytes and fluid. Tell your healthcare provider right away if you experience any of the following symptoms:
  • dryness of mouth
  • thirst
  • weakness
  • lethargy
  • drowsiness
  • restlessness
  • muscle pains, cramps, or fatigue
  • low blood sugar
  • reduced ability to urinate
  • rapid heart beats
  • nausea
  • vomiting
  • being very thirsty
  • having blurry vision
  • having dry skin
  • feeling weak or tired
  • needing to urinate a lot
• Increase in blood sugars. Tell your healthcare provider right away if you experience any of the following symptoms:
• Increase in uric acid levels. This may lead to gout, especially in patients with a history of gout. Tell your healthcare provider right away if you experience pain, redness, swelling, or tenderness in your joints.
• Sunlight sensitivity. Your skin may become more sensitive to sunlight while taking furosemide. If so, make sure to wear sun block and to avoid sunlight where appropriate.
• If you have high blood pressure, avoid over-the-counter medications that may increase your blood pressure such as appetite suppressants and certain decongestants.

Furosemide can cause drowsiness. Do not drive or operate heavy machinery until you know how furosemide affects you.

Do not take furosemide if you are allergic to furosemide or to any of its ingredients or if you are unable to urinate.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of furosemide, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking furosemide, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to furosemide or to any of its ingredients
• are allergic to sulfonamides (a “sulfa” allergy)
• have liver problems
• have kidney problems
• have a blood disorder
• have diabetes
• have a history of lupus
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Furosemide into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Furosemide has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from furosemide, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Take furosemide exactly as prescribed.

This medication comes in tablet and oral (by mouth) solution forms and is taken once or twice a day, with or without food.

This medication is available in an injectable form to be given directly into a vein (IV) or the muscle (IM) by a healthcare professional.

The adverse side effects may be worsened with use of alcoholic beverages.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of furosemide at the same time.

Take furosemide exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The furosemide dose your doctor recommends will be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your age

The recommended dose range of furosemide for the treatment of edema in adults is 20 to 80 mg as a single dose. If necessary, it may be increased by your healthcare provider up to 600 mg per day, divided into multiple doses, for those with severe edema.

The recommended dose range of furosemide for the treatment of edema in children is 2 mg/kg to 6 mg/kg as a single dose.

The recommended dose range of furosemide for the treatment of high blood pressure is 80 mg, usually divided into 40 mg twice a day.

The dose of the injectable form will be determined by your healthcare provider.

If you take too much furosemide, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

Injectable furosemide:

• Store at controlled room temperature 15° to 30°C (59° to 86°F).
• Do not use if the solution is discolored.
• Protect medication from light.
• Do not remove syringes from individual package until time of use.

Tablet and oral solution furosemide:

• Store at controlled room temperature 15° to 30°C (59° to 86°F).
• Dispense in a tight light-resistant container.
• Protect medication from light.
• Discolored tablets should not be used.