Cardiac, pulmonary, hepatic & renal oedema, peripheral oedema & hypertension.
Furosemide is a monosulphonyl diuretic. It is an effective diuretic that retains its activity even in low glomerular filtration rate (GFR). Furosemide has a distinctive action on renal tubular function. It affects a peak diuresis far greater than that observed with other agents. Other features are (I) prompt onset of action (II) inhibition of sodium and chloride transport in the ascending limb of the loop of Henle and (III) independence of their action from acid-base balance changes. Furosemide acts primarily to inhibit electrolyte reabsorption in the thick ascending limb of the loop of Henle. Furosemide is readily absorbed from the gastrointestinal tract and considerable proportions are bound to plasma proteins. It is rapidly excreted in the urine. With an hour after intravenous injection, its effect is evident in about 5 minutes and last for about 2 hours.
Tablet : In mild cases, 20 mg daily or 40 mg on alternate days. In resistant cases, 80 mg/day. Children- 1 to 3 mg/kg/day, max. 40 mg/day. Injection : 20-50 mg/day IM/IV. Children- 0.5- 1.5 mg/kg/day. max. 20 mg/day.
A marked fall in blood pressure may be seen when ACE inhibitors are added to furosemide therapy. Serum lithium levels may be increased when lithium is given concomitantly with furosemide. The toxic effects of nephrotoxic antibiotics may be increased by concomitant administration of potent diuretics such as furosemide.
Anuria, electrolyte deficiency & precomatose states associated with liver cirrhosis. Hypersensitivity to furosemide or sulphonamides.
Alkalosis, uric acid retention & may rarely produce acute gout. Fusid may provoke hyperglycemia & glycosuria.
Fusid should be cautiously used in cardiogenic shock complicated by pulmonary oedema & in the first trimester of pregnancy. Blood pressure & pulse during rapid diuresis should be monitored. Should be used with caution during lactation.
Signs and symptoms: The clinical picture in acute or chronic overdose depends primarily on the extent and consequences of electrolyte and fluid loss, e.g. hypovolaemia, dehydration, haemoconcentration, cardiac arrhythmias (including AV block and ventricular fibrillation).
Management: No specific antidote to furosemide is known. If ingestion has only just taken place, attempts may be made to limit further systemic absorption of the active ingredient by measures such as gastric lavage or those designed to reduce absorption (e.g. activated charcoal).
Protect from light. Do not use it later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.
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