Furosemide Drug - Indications, Dosage, Contra Indications, Special Precautions, Side effects,

Classification        :    Diuretics
Trade Name          :    Lasix
Generic Name       :    Frusamide

• It is a strong diuretic but lacks specific anti-hypertensive action. ( has no direct effect on resistance vessels). 

• Thus anti hypertensive efficacy is directly related to diuretic potency. 

• Fall in BP is due only to reduced plasma extracellular fluid volume.

Indications :

• Oedema in congestive heart failure,

• hepatic and renal disease. 

• Cerebral oedema, 

• forced diuresis for poisoning, 

• toxaemia of pregnancy.

•  Hypertension and hypertensive crisis.

• Pulmonary edema

  Dosage : 

•  ADULT : 20-80 mg as a single dose. if satisfactory results are not obtained than 20-40 mg after 6 hrs.  

• INFANT & CHILDREN : 2mg /kg body wt increased by 1-2 mg/kg 6-8 hrs after the previous dose.  MAX : 40 mg /day.

Contra Indications :

• Renal failure with anuria,

• potassium deficiency ( i.e. malnutrition, diarrhoea).

• Hypersensitivity to frusemide & sulphonamides,

• Hypokalaemia 

• Hyponatraemia

• Hepatic coma

• Hypovolaemia with/without hypotension.

Special Precautions :

• Electrolyte imbalance (monitor serum electrolyte)

• Paediatrics : can be used safely.

• Pregnancy : Contraindicated.

• Lactation : Used if clearly indicated.

• Elderly : Increased risk of side effects. Dose to be reduced.

Side Effects :

• Vertigo.

• Visual impairment.

• Sodium deficiency may cause orthostatic hypotension.

• Calf muscle cramps.

• Anorexia.

• Weakness.

• Dizzinesss.

• Drowsiness.

• Vomiting.

• hyperuricaemia reduced glucose tolerance.

• Deafness.

Drug Interactions :

Aminoglycoside  antibiotics may enhance the risk of deafness, potentiates anti hypertensives, causes litihum toxicity in those receiving both drugs. With cotrimoxazole produces thrombocytopenia. NSAIDs diminish the diuretic effects.