Please check your internet connection and try again.
# Furosemide (Lasix)
## Overview
Furosemide is a loop diuretic used to treat fluid overload (edema) and high blood pressure.
## Primary Indications
* Edema associated with congestive heart failure, liver cirrhosis, and renal disease.
* Hypertension.
## Adult Dosing
* **Edema:** 20-80 mg orally once daily. May increase by 20-40 mg every 6-8 hours until desired response is achieved. Doses above 80 mg once daily are generally not more effective and increase the risk of adverse effects. Doses may be given in divided doses. Usual maintenance dose: 20-80 mg orally daily.
* **Hypertension:** 40 mg orally twice daily.
* **Intravenous (IV) or Intramuscular (IM):** 20-40 mg once daily. May increase by 20 mg every 2 hours until desired response. Doses above 80 mg IV/IM once daily are generally not more effective and increase the risk of adverse effects. May be given as a continuous infusion.
## Pediatric Dosing
* **Edema and Hypertension:** 1-2 mg/kg orally once daily. Maximum: 6 mg/kg/day.
* **IV/IM:** 1 mg/kg once daily. Maximum: 20 mg/dose. May increase by 1 mg/kg every 2 hours until desired response.
## Dose Adjustments
* **Renal Impairment:** Dose reduction may be necessary. Monitor electrolytes and renal function closely.
* **Hepatic Impairment:** May require dose adjustment. Monitor electrolytes and fluid status closely.
## Contraindications
* Anuria.
* Known hypersensitivity to furosemide or sulfonamides.
## Adverse Effects
* **Electrolyte imbalances:** Hypokalemia, hyponatremia, hypochloremia, hypomagnesemia, hypocalcemia.
* **Dehydration.**
* **Ototoxicity:** Especially with rapid IV administration or high doses.
* **Hypotension.**
* **Hyperuricemia.**
* **Hyperglycemia.**
* **Photosensitivity.**
## Key Drug Interactions
* **Aminoglycosides:** Increased risk of ototoxicity.
* **NSAIDs:** May reduce diuretic and antihypertensive effects, increase risk of renal impairment.
* **Lithium:** Increased lithium levels and risk of toxicity.
* **Digoxin:** Increased risk of digoxin toxicity due to furosemide-induced hypokalemia.
* **Antihypertensives:** Additive hypotensive effect.
* **Corticosteroids:** Increased risk of hypokalemia.
## Monitoring
* Electrolytes (sodium, potassium, chloride, magnesium, calcium).
* Renal function (BUN, creatinine).
* Blood pressure.
* Fluid intake and output.
* Weight.
* Blood glucose (in diabetic patients).
* Uric acid (in patients with gout history).
* Hearing (especially with high doses or IV administration).
## Clinical Pearls
* Administer oral furosemide in the morning to minimize nocturia.
* Rapid IV administration can lead to ototoxicity. Infuse IV furosemide slowly, typically over 30-60 minutes or as a continuous infusion.
* Monitor for signs of hypokalemia (muscle cramps, weakness, arrhythmias). Potassium supplementation may be required.
* Advise patients to report significant weight gain, swelling, shortness of breath, dizziness, or hearing changes.
***
*This information is intended for healthcare professionals. Always consult the official prescribing information and your institution's protocols for the most current and complete drug information.*
