Please check your internet connection and try again.
# Furosemide (Lasix)
## Overview
Furosemide is a potent loop diuretic that inhibits the reabsorption of sodium and chloride in the thick ascending limb of the Loop of Henle. This leads to increased excretion of sodium, chloride, potassium, calcium, magnesium, and water.
## Primary Indications
* Edema associated with congestive heart failure (CHF), liver cirrhosis, and renal disease (including the nephrotic syndrome).
* Hypertension (usually in combination with other antihypertensives).
* Acute pulmonary edema.
## Adult Dosing
* **Edema:** Oral: Start with 20-80 mg once daily. May increase by 20-40 mg every 6-8 hours as needed. Maximum daily dose: 600 mg. For more rapid or pronounced diuresis, doses may be given more frequently or intravenously. IV/IM: 20-40 mg once daily. May increase by 20 mg every 2 hours as needed. Maximum dose: 200 mg per dose.
* **Hypertension:** Oral: 40 mg twice daily. Adjust dosage based on response.
* **Acute Pulmonary Edema:** IV/IM: 20-40 mg. If inadequate response after 1 hour, may repeat dose every 2 hours, up to a maximum of 200 mg per dose.
## Pediatric Dosing
* **Edema/Hypertension:** Oral: 1-2 mg/kg/dose once daily. May increase by 1-2 mg/kg/dose every 6-8 hours as needed. Maximum dose: 6 mg/kg/day. IV/IM: 1 mg/kg/dose once daily. May increase by 1 mg/kg/dose every 2 hours as needed. Maximum dose: 6 mg/kg/day.
## Dose Adjustments
* **Renal Impairment:** Dose reduction may be necessary. Monitor electrolytes and fluid status closely.
* **Hepatic Impairment:** May require dose reduction due to altered protein binding and metabolism.
## Contraindications
* Anuria.
* History of hypersensitivity to furosemide or sulfonamides.
## Adverse Effects
* Electrolyte imbalances (hypokalemia, hyponatremia, hypochloremia, hypomagnesemia, hypocalcemia).
* Dehydration.
* Hypotension.
* Ototoxicity (especially with rapid IV administration or high doses).
* Hyperuricemia, hyperglycemia.
* Dizziness, lightheadedness.
* Rash, photosensitivity.
## Key Drug Interactions
* **Aminoglycosides:** Increased risk of ototoxicity and nephrotoxicity.
* **NSAIDs:** May reduce the diuretic and antihypertensive effects of furosemide.
* **Antihypertensives (including other diuretics):** Additive hypotensive effect.
* **Digoxin:** Increased risk of digoxin toxicity due to hypokalemia.
* **Lithium:** Reduced renal clearance of lithium, increasing risk of lithium toxicity.
* **Corticosteroids:** Increased risk of hypokalemia.
## Monitoring
* Electrolytes (sodium, potassium, chloride, magnesium, calcium).
* Renal function (BUN, creatinine).
