Furosemide

Class: Loop Diuretics
VA Class: CV702
CAS Number: 54-31-9
Brands: Lasix

• 
  

  Furosemide is a potent diuretic that given in excessive amounts may induce a profound diuresis with water and electrolyte depletion.^{133 e} Careful medical supervision is required; dosage selection and titration should be adjusted to the individual patient’s needs.^{133 e} (See Dosage and Administration.)

  
  

Introduction

A sulfonamide, loop-type diuretic and antihypertensive agent.^{133 e}

Uses for Furosemide

Edema

Management of edema associated with CHF, hepatic cirrhosis, and renal disease (e.g., nephrotic syndrome).^{133 e}

Considered a diuretic of choice for most patients with CHF.¹³¹

IV management of acute pulmonary edema (in combination with oxygen and a cardiac glycoside).¹⁵⁰

Hypertension

Management of hypertension (alone or in combination with other classes of antihypertensive agents).^{100 101 109 124 127 133 144}

One of several preferred initial therapies in hypertensive patients with CHF or renal disease.^{100 101 109 124 127 144}

Can be used as monotherapy for initial management of uncomplicated hypertension; however, thiazide diuretics are preferred by JNC 7.^{100 101 124 127 142 143 144}

Furosemide Dosage and Administration

General

Edema

• 
  

  Careful etiologic diagnosis should precede the use of any diuretic.^e

  
  


• 
  

  Hospitalization of the patient during initiation of therapy is advisable, especially for patients with hepatic cirrhosis and ascites or chronic renal failure.^{133 e}

  
  


• 
  

  Most experts state that all patients with symptomatic CHF who have evidence for, or a prior history of, fluid retention generally should receive diuretic therapy in conjunction with moderate sodium restriction (≤3 g of sodium daily), an ACE inhibitor, and usually a β-blocker, with or without a cardiac glycoside.¹³¹

  
  


• 
  

  In prolonged diuretic therapy, intermittent use of the drug (e.g., on 2–4 consecutive days each week) may be advisable.^e

  
  

Hypertension

• 
  

  Monitor BP carefully, especially during initial therapy.¹³³

  
  


• 
  

  If added to regimen of a patient receiving another antihypertensive agent, reduce dosage of preexisting therapy by at least 50% initially to avoid severe hypotension; additional dosage adjustment may be required.¹³³

  
  

Administration

Administer orally, IV, or IM.^{133 150}

Oral Administration

Administer orally once (preferably in the morning)^e or twice daily .¹³³

For ease of administration and maximum dosage flexibility in children, consider use of oral solution preparation.¹⁵¹

IV Administration

For solution and drug compatibility information, see Compatibility under Stability.

IV administration may be used in emergency clinical circumstances when a rapid onset of diuresis is desired, or in patients unable to take oral medication or those with impaired GI absorption; replace with oral therapy as soon as possible.^{133 150 e}

Consider the potential risks, when using large parenteral doses; monitor patient closely.^{105 107}

Dilution

For IV infusion, dilute in 5% dextrose, 0.9% sodium chloride, or lactated Ringer’s injection and adjust pH to >5.5.^{150 e}

Whenever possible, use vials instead of ampuls to prepare large doses to prevent large quantities of glass particles from entering the solutions.^e If ampuls must be used, consider filtering through a sterile membrane filter before use to remove any particles that may be present.^e

Rate of Administration

For direct IV injection, administer slowly over a period of 1–2 minutes.^{150 e}

If high-dose parenteral furosemide therapy is necessary, the manufacturer recommends that the drug be administered as a controlled infusion at a rate not exceeding 4 mg/minute in adults.^{150 e}

Dosage

Individualize dosage according to patient’s requirements and response; titrate dosage to gain maximum therapeutic effect while using the lowest possible effective dosage.^e (See Boxed Warning.)

Pediatric Patients

Edema

Oral

2 mg/kg administered as a single dose.^{103 104 105 107 108 133} If necessary, increase in increments of 1 or 2 mg/kg every 6–8 hours^{103 104 105 107 108} to a maximum of 6 mg/kg.^{103 133} Generally not necessary to exceed individual doses of 4 mg/kg or a dosing frequency of once or twice daily.¹⁰⁴ Use minimum effective dosage for maintenance therapy.¹³³

IV or IM

1 mg/kg administered as a single IM or IV injection.^{103 104 105 106 107 108 150} If necessary for resistant forms of edema, the initial dose may be increased by 1 mg/kg^{103 104 105 108} no more often than every 2 hours until the desired effect has been obtained or up to a maximum dosage of 6 mg/kg.¹⁰³ Adequate response usually is obtained with individual parenteral doses of 1 mg/kg.^{104 105 107 108}

Acute Pulmonary Edema

IV or IM

1 mg/kg administered as a single IM or IV injection.^{103 104 105 106 107 108 150} If necessary for resistant forms of edema, the initial dose may be increased by 1 mg/kg^{103 104 105 108} no more often than every 2 hours until the desired effect has been obtained or up to a maximum dosage of 6 mg/kg.¹⁰³ Adequate response generally obtained with 1 mg/kg.^{104 105 107 108}

Hypertension†

Oral

Initially, 0.5–2 mg/kg given once or twice daily.¹⁴⁹ Increase as necessary up to a maximum of 6 mg/kg daily.¹⁴⁹

Adults

Edema

Oral

20–80 mg given as a single dose, preferably in the morning.^{133 e} If needed, repeat same dose 6–8 hours later or increase dose by 20- to 40-mg increments and give no sooner than 6–8 hours after last dose until desired diuretic response (including weight loss) is obtained.^{133 e} May titrate carefully up to 600 mg daily in severe cases.¹³³

The effective dose may be given once or twice daily thereafter, or, in some cases, by intermittent administration on 2–4 consecutive days each week.^{133 e} Dosage may be reduced for maintenance therapy.^e

IV or IM

20–40 mg given as a single IM or IV injection.^{150 e} If needed, repeat same dose 2 hours later or increase dose by 20-mg increments and give no sooner than every 2 hours until the desired diuretic response is obtained.¹⁵⁰ Effective dosages may then be given once or twice daily.¹⁵⁰

Acute Pulmonary Edema

IV

40 mg given as a single IV injection.¹⁵⁰ If needed, an 80-mg dose may be given 1 hour after the initial dose.¹⁵⁰

Hypertension

Oral

40 mg twice daily.¹³³ If desired BP not attained, consider adding other antihypertensive agents.¹³³

Usual dosage recommended by JNC 7: 10–40 mg twice daily.^{127 144}

Prescribing Limits

Pediatric Patients

Edema

Oral

Maximum of 6 mg/kg.^{103 133}

IV or IM

Maximum of 6 mg/kg in infants and children; do not exceed 1 mg/kg daily in premature infants.¹⁵⁰

Hypertension†

Oral

Maximum 6 mg/kg daily.¹⁴⁹

Adults

Edema

Oral

Maximum of 600 mg daily.¹³³

Special Populations

Renal Impairment

Higher doses may be required for patients with acute or chronic renal failure.^e

Hypertension

Higher doses may be required for patients with acute or chronic renal failure.^e

Oral

Use of ≥3 antihypertensive agents usually is required to achieve a target BP <130/80 mm Hg.¹⁴⁴

Cautions for Furosemide

Contraindications

• 
  

  Anuria.¹³³

  
  


• 
  

  Known hypersensitivity to furosemide or any ingredient in the formulation.¹³³

  
  

Warnings/Precautions

Warnings

Hepatic Effects

Sudden alterations of electrolyte balance in patients with cirrhosis may precipitate hepatic coma; use with caution in patients with hepatic cirrhosis and ascites.¹³³

Do not initiate therapy in patients with hepatic coma or electrolyte depletion until the basic condition is improved.¹³³ Therapy in such patients is best initiated in the hospital with careful monitoring of clinical status and electrolyte balance.¹³³

Renal Effects

If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, discontinue the drug.^{133 150}

Sensitivity Reactions

Anaphylaxis

Anaphylaxis (e.g., urticaria, angioedema, hypotension) within 5 minutes after IV administration reported.¹⁰²

Systemic Lupus Erythematosus

Possible exacerbation or activation of systemic lupus erythematosus.^{133 150}

Sulfonamide Sensitivity

Patients sensitive to sulfonamides may show allergic reactions to furosemide.^e

Photosensitivity

Photosensitivity may occur.¹³³

Major Toxicities

Ototoxicity

Risk of tinnitus, reversible or permanent hearing impairment increased following IV or IM administration, especially at high dosages,^{133 e} after too-rapid administration,¹³³ in patients with severely impaired renal function, and/or in patients receiving other ototoxic drugs (e.g., aminoglycosides).^{133 e} (See Specific Drugs under Interactions.)

If high-dose IV therapy is indicated, administer by slow IV infusion (e.g., at a rate not exceeding 4 mg/minute in adults).^{133 150}

General Precautions

Fluid, Electrolyte, and Cardiovascular Effects

Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in elderly patients.¹³³ (See Boxed Warning.)

Risk of orthostatic hypotension, especially with brisk diuresis.^{133 150 151} May be aggravated by concomitant use with alcohol, barbiturates, or narcotics.^{133 151 e}

Risk of hypokalemia, especially with brisk diuresis, inadequate oral electrolyte intake, when cirrhosis is present, or during concomitant use of corticosteroids or ACTH.^{133 150} Concomitant therapy with digitalis may exaggerate metabolic effects of hypokalemia, especially myocardial effects.^{133 150}

Observe carefully for manifestations of fluid and electrolyte depletion (e.g., dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, nausea, vomiting).¹³³

Endocrine Effects

Possible increased blood glucose and alterations in glucose tolerance tests (with abnormalities of the fasting and 2-hour postprandial sugar); precipitation of diabetes mellitus rarely reported.^{133 150} Monitor urine and blood glucose concentrations periodically in patients with diabetes and those suspected of latent diabetes.^e

Possible hyperuricemia and precipitation of gout;^{133 150} use with caution in patients with a history of gout or elevated serum uric acid concentrations.^e

Patient Monitoring

Monitor regularly for the possible occurrence of blood dyscrasias, liver or kidney damage, or other idiosyncratic reactions.^{133 150}

Serum electrolytes (particularly potassium), CO₂, creatinine and BUN should be determined frequently during the first few months of therapy and periodically thereafter.^{133 150}

Elective Surgery

Discontinue therapy 1 week (oral furosemide) or 2 days (parenteral furosemide) before elective surgery.^e

Specific Populations

Pregnancy

Category C.¹³³

Lactation

Distributed into milk.¹³³ Use with caution.¹³³

Pediatric Use

Risk of persistent patent ductus arteriosus (PDA) may be increased in premature neonates with respiratory distress syndrome (RDS) who receive furosemide during the first weeks of life.^{103 e}

Do not exceed dosage of 1 mg/kg per 24 hours in premature neonates with <31 weeks’ postconception age (gestational age at birth plus postnatal age); risk of potentially toxic furosemide plasma concentrations with higher dosages.¹⁵⁰

Renal calcification reported in severely premature infants treated with IV furosemide for edema due to PDA and hyaline membrane disease; concomitant chlorothiazide therapy may decrease hypercalciuria and dissolve some calculi.¹⁵⁰

Hearing loss reported in neonates; possibly secondary to renal immaturity.^{103 125 126 150}

Oral solutions contain sorbitol; high dosages may cause diarrhea in children.^e

Hepatic Impairment

Use with caution.^{133 e}

Renal Impairment

Use with caution.^{133 e}

Common Adverse Effects

Orthostatic hypotension, dizziness, electrolyte imbalance (hyponatremia, hypokalemia, hypochloremia) tinnitus, photosensitivity.^{133 e}

Interactions for Furosemide

Specific Drugs

Drug	Interaction	Comments
Alcohol	May aggravate orthostatic hypotension133 151 e
Anticonvulsant agents (e.g., phenytoin sodium, phenobarbital)	Possible reduced diuretic effecte
Antidiabetic agents (e.g., insulin, oral agents)	Possible antagonism of hypoglycemic effect as result of hypokalemia133	Observe for possible decreased diabetic control; correct potassium deficit and/or adjust dosage of antidiabetic agente
Antihypertensive agents	Additive antihypertensive effect; orthostatic hypotension may occur133	Reduce dosage of both drugse Concomitant therapy generally used to therapeutic advantagee
Barbiturates	May aggravate orthostatic hypotension133 151 e
Cardiac glycoside (e.g., digoxin)	Possible electrolyte disturbances (e.g., hypokalemia, hypomagnesemia), increased risk of digitalis toxicity, and/or fatal cardiac arrhythmias e	Monitor electrolytes; correct hypokalemia e
Chloral hydrate	Possible reaction characterized by diaphoresis, flushes, hypertension, and uneasiness in patients with acute MI and CHFe	Consider alternate hypnotic drug (e.g., a benzodiazepine) in patients who require IV furosemidee
Diuretics, loop (e.g., bumetanide, ethacrynic acid, torsemide)	Share similar diuretic mechanisms e	No therapeutic rationale for concomitant usee
Diuretics, potassium- sparing (e.g., amiloride, spironolactone, triamterene)	Possible reduction in potassium loss 133	May be used to therapeutic advantage133
Diuretics, thiazides	Additive diuretic effecte	Use reduced dosage of furosemide when added to existing diuretic regimene
Drugs that cause potassium loss (e.g., corticosteroids, corticotropin, amphotericin B)	Additive hypokalemic effects133 e	Monitor electrolytes; correct hypokalemia 133 e
Indomethacin	Possible decreased diuretic and natriuretic effect133	Monitor closely to determine if desired diuretic and/or hypotensive effect is obtained133
Lithium	Reduced renal clearance of lithium and increased risk of lithium toxicity 133	Avoid concomitant use;133 e if concomitant therapy is necessary, monitor for lithium toxicitye
Narcotics	May aggravate orthostatic hypotension133 151 e
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium besylate, tubocurarine chloride)	Potential for prolonged neuromuscular blockadee
Norepinephrine	Decreased arterial responsive to norepinephrine133	Norepinephrine may still be used effectively133
Ototoxic drugs (e.g., aminoglycoside antibiotics)	Possible additive ototoxic effect, especially in patients with impaired renal function133	Avoid concomitant use except in life-threatening situations133
Salicylates (e.g., aspirin, NSAIAs)	Possible transient reductions in Clcr in patient with chronic renal insufficiencye Possible weight gain and increased Scr, serum potassium concentrations, and BUN (NSAIAs)133	Monitor for toxicity133
Succinylcholine	May potentiate action of succinylcholine133
Sucralfate	Possible reduced natriuretic and antihypertensive effects133	Do not administer simultaneously; separate administration by ≥2 hours133 Observe closely for desired diuretic and/or antihypertensive effect133
Uricosuric drugs (probenecid, sulfinpyrazone)	Possible antagonism of uricosuric effectse	Monitor serum uric acid concentrationse

Furosemide Pharmacokinetics

Absorption

Bioavailability

Mean oral bioavailability of furosemide from commercially available tablets and oral solution is 64% and 60%, respectively.¹³³

Commercially available tablets and oral solution are bioequivalent.¹³³

Onset

Following oral administration, onset of diuresis occurs within 30 minutes to 1 hour; maximal effect after 1–2 hours.^{133 e}

Following IV administration, diuresis occurs within 5 minutes and peaks within 20–60 minutes.^{150 e}

Onset of diuresis after IM administration occurs somewhat later than after IV administration.¹⁵⁰

Maximum hypotensive effect may not be apparent until after several days of therapy.^e

Duration

Diuretic effect persists 6–8 hours following oral administration and approximately 2 hours following IV administration.^{133 150 e}

Food

Food does not appear to affect diuretic effect.^e

Special Populations

In patients with severely impaired renal function, the diuretic response may be prolonged.^e

Distribution

Extent

Crosses the placenta and is distributed into milk.^e

Plasma Protein Binding

Approximately 95% bound to plasma proteins (mainly albumin) in both normal and azotemic patients.^{133 e}

Elimination

Metabolism

Metabolized in the liver to the defurfurylated derivative, 4-chloro-5-sulfamoylanthranilic acid.^e

Elimination Route

Rapidly excreted in urine by glomerular filtration and by secretion from the proximal tubule.^e

Approximately 50% of an oral dose and 80% of an IV or IM dose are excreted in urine within 24 hours; 69–97% of these amounts is excreted in the first 4 hours.^{150 e} The remainder of the drug is eliminated by nonrenal mechanisms including degradation in the liver and excretion of unchanged drug in the feces.^e

Half-life

Biphasic;^e terminal half-life is approximately 2 hours.¹³³

Special Populations

Hepatic or renal impairment prolongs the elimination half-life of the drug.^e

In patients with marked renal impairment without liver disease, nonrenal clearance is increased to the extent that up to 98% of the drug is cleared within 24 hours.^e

Not removed by hemodialysis.¹³³

Stability

Storage

Oral

Solution or Tablets

Tight, light resistant containers at 15–30°C.^{133 151}

Parenteral

Injection

15–30°C; protect from light.¹⁵⁰ Discard unused portion.¹⁵⁰

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

Do not mix with strongly acidic solutions (i.e., pH < 5.5), such as those containing ascorbic acid, amrinone, ciprofloxacin, labetalol, tetracycline, milrinone, epinephrine, or norepinephrine, because furosemide may be precipitated.^{150 e}

Solution Compatibility^a

Compatible
Alcohol 5% and dextrose 5%
Amino acids 4.25%, dextrose 25%
Dextrose 5% in Ringer’s injection, lactated
Dextrose 5% in sodium chloride 0.9%
Dextrose 5, 10, or 20% in water
Invert sugar 10% in Electrolyte #1
Mannitol 20%
Ringer’s injection, lactated
Sodium chloride 0.9%
Sodium lactate (1/6) M
Incompatible
Fructose 10% in water
Invert sugar 10% in Electrolyte #2

Drug Compatibility

Admixture Compatibilitya

Compatible
Amikacin sulfate
Aminophylline
Ampicillin sodium
Atropine sulfate
Bumetanide
Calcium gluconate
Cefuroxime sodium
Cimetidine HCl
Dexamethasone sodium phosphate
Diamorphine HCl
Digoxin
Epinephrine HCl
Heparin sodium
Hydrocortisone sodium succinate
Isosorbide dinitrate
Kanamycin sulfate
Lidocaine HCl
Midazolam HCl
Meropenem
Morphine sulfate
Nitroglycerin
Penicillin G
Potassium chloride
Ranitidine HCl
Scopolamine butylbromide
Sodium bicarbonate
Sulphadimidine
Theophylline
Tobramycin sulfate
Incompatible
Buprenorphine HCl
Chlorpromazine HCl
Diazepam
Dobutamine HCl
Erythromycin lactobionate
Isoproterenol HCl
Meperidine HCl
Metoclopramide HCl
Papaveretum
Prochlorperazine edisylate
Promethazine HCl
Variable
Amiodarone HCl
Gentamicin sulfate
Hydrocortisone sodium succinate
Verapamil HCl

Y-Site Compatibilitya

Compatible
Allopurinol sodium
Amifostine
Amikacin sulfate
Amphotericin B cholesteryl sulfate complex
Aztreonam
Bivalirudin
Bleomycin sulfate
Cefepime HCl
Ceftazidime
Cisplatin
Cladribine
Cyclophosphamide
Cytarabine
Dexmedetomidine HCl
Docetaxel
Doxorubicin HCl liposome injection
Epinephrine HCl
Etoposide phosphate
Fentanyl citrate
Fludarabine phosphate
Fluorouracil
Foscarnet sodium
Granisetron HCl
Heparin sodium
Hetastarch in lactated electrolyte injection (Hextend)
Hydrocortisone sodium succinate
Hydromorphone HCl
Indomethacin sodium trihydrate
Kanamycin sulfate
Leucovorin calcium
Linezolid
Lorazepam
Melphalan HCl
Meropenem
Methotrexate sodium
Mitomycin
Nitroglycerin
Norepinephrine bitartrate
Paclitaxel
Piperacillin sodium–tazobactam sodium
Potassium chloride
Propofol
Ranitidine HCl
Remifentanil HCl
Sargramostim
Sodium nitroprusside
Tacrolimus
Tirofiban HCl
Teniposide
Thiotepa
Tirofiban
Tobramycin sulfate
Vitamin B complex with C
Incompatible
Amsacrine
Azithromycin
Chlorpromazine HCl
Ciprofloxacin
Clarithromycin
Diltiazem HCl
Droperidol
Esmolol HCl
Fenoldopam mesylate
Filgrastim
Fluconazole
Gatifloxacin
Gemcitabine HCl
Gentamicin sulfate
Hydralazine HCl
Idarubicin HCl
Levofloxacin
Metoclopramide HCl
Midazolam HCl
Milrinone lactate
Nicardipine HCl
Ondansetron HCl
Quinidine gluconate
Thiopental sodium
Vecuronium bromide
Vinblastine sulfate
Vincristine sulfate
Vinorelbine tartrate
Variable
Amiodarone HCl
Dobutamine HCl
Dopamine HCl
Doxorubicin HCl
Famotidine
Labetalol HCl
Meperidine HCl
Morphine sulfate

ActionsActions

• 
  

  Inhibits primarily the absorption of sodium and chloride not only in the proximal and distal tubules but also in the ascending limb of the loop of Henle.^{133 e} Does not inhibit carbonic anhydrase and is not an aldosterone antagonist.^e

  
  


• 
  

  Mechanism of hypotensive effect not definitively determined but presumed to result from decreased plasma volume.^e

  
  


• 
  

  Induces greater diuresis and electrolyte loss than with thiazides or most other diuretics except ethacrynic acid.^e

  
  


• 
  

  Possesses some renal vasodilator effect; renal vascular resistance decreases and renal blood flow increases following administration.^e

  
  

Advice to Patients

• 
  

  Risks associated with excessive fluid loss or electrolyte imbalance.¹³³

  
  


• 
  

  Potential for postural hypotension; importance of rising slowly from a seated position.¹³³

  
  


• 
  

  Importance of discussing dietary measures and supplementation to prevent or correct hypokalemia.¹³³

  
  


• 
  

  Importance of informing patients with diabetes mellitus that blood glucose and urine glucose concentrations may increase.^{133 e}

  
  


• 
  

  Importance of informing patients of possible photosensitivity.^{133 e}

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs (e.g., appetite suppressants, cold remedies) as well as any concomitant illnesses.^{133 e}

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^{133 e}

  
  


• 
  

  Importance of informing patients of other important precautionary information.^{133 e} (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Furosemide

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Solution	40 mg/5 mL*	Furosemide Solution (with alcohol 0.2% and sorbitol)	Roxane
		10 mg/mL*	Furosemide Solution	Morton Grove, Roxane
	Tablets	20 mg*	Furosemide Tablets	IVAX, Mylan, Qualitest, Roxane, Sandoz, UDL
			Lasix	Sanofi-Aventis
		40 mg*	Furosemide Tablets	IVAX, Mylan, Qualitest, Roxane, Sandoz, UDL
			Lasix (scored)	Sanofi-Aventis
		80 mg*	Furosemide Tablets	Mylan, Qualitest, Roxane, Sandoz, UDL
			Lasix	Sanofi-Aventis
Parenteral	Injection	10 mg/mL*	Furosemide Injection	American Pharmaceutical Partners, American Regent, Hospira, IMS

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Furosemide 10MG/ML Solution (MORTON GROVE PHARMACEUTICALS): 120/$15.99 or 360/$35.97

Furosemide 10MG/ML Solution (ROXANE): 60/$17.99 or 120/$25.98

Furosemide 20MG Tablets (SANDOZ): 100/$13.99 or 200/$18.97

Furosemide 40MG Tablets (SANDOZ): 100/$13.99 or 200/$19.96

Furosemide 80MG Tablets (SANDOZ): 30/$12.99 or 60/$15.98

Lasix 20MG Tablets (SANOFI-AVENTIS U.S.): 30/$24.25 or 90/$45.92

Lasix 40MG Tablets (SANOFI-AVENTIS U.S.): 30/$25.99 or 90/$54.91

Lasix 80MG Tablets (SANOFI-AVENTIS U.S.): 30/$35.99 or 90/$85.97

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions April 2010. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

Only references cited for selected revisions after 1984 are available electronically.

100. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The 1984 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1984; 144:1045-57. [IDIS 184763] [PubMed 6143542]

101. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The 1980 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1980; 140:1280-5. [IDIS 375724] [PubMed 6775608]

102. Hansbrough JR, Wedner HJ, Chaplin DD et al. Anaphylaxis to intravenous furosemide. J Allergy Clin Immunol. 1987; 80:538-41. [IDIS 235418] [PubMed 3668117]

103. Hoechst-Roussel. Lasix (furosemide) injection, oral solution, and tablets prescribing information (dated 1994 Oct). In: Physicians’ desk reference. 50th ed. Montvale NJ: Medical Economics Company Inc; 1996:1240-2.

104. Engle MA, Lewy JE, Lewy PR et al. The use of furosemide in the treatment of edema in infants and children. Pediatrics. 1978; 62:811-8. [IDIS 118470] [PubMed 724325]

105. Baliga R, Lewy JE. Pathogenesis and treatment of edema. Pediatr Clin North Am. 1987; 34:639-48. [PubMed 3588044]

106. Repetto HA, Lewy JE, Braudo JL et al. The renal functional response to furosemide in children with acute glomerulonephritis. J Pediatr. 1972; 80:660-6. [PubMed 5015080]

107. Lewy JE. Diuretics in infancy. Controversies Nephrol. 1981; 27:33-44.

108. Lewy JE, Moel DI. Pathogenesis and management of edema in the newborn. Clin Perinatol. 1975; 2:117-23. [PubMed 1102212]

109. 1988 Joint National Committee. The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1988; 148:1023-38. [IDIS 242588] [PubMed 3365073]

110. Lardinois CK, Neuman SL. The effects of antihypertensive agents on serum lipids and lipoproteins. Arch Intern Med. 1988; 148:1280-8. [IDIS 242671] [PubMed 2897834]

111. Holland OB, Pool PE. Metabolic changes with antihypertensive therapy of the salt-sensitive patient. Am J Cardiol. 1988; 61:53-9H.

112. Weinberger MH. Diuretics and their side effects: dilemma in the treatment of hypertension. Hypertension. 1988; 11(Suppl II):II-16-20.

113. Ames R. Effects of diuretic drugs on the lipid profile. Drugs. 1988; 36(Suppl 2):33-40. [IDIS 248276] [PubMed 3063504]

114. Lasser NL, Grandits G, Caggiula AW et al. Effects of antihypertensive therapy on plasma lipids and lipoproteins in the Multiple Risk Factor Intervention Trial. Am J Med. 1984; 76(Suppl 2A):52-66. [IDIS 182290] [PubMed 6367451]

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