Furosemide is a type of medicine that can be used to reduce the buildup of fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This medicine will cause you to urinate more, thus helping get rid of excess water and salt from your body.
This medicine can also help reduce symptoms such as shortness of breath and swelling in your arms, legs, and stomach. Additionally, it can also be used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
Furosemide Dosage Considerations
You should not increase or lower the dose without your doctor’s approval. If you miss a dose of furosemide, take the drug as soon as you remember.
Edema associated with congestive heart failure, cirrhosis of the liver, and kidney disease are considered as nephrotic syndrome.
- Recommended dose is 20 mg to 80 mg PO once / day. The dose can be increased by 20 mg to 40 mg every 6 to 8 hours – not more than 600 mg / day.
- Alternative dose is 20 mg to 40 mg IV / IM once. The dose can be increased by 20 mg every 2 hours. Individual dosage recommendation is not more than 200 mg / dose.
- Dosage recommendation for hypertension is 20 mg to 80 mg PO every 12 hours.
Conditions: Acute Pulmonary Edema, Hypertensive Crisis, Increased Intracranial Pressure
- Recommended dose is 0.5 mg to 1 mg / kg (or 40 mg) IV over one to two minutes. The dose may be increased to 80 mg if there is no response within one hour. Maximum dose is 160 mg to 200 mg / dose.
Condition: Hyperkalemia in Advanced Cardiac Life Support (ACLS)
- Recommended dose is 40 mg to 80 mg IV.
Guidelines for Furosemide
Use furosemide as directed by your doctor. Here’s how to use furosemide:
- Read the drug information leaflet if available from your pharmacist before taking furosemide and each time you get a refill. If you have any questions, don’t hesitate to ask your doctor or pharmacist.
- Take oral furosemide as directed by your doctor, with or without food, usually once or twice a day. You should avoid taking this medication within 4 hours before your bedtime to prevent you from having to wake up in the middle of the night to pee.
- Recommended dosage for furosemide is based on your medical condition, age, and response to treatment. For children, the dosage is also based on weight. Older adults usually start taking this drug with a lower dose to reduce the risk of side effects.
- Do not increase your dose of furosemide or take it more often than recommended by your doctor.
- Take furosemide regularly to get the most benefit. To keep track of your medication schedule, take furosemide at the same time as directed. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick
- If you are taking certain medications, supplements, or herbal medicines, you should tell your doctor.
- Sucralfate, cholestyramine, and colestipol can decrease the absorption of furosemide. If you are taking either of these drugs, separate the timing of each dose from this medicine at least 2 hours apart.
- If you forget to take a dose, take it as soon as you remember – unless it is almost time for the next dose, which you can skip the missed dose. Do not take two doses at the same time to make up for a missed dose.
- Do not take furosemide if you have an allergy to this drug. Make sure you tell your doctor or pharmacist about your allergy history.
- Tell your doctor if your condition does not improve or gets worse, for example, your blood pressure remains high or increases after taking furosemide.
What is Furosemide Used For
Furosemide can be used for treatments, such as:
- Hypertension (or high blood pressure)
- Additional treatment of edema in patients with acute or chronic kidney failure
- Prevention of the negative effects of hemodynamics or pulmonary edema associated with blood transfusions
- Management of pulmonary edema or prevention of the negative effects of hemodynamics associated with blood transfusions
- Treatment of peripheral edema or edema associated with heart failure, chronic lung disease, or nephrotic syndrome
Contraindications for Furosemide
Be aware of furosemide contraindications, including:
- Hypersensitivity to furosemide or sulfonamides.
- Anuria, a condition when the kidneys stop producing urine. This condition usually occurs due to disease or kidney damage.
Below are several precautions before consuming furosemide that you should pay attention to:
- Before taking furosemide, tell your doctor or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients that can cause allergic reactions or other problems.
- Before using furosemide, tell your doctor or pharmacist your medical history, especially if you have kidney problems, liver problems, inability to make urine, gout, or lupus.
- If you have diabetes, furosemide may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.
- Furosemide may reduce the level of potassium in your blood. Your doctor may recommend that you add potassium-rich foods to your diet or prescribe potassium supplements to prevent potassium loss. Ask your doctor for more details.
- This drug may make you more sensitive to the sun. Limit your time in the sun. Use sunscreen and wear protective clothing when outdoors.
- Furosemide may also make you dizzy or make your vision blurry. Alcohol or marijuana can make you more dizzy. Do not drive or do anything that requires alertness or clear vision until you can do it safely.
- Intense sweating, diarrhea, or vomiting can increase the risk of dehydration. Tell your doctor if you have prolonged diarrhea or vomiting.
- Premature infants and children may be more sensitive to certain effects of this drug, such as kidney stones.
- Older adults may be more sensitive to the effects of this drug, especially dizziness and dehydration.
- During pregnancy, the drug should only be used when clearly needed. Discuss the risks and benefits with your doctor.
- Furosemide passes into breast milk and may affect the production of breast milk. Consult your doctor before breastfeeding.
Furosemide Drug Interactions
Drug interactions may change how medications work or increase the risk of serious side effects. Types of drugs that may interact with furosemide include:
- Ethacrynic acid
Some products have ingredients that can increase blood pressure or worsen your swelling. Tell the pharmacist what products you use and ask how to use them safely, especially cough and cold medicines, diet aids, or NSAIDs such as ibuprofen and naproxen.
Consumption of furosemide may also interfere with certain laboratory tests, possibly causing false test results. Make sure the lab team and your doctor know you are taking furosemide.
List of Furosemide Side Effects
The following are some of the most common side effects of furosemide:
- Dizziness, headaches, or blurred vision may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist immediately.
- To reduce the risk of dizziness, get up slowly when getting up from a sitting or lying position.
- Remember that your doctor has prescribed this medication because he or she has assessed that the benefits outweigh the risk of side effects. Many people take furosemide without serious side effects.
- Furosemide can cause serious dehydration. Tell your doctor if you have any of the unusual side effects, such as muscle cramps, weakness, confusion, dizziness, fainting, drowsiness, dry mouth, unusual thirst, nausea, vomiting, or fast and irregular heartbeat.
- Tell your doctor right away if you have signs of kidney problems (such as a change in urine volume, numbness, tingling, pain, redness, swelling in your arms or legs), hearing changes (such as ringing in your ears, hearing loss, or deafness), abdominal pain, yellowing eyes or skin.
- Seek immediate medical help if you notice any symptoms of a serious allergic reaction, such as rash, itching, swelling (especially of the face, tongue, or throat), dizziness, and difficulty breathing.
Book an appointment with your doctor or pharmacist through Smarter Health to find out more about the recommended dosage for furosemide and its proper use based on your condition Smarter Health allows you to access health care services and facilities whenever you need them.