Please check your internet connection and try again.
# Furosemide Tablets
## Overview
Furosemide is a loop diuretic used to treat edema associated with heart failure, liver disease, and kidney disease, as well as hypertension.
## Primary Indications
* Edema (congestive heart failure, cirrhosis, renal disease)
* Hypertension
## Adult Dosing
* **Edema:**
* Initial: 20-80 mg orally once daily.
* Maintenance: 20-40 mg orally once daily or divided BID. Doses may be increased by 20-40 mg every 6-8 hours as needed.
* Maximum: 600 mg orally daily (use with caution and close monitoring).
* **Hypertension:**
* Initial: 40 mg orally once daily.
* Maintenance: Adjust dose based on response. Usually not recommended as a first-line agent for uncomplicated hypertension due to duration of action and electrolyte disturbances.
* Maximum: Not established, but higher doses increase the risk of adverse effects.
## Pediatric Dosing
* **Edema:**
* 2 mg/kg orally once daily.
* If inadequate response, may increase by 1-2 mg/kg every 6-8 hours.
* Maximum: 6 mg/kg orally once daily.
* **Hypertension:**
* Dosing is not well established. Generally not recommended as a first-line agent.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose may need to be adjusted based on severity of renal impairment and patient response. Higher doses may be required in some patients with severe renal impairment.
* **Hepatic Impairment:** Use with caution. Patients with cirrhosis may be more sensitive to the effects of furosemide and may develop hepatic coma. Start with lower doses.
## Contraindications
* Anuria
* History of hypersensitivity to furosemide or sulfonamides.
## Adverse Effects
* **Electrolyte imbalances:** Hypokalemia, hyponatremia, hypochloremia, hypomagnesemia, hypocalcemia.
* **Dehydration and hypotension.**
* **Ototoxicity** (especially with rapid IV administration or high doses).
* Hyperuricemia, hyperglycemia.
* Dizziness, lightheadedness.
* Rash.
## Key Drug Interactions
* **Aminoglycosides and other ototoxic drugs:** Increased risk of ototoxicity.
* **Antihypertensives:** Additive hypotensive effects.
* **Digoxin:** Increased risk of digoxin toxicity due to furosemide-induced hypokalemia.
* **NSAIDs:** May decrease diuretic and antihypertensive effects.
* **Potassium supplements/potassium-sparing diuretics:** Monitor potassium levels closely.
## Monitoring
* Serum electrolytes (sodium, potassium, chloride, magnesium, calcium)
* BUN, creatinine
* Blood pressure
* Urine output
* Hearing (especially with high doses or risk factors for ototoxicity)
## Clinical Pearls
* Administer oral furosemide on an empty stomach; however, if gastric irritation occurs, administer with food or milk.
* For edema, doses are often given every other day or with a lower dose daily to prevent electrolyte depletion.
* Monitor patients closely for signs of dehydration and electrolyte imbalance.
* Patients with severe renal insufficiency may require higher doses, but monitor for ototoxicity.
***
*Disclaimer: This information is intended for healthcare professionals. Always consult the official prescribing information and relevant guidelines for complete and up-to-date details before making clinical decisions.*
