Drugs List
- furosemide 20mg tablet
- furosemide 40mg tablets
- furosemide 500mg tablets
Therapeutic Indications
Uses
Hypertension
Oedema
All conditions requiring prompt diuresis including:
Oedema of cardiac, pulmonary, hepatic or renal (including nephrotic syndrome) origin,
Peripheral oedema of mechanical obstruction or venous insufficiency.
Maintenance therapy of mild oedema of any origin.
Hypertension.
Dosage
Oedema
Initial dose: 40mg in the morning.
Maintenance dose: 20mg or 40mg on alternate days. This dose may be increased to 120mg daily in the case of resistant oedema. Higher doses may be used.
Hypertension
20mg to 40mg twice daily, titrated to response.
If no clinical response is seen at the higher dose, it is advisable to consider the addition of other hypertensive agents, rather than an increase in furosemide dosage.
As furosemide is eliminated more slowly in elderly patients the dose should be titrated to the minimum effective dose.
Children aged 12 years and over
(See Dosage; Adult)
Children aged under 12 years
1mg/kg to 3mg/kg daily.
Maximum daily dose: 40mg.
The following dosing regimes may be suitable:
Pulmonary oedema; Oedema in heart failure, renal disease, and hepatic disease
Children aged 12 to 18 years
20mg to 40mg daily. Increase in resistant oedema to 80mg to 120mg daily.
Children aged 1 month to 12 years
0.5mg/kg to 2mg/kg given two or three times a day (or given once a day if postmenstrual age under 31 weeks). Higher doses may be required in resistant oedema.
Maximum daily dose: 12mg/kg or 80mg total.
Oliguria (unlicensed)
Children aged 12 to 18 years
Initial dose: 250mg daily.
Increase dose, if necessary, in steps of 250mg given every 4 to 6 hours.
Maximum dose: 2g.
Tablets can be crushed and mixed with water or injection solution diluted and given by mouth.
Pulmonary oedema; Oedema in heart failure, renal disease, and hepatic disease
0.5mg/kg to 2 mg/kg given one or two times a day (or given once a day if postmenstrual age under 31 weeks).
Tablets can be crushed and mixed with water or injection solution diluted and given by mouth.
Diuresis lasts for approximately 4 hours following administration so the dosing regime can be adjusted to suit the patient's requirements.
Precautions and Warnings
Elderly
Family history of long QT syndrome
Hypoproteinaemia
Predisposition to hypotension
Premature infants
Adrenal disorder
Benign prostatic hyperplasia
Diabetes mellitus
Electrolyte imbalance
Glucose-galactose malabsorption syndrome
Gout
Hepatic impairment
Hepato-renal syndrome
History of gout
History of torsade de pointes
Hypercalcaemia
Lactose intolerance
Metabolic alkalosis
Pregnancy
Renal impairment
Urinary obstruction
Pregnancy and Lactation
Pregnancy
Use furosemide with caution in pregnancy.
Furosemide has been given after the first trimester of pregnancy without causing foetal or newborn adverse effects. It should only be given during pregnancy if strictly indicated and for short-term treatment.
Lactation
Furosemide is contraindicated in breastfeeding.
Furosemide should be discontinued during furosemide treatment as the drug may inhibit lactation and is secreted into the breast milk.
An alternative drug may be preferred especially whilst nursing a newborn or premature infant.
Side Effects
Acute renal failure
Aggravation of metabolic alkalosis
Agranulocytosis
Anaphylactic reaction
Anaphylactoid reaction
Aplastic anaemia
Arrhythmias
Blood urea increased
Blurred vision
Bone marrow depression
Confusion
Decrease in plasma calcium
Decreased glucose tolerance
Dehydration
Delayed reactions
Diarrhoea
Dizziness
Drowsiness
Dry mouth
Eosinophilia
Erythema multiforme
Exfoliative dermatitis
Fever
Gout
Haemolytic anaemia
Headache
Hearing loss (reversible)
Hepatic encephalopathy
Hypochloraemia
Hypokalaemia
Hypomagnesaemia
Hyponatraemia
Hypotension
Hypovolaemia
Impaired concentration
Increase in plasma triglyceride concentration
Increase in serum cholesterol (transient)
Increase in serum transaminases
Increased thirst
Interstitial nephritis
Intrahepatic cholestasis
Jaundice
Leucopenia
Light-headedness
Malaise
Metabolic alkalosis
Muscle cramps
Muscle weakness
Nausea
Nephrocalcinosis
Nephrolithiasis
Orthostatic dysregulation
Pancreatitis
Paraesthesia
Photosensitivity
Precipitation of diabetes
Pruritus
Psychiatric disorders
Purpura
Rash
Sensation of pressure
Serum creatinine increased
Severe bullous lesions
Shock
Tetany
Thrombocytopenia
Thrombosis
Tinnitus
Toxic epidermal necrolysis
Urinary retention
Urticaria
Vasculitis
Visual disturbances
Vomiting
Weakness
Yellow vision
Contraindications
Cardiac glycoside toxicity
Addison's disease
Anuria
Breastfeeding
Dehydration
Galactosaemia
Hepatic coma
Hepatic encephalopathy
Hereditary fructose intolerance
Hypotension
Hypovolaemia
Long QT syndrome
Pre-coma associated with hepatic cirrhosis
Renal damage secondary to nephrotoxic agents
Renal impairment secondary to hepatotoxic agents
Severe hypokalaemia
Severe hyponatraemia
Torsade de pointes