What is the minimum dosage of furosemide. What helps "Furosemide"

To remove excess fluid from the body, as well as cleanse it and balance the acid-base index, diuretics are used, which in medicine are called diuretics. They can be of 2 types: synthetic and natural.

Usually prescribed to patients with problems of the heart muscle, liver, kidneys, with high blood pressure if the pathology is accompanied by edema. In addition, patients are discharged with pulmonary edema, the brain, with intoxication with harmful substances excreted by the kidneys unchanged.

A diuretic is a drug widely used in medicine. However, when taking this remedy, few people think about the effect Furosemide has on the body and what side effects and consequences you may encounter after completing the intake.

How a diuretic works

Furosemide is a pharmacological agent with a diuretic effect, related to the "loop" diuretics. It is able to accelerate the formation of urine, reduce the volume of fluid in the tissues of the body. The medicine is very powerful and starts the process almost instantly, however, its effect does not last long.

20 minutes after ingestion, the mechanism of action starts, the greatest effect is achieved after 2 hours and lasts 3-6 hours. The drug acts depressingly on the reabsorption of sodium, chlorine ions, promotes the excretion of calcium, potassium, magnesium ions. Furosemide has a strong diuretic effect, natriuretic and chloruretic effect.

When using tablets for heart failure, the load on the heart subsides 20 minutes after ingestion. After 60-120 minutes, blood circulation decreases, vascular tone decreases and the amount of fluid in the tissues decreases. It is at this point that Furosemide reaches the peak of its effects. It also increases the leaching of sodium chloride, which helps to reduce blood pressure.

Side effects

We list what adverse reactions from the body may occur, as well as their symptoms:

Furosemide is dangerous medication, which can lead to serious malfunctions in the human body. For this reason, the drug should be taken only as prescribed by a doctor and, if necessary, adjust the dosage.

The danger of long-term use of a diuretic for weight loss

Long-term use of Furosemide during weight loss increases the risk of side effects, at times increases the chance of death due to metabolic disorders and cardiac arrest. This is due to the fact that in the body there is a pronounced deficiency of minerals necessary for the normal functioning of all organs and systems.

For this reason, taking any diuretics for a long time is prohibited. In physical terms, a person loses working capacity, endurance, the body loses the ability to regulate body temperature, which leads to dehydration, weakness, and failure of blood circulation.

What is the danger of the drug: unpleasant consequences

Due to long-term use of the drug in humans, a dose-dependent effect appears. In more detail, the increase in the volume of urine occurs due to the intake of different amounts of medication associated with the pathology and personal characteristics of the patient's body. In addition, over time, the kidneys stop responding to the initial dose, which requires its increase.

Cases have been recorded when, upon discontinuation of diuretics, a person experiences psychological changes, i.e. there is a direct dependence on the drug. This is especially true for those who independently practice taking Furosemide for weight loss.

Pseudo-Bartter syndrome may also develop. Pathology is characterized by water and electrolyte failures - a decrease in the concentration of potassium, sodium, chlorine in the blood, a violation of the acid-base balance, signs of dehydration of the body appear, and the activity of blood plasma renin increases.

The benefits of using the drug

but positive sides the drug still has. It helps to quickly remove poisons, toxins and excess fluid, thereby removing puffiness. That is, it performs its original functions properly.

IMPORTANT! Taking the drug under the supervision of a doctor in combination with other medicines does not cause any harm.

How to recover from furosemide

After discontinuation of the diuretic, the patient may experience aggravated edema. This can happen for one of the following reasons:

1. A consequence of the disease that was treated with Furosemide. In this case, you will need to consult the attending physician with subsequent correction of the pathology.
2. A symptom of drug addiction.

With a furosemide-dependent effect, everything is a little more complicated. Requires mineral intake medications with a content of potassium and magnesium, while it is better to drink liquid in small quantities. In the role of diuretics, use herbal preparations. It is advisable to drink no later than 4 o'clock in the afternoon, and the last meal should be taken before 6 o'clock in the evening. These recommendations will have to be followed for 30 days or more.

In order to prevent hypokalemia, foods high in potassium should be introduced into the diet - nuts, dried apricots, raisins, beans, peas and other legumes, sea cabbage, potatoes. In parallel, it is recommended to drink potassium preparations.

To compensate for magnesium deficiency, you will need to take chloride, or magnesium gluconate. Therapy with sodium chloride with a low content of sodium in the blood is carried out carefully, since salt retains fluid in the body.

The opinion of patients and doctors

Below are provided real reviews doctors and patients. We will find out what is the opinion about the diuretic in medical practice and among those who used the remedy for any reason.

Photo of the preparation

Latin name: Furosemide

ATX Code: C03CA01

Active substance: Furosemide (Furosemide)

Manufacturer: Borisovsky Zavod medical preparations(Republic of Belarus), Novosibkhimfarm, Dalkhimfarm, Biochemist, Binnopharm CJSC, Ozon Pharm OOO (Russia), Mangalam Drugs & Organics Ltd, Ipca Laboratories (India)

The description applies to: 01.11.17

Furosemide is a drug for removing edematous syndrome, which enhances the excretion of water from the body, as well as magnesium and calcium ions.

Active substance

Furosemide (Furosemide).

Release form and composition

Available in the form of tablets and solution for intramuscular and intravenous administration.

Indications for use

Edema that develops with diseases:

• nephrotic syndrome;
• chronic heart failure of the second and third degree;
• cirrhosis of the liver.

It is used in the following pathological conditions:

• pulmonary edema;
• swelling of the brain;
• cardiac asthma;
• eclampsia;
• hypercalcemia;
• severe arterial hypertension;
• some forms of hypertensive crisis.

The drug is used during forced diuresis.

Contraindications

• acute glomerulonephritis;
• stenosis of the urethra;
• hyperuricemia, hypokalemia;
• obstruction urinary tract stone;
• acute renal failure, accompanied by anuria;
• alkalosis;
• acute myocardial infarction;
• severe liver failure;
• diabetic coma, hyperglycemic coma;
• hepatic precoma and coma;
• arterial hypotension;
• gout;
• decompensated aortic and mitral stenosis;
• hypertrophic obstructive cardiomyopathy;
• high central venous pressure;
• digitalis intoxication;
• pancreatitis;
• violation of water and electrolyte metabolism (hypomagnesemia, hypocalcemia, hyponatremia, hypochloremia, hypokalemia, hypovolemia);
• hypersensitivity to the drug;
• precomatose states.

With extreme caution prescribed to women during pregnancy and breastfeeding, the elderly, as well as patients suffering from severe atherosclerosis, hypoproteinemia, diabetes mellitus and prostatic hyperplasia.

Instructions for use Furosemide (method and dosage)

The dosage and form of the drug is selected individually depending on the indications, the severity of the disease and the age of the patient. If necessary, the dosage may be adjusted during therapy.

Tablets

Taken orally before breakfast.

The initial dosage for adults is 20-40 mg per day. If necessary, the dose is increased to 80-160 mg per day, which are taken in 2-3 doses with an interval of 6 hours. The maximum daily dosage is 600 mg. After elimination of puffiness, the dosage is reduced and the drug is taken at intervals of 1-2 days.

The initial dosage for children is 1-2 mg per kilogram of body weight. The maximum allowable dose is 6 mg/kg.

• For the treatment of edema in CHF, 20-80 mg of furosemide per day is prescribed. The recommended dose is divided into 2-3 doses with an equal interval.
• To eliminate edema in chronic kidney disease, the initial dosage is 40-80 mg per day. The drug is taken once or divided into 2 equivalent doses. In the future, the dosage is adjusted depending on the diuretic response. Maintenance therapy for patients on hemodialysis is 250-1500 mg per day.
• For the treatment of arterial hypertension, 20-40 mg per day is prescribed. To achieve the maximum effect, Furosemide should be combined with antihypertensive drugs.
• With nephrotic syndrome, 40-80 mg per day is prescribed. In the future, the dosage is adjusted depending on the body's response to ongoing therapy.

Injection

With jet intravenous or intramuscular injection the recommended dose for adult patients is 20-40 mg per day. In rare cases, it is possible to increase the dosage by 2 times, which are administered twice a day.

Side effects

Furosemide may cause the following side effects:

• Cardiovascular system: decrease blood pressure, arrhythmia, tachycardia, orthostatic hypotension, collapse.
• Nervous system: drowsiness, myasthenia gravis, apathy, weakness, lethargy, confusion, calf muscle cramps, headache, paresthesia, adynamia.
• Sense organs: impaired hearing and vision.
• Gastrointestinal tract: dry mouth, nausea, exacerbation of pancreatitis, thirst, vomiting, loss of appetite, diarrhea or constipation and cholestatic jaundice.
• Genitourinary system: hematuria, interstitial nephritis, acute urinary retention, reduced potency.
• Hematopoietic system: aplastic anemia, agranulocytosis, leukopenia and thrombocytopenia.
• Water and electrolyte metabolism: hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, hypocalcemia, hypochloremia, hypokalemia.
• Metabolism: hyperglycemia, muscle weakness, convulsions, arterial hypotension, hyperuricemia and dizziness.
• Allergic reactions: multiform exudative erythema, photosensitivity, pruritus, exfoliative dermatitis, urticaria, vasculitis, purpura, fever, chills, necrotizing angiitis and anaphylactic shock.

Overdose

In case of an overdose of Furosemide, the following is observed:

• pronounced decrease in blood pressure, collapse, shock;
• hypovolemia, dehydration, hemoconcentration;
• arrhythmias;
• acute renal failure with anuria;
• thrombosis, thromboembolism;
• drowsiness, confusion;
• flaccid paralysis, apathy.

Treatment requires normalization of the water-electrolyte balance and acid-base state, replenishment of the volume of circulating blood, gastric lavage, activated carbon, symptomatic treatment. There is no specific antidote.

Analogues

Furosemide analogues according to the ATC code: Lasix, Furon, Furosemide injection solution, Fursemide.

Do not make the decision to change the drug yourself, consult your doctor.

pharmachologic effect

The active component of the drug has a diuretic property, helping to remove water from the body with magnesium and calcium ions.

The use of Furosemide in heart failure leads to a rapid decrease in the preload on the heart caused by the expansion of large veins.

The effect of the drug after intravenous administration occurs very quickly - after five to ten minutes, and after oral use - after an hour. The duration of the diuretic action of Furosemide varies from two to three hours. With reduced kidney function therapeutic effect medication lasts up to eight hours.

special instructions

• Before starting treatment, you should make sure that the urinary system is functioning normally and that there is no violation of the outflow of urine.
• Patients undergoing treatment with Furosemide require periodic monitoring of blood pressure, uric acid, plasma electrolytes, creatinine, kidney and liver function, and glucose levels.
• During the administration of the drug, administration should be discontinued. vehicle and work with complex mechanisms requiring increased concentration and reaction rate.
• Furosemide solution for intravenous or intramuscular injection should not be mixed in the same syringe with other drugs.

During pregnancy and breastfeeding

Contraindicated during pregnancy and breastfeeding.

In childhood

Contraindicated in children under the age of 3 years.

In old age

It is prescribed with caution to elderly patients.

For impaired renal function

Patients with chronic renal failure require careful selection of the dosage of the drug.

Contraindicated in acute glomerulonephritis and acute kidney failure with anuria.

For impaired liver function

It is prescribed with extreme caution to patients with severe liver dysfunction. Requires selection of the dosage of the drug. Contraindicated in patients with severe liver failure, with hepatic coma and precoma.

Furosemide for weight loss is a very popular method that allows you to get rid of extra pounds in a couple of days. The number of drugs that are used for these purposes is huge, but this diuretic is considered the most accessible and well-known. In medical practice, Furosemide has been used for a long time, so all its positive aspects and side effects have been well studied. According to the reviews of losing weight, Furosemide helps to lose weight perfectly when it appears as a result of fluid retention in the body.

Can Furosemide Help You Lose Weight?

Before studying the question of how to drink Furosemide for weight loss, you need to find out how effective the drug is. The composition of the tablets, in addition to the main component, contains: potato starch, magnesium stearate and milk sugar. A diuretic (a group of diuretics) increases urine production. This process helps to draw additional fluid from the tissues, so the medicine is prescribed for people suffering from kidney, liver, cardiovascular pathologies, and not from excess weight.

A side effect of treatment with Furosemide is weight loss, but this is only a temporary effect. Fat deposits remain in place, only water leaves, which, after the abolition of the diuretic, will return again. For this reason, you should not rely solely on Furosemide if you want to get rid of a few excess weight. The drug will only help for a short period of time, so it is better to use it as an express method, but first you need to consult a specialist.

How does Furosemide work on excess weight?

According to the instructions for use, Furosemide diuretic tablets for weight loss are not used. However, reviews of those who are losing weight about this drug claim that its periodic use allows you to control weight and keep your figure normal. Just one tablet of Furosemide after a stormy feast helps to avoid swollen legs and a swollen face in the morning, which means you can seem slim and fresh at work. But do not think that this medicine is a panacea for weight loss. Furosemide is a very powerful drug that should be used as directed by a doctor.

The main plus of Furosemide is the ability to instantly start the withdrawal of water. Already two hours after taking the pill, excess fluid begins to be released from the body. However, along with it, useful substances also leave: vitamins, trace elements, especially calcium, iron, sodium, magnesium, and potassium. The result of such weight loss can be deplorable for health. The heart suffers first, as its work becomes difficult due to a lack of potassium and magnesium, then the muscles lose their tone. It may take several weeks to restore the normal functioning of the body after taking Furosemide for weight loss.

Contraindications for use

Weight loss with Furosemide is contraindicated during pregnancy and lactation. Also, the medication should be abandoned in the presence of the following conditions:

• diabetes;
• gout;
• pancreatitis;
• violation of water-salt metabolism;
• obstruction of the urinary tract;
• kidney or liver failure;
• hypersensitivity to sulfonamides.

How to take Furosemide for weight loss

As already mentioned, if you take Furosemide to lose weight without diets and physical activity the effect will not last long. The lost fluid, respectively, and the initial weight, will return in two days. Taking Furosemide for weight loss requires strict adherence to the dosage. It is advisable to drink no more than 1-3 tablets per day (depending on weight) with a break of 3-4 hours. If Furosemide is selected in ampoules, then it must be administered intravenously for two minutes (dose 2-4 ml). If it is impossible to administer the drug into a vein, an intramuscular method can be used.

Doctors strongly recommend a one-day daily intake of the drug for weight loss. If there are no side effects, then if necessary, Furosemide tablets can be used for two days in a row. In order not to harm the body, you should follow some rules:

1. Salt should be excluded from the diet, otherwise, in combination with Furosemide, weight loss can lead to dehydration.
2. When combining a diuretic with other drugs, you should carefully read the instructions, because if they are incompatible, their effectiveness is reduced.
3. It is necessary to increase the amount of water consumed to 2-3 liters per day.
4. It is advisable to include in the diet natural products with a diuretic effect: oats, lemon and cranberry juice, beets, celery, carrots and other natural diuretics.

Side effects

The body can react to the action of diuretic tablets with unwanted side reactions. Uncontrolled intake of Furosemide for weight loss can provoke disturbances in work following systems and organs:

• heart, blood vessels and circulatory system: arrhythmia, tachycardia, lowering blood pressure, dizziness, convulsions.
• Genitourinary system: decreased potency, urinary retention, nephritis, oliguria.
• Sense organs: dry mouth, blurred vision, hearing loss.
• Skin: itching, rashes, redness.
• Digestive system: nausea, vomiting, diarrhea, constipation.

Why should Furosemide and Asparkam be taken together?

Asparkam is a medicine designed to improve metabolic processes in the body. Prescribe a drug to restore electrolyte balance, for fast travel potassium and magnesium ions into tissue cells. The agent has an antiarrhythmic effect, reduces myocardial excitability, improves blood circulation.

When losing weight with the diuretic Furosemide, beneficial substances leave the body. In order for them to be quickly replenished, the lost resources will help to return Asparkam's reception. It is desirable to take the medicine in the same dosage, at the same time and with the same course as Furosemide.

The opinion of doctors about the drug

Doctors say that powerful diuretics, such as Furosemide, are prescribed exclusively for pathologies of the liver, kidneys or heart, in order to get rid of painful swelling. The instructions for use of the drug do not say anything about losing weight, so using the medicine for this purpose is not only useless, but also dangerous.

In case of an overdose, all systems can suffer. The consequences of taking Furosemide can lead to symptoms of diseases of the nervous, digestive, genitourinary and cardiovascular systems. For men, such weight loss can result in impotence. Furosemide should be taken strictly under the supervision of the attending physician.

Highly active diuretics. Sulfonamides. ATS code: C03CA01.

pharmachologic effect

"Loop" diuretic. In ordinary therapeutic doses violates the reabsorption of sodium ions, chlorine in the thick segment of the ascending part of the loop of Henle. Due to the increase in the release of sodium ions, there is a secondary (mediated by osmotically bound water) increased excretion of water and an increase in the secretion of potassium ions in the distal part of the renal tubule. Furosemide has secondary effects due to the release of intrarenal mediators and the redistribution of intrarenal blood flow. These effects increase the perfusion of the medullary layer of the kidneys. Furosemide has a hypotensive effect due to an increase in the excretion of sodium chloride and a decrease in the response of vascular smooth muscles to vasoconstrictor effects and as a result of a decrease in BCC. In heart failure, it quickly leads to a decrease in the preload on the heart through the expansion of large veins. The diuretic effect is dose dependent. Against the background of course treatment, the weakening of the effect does not occur. Furosemide does not change the glomerular filtration rate and remains effective at a low glomerular filtration rate.

The onset of diuresis is observed within the first hour after oral intake furosemide. The peak of the diuretic action occurs in the first two hours after ingestion, and the duration of the diuretic effect is 6-8 hours.

Indications for use

Edema of cardiac or renal origin. Edema of hepatic origin, usually in combination with potassium-sparing diuretics. Arterial hypertension in patients with chronic renal failure who are contraindicated in the appointment of thiazide diuretics (especially with creatinine clearance below 30 ml / min). Dosage and administration

The drug is taken orally before meals. The dose depends on the course and severity of the disease.

Adults. With edema of cardiac, renal or hepatic origin:

Moderate condition: Vi-l tablet per day; severe condition: 2-3 tablets per day in 1 or 2 doses, or 3-4 tablets per day in 2 doses.

With high blood pressure in patients with chronic renal failure: in combination with other antihypertensive agents (antagonists of the renin-angiotensin system), the recommended usual doses are 20-120 mg per day in 1 or 2 doses. Changes in blood pressure should be carefully monitored when furosemide is used in conjunction with other antihypertensive drugs, especially during initial therapy. To prevent an excessive fall in blood pressure, the dose of other antihypertensive drugs should be reduced by at least 50% when furosemide is added to the main treatment.

Children. For the treatment of edema, the daily dose is 1-2 mg / kg of body weight in 1-2 doses.

Use in elderly patients. Dose selection and adjustment in elderly patients should be made with caution, usually starting at the lower end of the therapeutic dose range.

Side effect

Sosides of cardio-vascular system: lowering blood pressure, orthostatic hypotension, collapse, tachycardia, arrhythmias, decreased blood volume.

From the side nervous system: dizziness, headache, muscle weakness, spasms of the calf muscles (tetany), apathy, adynamia, weakness, lethargy, drowsiness, confusion.

From the sense organs: visual and hearing impairment (hearing loss and tinnitus, usually transient, appear in rare cases, especially in patients with renal insufficiency, hypoproteinemia (for example, with nephrotic syndrome)).

From the side digestive system: hepatic encephalopathy in patients with hepatocellular insufficiency, increased transaminases, anorexia, dry mouth, thirst, nausea, vomiting, diarrhea, constipation, cholestatic jaundice, pancreatitis (exacerbation).

From the side genitourinary system: oliguria, acute urinary retention (in patients with prostate adenoma), muscle spasm, spasm Bladder, interstitial nephritis, hematuria, reduced potency.

Allergic reactions: urticaria, eosinophilia, exfoliative dermatitis, erythema multiforme, vasculitis, necrotizing angiitis, pruritus, chills, fever, photosensitivity, anaphylactic and/or anaphylactoid reactions, purpura, paresthesias (burning, pain), bullous reactions (bullous pemphigoid, erythema), syndrome Stevens-Johnson, toxic epidermal necrolysis.

From the side of the hematopoietic organs: leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia.

From the side of water-electrolyte metabolism: hypovolemia, dehydration (risk of thrombosis and thromboembolism), hypokalemia, hyponatremia, hypochloremia, hypocalcemia, hypomagnesemia, metabolic alkalosis.

Impact on laboratory parameters: hyperglycemia, increased cholesterol, low-density lipoproteins (when taking large doses of the drug), hyperuricemia, glucosuria, hypercalciuria, increased blood creatinine levels.

When adverse reactions you should reduce the dose or stop the drug, and also consult a doctor.

Contraindications

hypersensitivity to active substance or to any of the excipients of the drug; hypersensitivity to sulfonamides due to possible manifestation cross-allergy to furosemide; acute renal failure; hepatic encephalopathy; obstruction of the urinary tract; hypovolemia or dehydration; decompensated hypokalemia; decompensated hyponatremia; breast-feeding; galactosemia, glucose-galactose malabsorption syndrome, lactase deficiency; pregnancy; furosemide is not recommended for use in combination with lithium; hepatitis and hepatocellular insufficiency in patients on hemodialysis with severe renal failure (creatinine clearance

Overdose

Symptoms: pronounced decrease in blood pressure, collapse, shock, hypovolemia, dehydration, hemoconcentration, arrhythmias (including atrioventricular blockade, ventricular fibrillation), acute renal failure with anuria, thrombosis, thromboembolism, drowsiness, confusion, flaccid paralysis, apathy, hypokalemia and hypochloremic alkalosis.

Treatment: correction of water-salt balance and acid-base balance, replenishment of circulating blood volume, symptomatic treatment, maintenance of vital functions. There is no specific antidote.

Precautionary measures

In the presence of ascites without peripheral edema, it is recommended to use furosemide in doses that provide additional diuresis in a volume of not more than 700-900 ml per day in order to avoid the development of oliguria, azotemia and electrolyte disturbances.

Long-term use can lead to weakness, fatigue, low blood pressure and cardiac output, and excessive diuresis in myocardial infarction with congestion in the pulmonary circulation may contribute to the development of cardiogenic shock.

In patients receiving high doses of furosemide, in order to avoid the development of hyponatremia and metabolic alkalosis, it is not advisable to limit the intake of table salt. For the prevention of hypokalemia, the simultaneous administration of potassium preparations and potassium-sparing diuretics is recommended, as well as a diet rich in potassium. Increased diuresis causes dehydration and hypovolemia, which can lead to arterial thrombosis, especially in elderly patients. All patients receiving furosemide should be monitored for signs of electrolyte imbalance (hyponatremia, hypochloremic alkalosis, hypokalemia, hypomagnesemia): dry mouth, thirst, weakness, drowsiness, muscle pain, muscle spasms, muscle weakness, arterial hypotension, oliguria, tachycardia, arrhythmia, gastrointestinal disorders.

random reception medicinal product can lead to hypovolemia, dehydration. In hepatocellular insufficiency, treatment should be carried out with caution, under strict control of electrolytes, given the risk of hepatic encephalopathy. If necessary, stop treatment immediately.

Taking furosemide in case of partial obstruction of the urinary tract can lead to urinary retention. Diuresis should be closely monitored, especially at the start of treatment with furosemide.

Patients with hypersensitivity to sulfonamides and sulfonylurea derivatives may have cross-sensitization to furosemide.

When using thiazide diuretics, there have been cases of photosensitivity reactions. If photosensitivity reactions occur, furosemide should be discontinued. If necessary, it is recommended to protect exposed areas of the skin exposed to sunlight or ultraviolet radiation from artificial sources.

Since the drug contains lactose, its use is not recommended in patients with galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome.

When treating with furosemide, careful monitoring and dose adjustment is required in the following cases:

In patients at risk of cerebral, coronary ischemia or other ischemia associated with circulatory failure; in patients with hepatorenal syndrome (renal failure associated with severe liver disease); in patients with hypoproteinemia in the case of nephrotic syndrome: a possible decrease in the effect of furosemide and potentiation of side effects, especially ototoxicity.

Increased urine output may cause or worsen urinary retention in patients with urinary tract obstruction.

Treatment with furosemide can lead to a transient increase in creatinine, cholesterol, triglycerides.

There have been several cases of kidney stones in premature infants receiving high doses of furosemide injections due to the development of hypercalciuria.

Electrolyte balance:

Natremia, It is necessary to control the level of sodium before starting therapy and regularly monitor it thereafter. Treatment with diuretics can provoke hyponatremia. A decrease in the level of sodium in the blood is initially asymptomatic, regular monitoring should be more frequent in patients at risk: elderly age, cachexia (malnutrition) or cirrhosis.

Potassium. When applied loop diuretics possible decrease in sodium levels with hypokalemia. Risk of sudden hypokalemia (

Glycemia. The frequency of glycemia is low, however, with diabetes it is necessary to systematically monitor the level of glucose in the blood and urine.

Uricemia. The release of uric acid decreases, therefore, with hyperuricemia and especially gout, the use is not recommended.

Creatinine Regular monitoring of serum creatinine is recommended during treatment with furosemide.

Careful monitoring of patients with a high risk of developing electrolyte disorders (vomiting, diarrhea, sweating) is necessary. Dehydration, hypovolemia, or acid-base imbalance require treatment adjustment and/or temporary discontinuation of treatment.

Athletes. The presence of furosemide gives positive tests during anti-doping control.

Newborns and premature babies. In newborns and premature babies long-term use high doses of furosemide increases the risk of developing nephrocalcinosis and / or nephrolithiasis. Ultrasound monitoring of the kidneys is recommended.

Application during bpregnancy and lactation

There are currently insufficient clinical data to assess the potential teratogenicity of furosemide when taken during pregnancy. Furosemide should be avoided in pregnant women and should never be used to treat physiological edema in pregnancy. Diuretics can cause placental ischemia with the risk of fetal malnutrition. Careful monitoring of fetal growth is necessary. Because furosemide can be excreted from breast milk, as well as suppress lactation, if necessary, the use of the drug during lactation, breastfeeding should be stopped.

Influence on the ability to drive vehicles and otherpotentially dangerous mechanisms

When using furosemide, the possibility of a decrease in the ability to concentrate cannot be ruled out, therefore, driving vehicles and other activities that require increased attention and reaction speed are not recommended.

Interaction with other drugs

hypokalemia

With the simultaneous use of glucocorticosteroids, amphotericin B, laxatives, the risk of developing hypokalemia increases, with cardiac glycosides the risk of developing digitalis intoxication due to hypokalemia increases.

Hyponatremia

Taking diuretics, desmopressin, antidepressants that inhibit reverse capture serotonin, carbamazepine and oxcarbazepine increases the risk of hyponatremia.

Ototoxicity

The ototoxicity of aminoglycosides, glycopeptides such as vancomycin and teicoplanin, and other ototoxic drugs may be increased by concomitant use of furosemide. Since this can lead to irreversible hearing loss, these drugs are used concomitantly with furosemide only in exceptional cases.

The simultaneous use of furosemide and lithium preparations is not recommended. The level of lithium in the blood serum increases with signs of overdose, the renal clearance of lithium preparations decreases and the toxicity of lithium preparations increases. If simultaneous reception drugs cannot be avoided, close monitoring of serum lithium levels and dose adjustment of lithium are necessary.

Combinations requiring special care:

Furosemide should be used with caution in combination with risperidone, as mortality may be increased in elderly patients. The need for joint use must be justified taking into account the risk and benefits of this combination. The risk of mortality increases in the presence of dehydration.

anti-inflammatory nessteroid drugs, including aspirin, in anti-inflammatory doses acetylsalicylic acid(≥1 g per dose and/or ≥3 g per day) or analgesics at antipyretic doses (≥500 mg per dose and/or

Medicines that increase the risk of hypokalemia: monitoring of the level of potassium in the blood serum is necessary.

Digitalis preparations: hypokalemia increases the cardiac toxicity of digitalis preparations.

potassium-sparing diuretics, alone or in combination (amiloride, potassium canrenoate, eplerenone, spironolactone, triamterene): the possibility of hypokalemia cannot be ruled out. Serum potassium and ECG monitoring is recommended.

Aminoglycosides: potentiation of nephrotoxic and ototoxic effects of drugs.

Phenytoin: decrease in diuretic effect up to 50%. Higher doses of furosemide may be used.

Carbamazepine: risk of symptomatic hyponatremia.

Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists: risk of sudden arterial hypotension and / or acute renal failure. It is recommended to temporarily stop the use of furosemide or reduce its dose 3 days before the start of treatment with ACE inhibitors / angiotensin II receptor antagonists. In congestive heart failure, it is recommended to start treatment with low doses. ACE inhibitors. It is recommended to monitor kidney function (determination of creatinine) in the first weeks of treatment with ACE inhibitors / angiotensin II receptor antagonists.

Medicines that increase the risk of ventricularand arrhythmias:

Class 1a antiarrhythmic drugs (quinidine, hydroquinidine, disopyramide), class III (amiodarone, sotalol, ibutilide, dofetilide); some antipsychotics: phenothiazines (aminazine, cyamemazine, fluphenazine, levomepromazine, pipothiazine), benzamides (amisulpride, sulpiride, sultopride, tiapride), butyrophenones (droperidol, haloperidol, pipamrenone), other antipsychotics (pimozide, sertindole, flupentixol, zuclopenthixol); other drugs: bepridil, cisapride, difemanil, dolasetron IV, dronedarone, spiramycin, erythromycin IV, mizolastine, levofloxacin, halofantrine, lumefantrine, pentamidine, vincamine IV, moxifloxacin, mequitazine, methadone, toremifene, citalopram, escitalopram and others.

Concomitant use of furosemide with these medicinal products may increase the risk of ventricular arrhythmias, including potentially dangerous torsades de pointes (hypokalemia is a predisposing factor). Before taking the drug, monitoring of electrolyte, electrocardiographic parameters is recommended.

Metformin: development of lactic acidosis is possible. Metformin should not be used if creatinine levels exceed 15 mg/L (135 µmol/L) in men and 12 mg/L (110 µmol/L) in women.

Baclofen: increased risk of arterial hypotension, including orthostatic hypotension. It is recommended to monitor blood pressure and, if necessary, adjust the dose of the antihypertensive drug.

Significant interactions of furosemide with other drugsyou:

Cyclosporine: risk of increased blood creatinine levels, risk of hyperuricemia and gout; neuroleptics, tricyclic antidepressants, amifostine, nitrates: increased risk of arterial hypotension, including orthostatic hypotension; alpha-blockers used in urology (alfuzosin, doxazosin, prazosin, terazosin, tamsulosin), antihypertensive alpha-blockers: increase

hypotensive action, increased risk of orthostatic hypotension;

Vacation from pharmacies

On prescription.

Manufacturer

RUE "Belmedpreparaty"

Republic of Belarus, 220007, Minsk,

st. Fabriciusa, 30, t./fa.: (+375 17) 220 37 16,

e-mail: [email protected]

Some facts about the product:

Instructions for use

Price in the online pharmacy site: from 20

Description

Furosemide is a highly effective synthetic pharmaceutical agent intended for the treatment of excessive accumulation of fluid in the tissues and cavities of the body, which increases urine output.

Production form, composition

A pharmaceutical preparation is produced in the form of tablets for oral administration and a solution for injection into the muscle and intravenous administration.

Tablets of the medical device are flat, cylindrical in shape with a chamfer, white.

The active ingredient of the tablets: furosemide 40 mg.

Inactive substances: potato starch, lactose monohydrate, magnesium stearate.

The drug solution is made in the form of a clear liquid without color or with a slight yellowish tint.

Active ingredient: furosemide 20 mg.

Inactive ingredients: sodium hydroxide, sodium chloride, water for injection.

Pharmacology

The drug belongs to sulfonamide derivatives. Its effect occurs in the loop of Henle due to relaxation smooth muscles vessels and increased blood flow in the kidneys. As a result, the production of prostaglandin E2 and I2 in vascular cells increases, the mechanism of the reverse-countercurrent system of the loop of Henle is disrupted, glomerular filtration increases and, as a result, the diuretic effect increases.

In therapeutic doses, the pharmaceutical preparation leads to a reabsorption of sodium and chlorine ions in the thick segment of the ascending loop of Henle.

As a result of increased excretion of sodium ions, there is a secondary intensive excretion of fluid and an increase in the production of potassium ions in the distal convoluted tubules. The secondary effect of Furosemide is due to the release of intrarenal mediators and the redistribution of blood flow in the kidneys.

The drug helps to lower blood pressure by increasing the excretion of sodium ions and reducing the response of vascular smooth muscles to vasoconstrictor effects and, as a result, reducing the volume of circulating blood. With functional disorders of the heart, it instantly leads to a decrease in the volume of blood flowing to the myocardium due to the expansion of large veins. The acceleration of blood filtration in the nephron channels and the removal of excess fluid from the body depends on the dose of the drug. When Furosemide is used in a course, the effect of the drug does not weaken. The glomerular filtration rate is not impaired by the drug, but its effectiveness is maintained at a low glomerular filtration rate.

The diuretic effect when using the medication in tablets is noted after 20-30 minutes, the highest therapeutic result is manifested within 1-2 hours.

With the introduction of a medication into a vein, an almost instantaneous diuretic effect is achieved - after 5 to 10 minutes.

The duration of the result after a single application lasts longer than 4 hours, with disorders of the kidneys, this period can be extended up to 8 hours.

Pharmacokinetics

The active ingredient of the pharmaceutical product after administration is rapidly absorbed from the digestive organs, the bioavailability of which reaches 64%. The highest amount of the drug in the blood increases with increasing dosage, but the period of its achievement is independent of the dose, and varies over a wide range, depending on the patient's condition.

Up to 95% binds to blood albumins. The active substance passes through the placenta and is excreted in mother's milk. The process of biotransformation takes place in the liver, resulting in the formation of glucuronide. The pharmaceutical preparation and its biotransformation products are quickly excreted by the urinary system. The time for which serum concentration substances is reduced by half, is 1 - 1.5 hours. During the day, approximately 50% of the dose that enters the body is excreted in the urine, while in the first 4 hours 59% of the total medication that is excreted in 24 hours. The rest of the medication leaves the body with feces.

Indications for use

The instructions for the medication indicate the following range of indications for the appointment:

Regulations for the use of Furosemide, dosing

Instructions for use for the medicine gives clear instructions for use and dosing. Tablets are administered orally before meals. The selection of the dosage of the medication depends on the severity of the disease and the severity of the symptoms. Per day, 1 tablet (40 mg) is prescribed in the morning. With incomplete exposure, it is possible to increase the dosage from 2 to 4 tablets, the reception is divided into 2-3 times with an interval of 6 hours. After reducing swelling, the dosage is reduced, the reception is carried out with an interval of 1 - 2 days. The highest dose per day is 4 tablets (160 mg).

With high blood pressure, the medication is started with a dose of 80 mg once for 24 hours, divided into 2 times. The dosage should be prescribed according to the patient's condition. With an insufficient therapeutic result, Furosemide is recommended to be used with other pharmaceuticals that reduce blood pressure.

In the presence of myocardial dysfunction, the allowable dose per day can be increased to 2 tablets (80 mg).

For children aged 3 years and older, the dose per day averages 4-3 mg / kg, divided by 1-4 times. The highest therapeutic result from the medication is observed in the first 3-5 days of use.

After the disappearance of puffiness, the pharmaceutical preparation is prescribed in a day or up to 2 times a week.

In the case when the child did not receive this medication or other medications designed to remove fluids from the body with urine, Furosemide should not be prescribed in an average daily dosage. First, the pharmaceutical product is recommended to be used in ¼ - ½ of the average daily dose. Only in the absence of a diuretic effect, the dosage is increased. The initial dose for children is 2 mg / kg, if necessary, it can be increased by 1 - 2 mg / kg.

A solution of the drug is used for injection into a vein and rarely for injection into a muscle. The dosage is selected specifically for the individual patient on the basis of his condition, in the course of treatment it is possible to adjust it. This form of medication is used in urgent cases or with severe swelling of the tissues.

With a pathological accumulation of an excessive amount of fluid in the tissues and cavities of the body, the solution is used for adults and children from 15 years of age, starting with 1-2 ampoules (20-40 mg). It is injected into the vein for 1 - 2 minutes. If diuretic action is not achieved, then continue administration every 2 hours at a dose higher by 50% until healing effect. The highest daily dose is 600 mg.

For emergency methods detoxification of the body by increasing the volume of urine excreted from the body in case of severe poisoning, 1-2 ampoules (20-40 mg) are used together with an electrolyte infusion solution.

With a sharp excessive increase in blood pressure to critical levels, a pharmaceutical preparation is prescribed in 1-2 ampoules for injection into a vein. The dosage is adjusted according to need and the patient's response to treatment.

For children under 15 years of age, an average of 0.5 - 1.5 mg / kg is used for injection into the muscle and injection into the vein.

When the expected therapeutic result is achieved, therapy is continued by taking the medication inside.

Contraindications

Furosemide is contraindicated for use in the presence of the following list of pathologies and conditions of the body:

Carefully

Furosemide is used with caution in the following range of pathologies:

• BPH.
• Libman-Sachs disease.
• An abnormally low level of protein in the blood plasma (the risk of damage to the auditory and vestibular apparatus by chemical compounds).
• Diabetes.
• Violation of blood circulation in the vessels of the brain due to the formation of atherosclerotic plaques in them.

Unwanted Consequences

The use of the drug can lead to the following range of undesirable consequences:

• A painful feeling in the epigastric zone or in the pharynx, ending in vomiting.
• Reflex involuntary emptying of the stomach through the mouth.
• Decrease in the volume of circulating blood.
• Dehydration of the body.
• Increased blood flow to organs and tissues.
• Skin itching.
• Decreased blood pressure.
• Disorders of frequency, rhythm and sequence of contractions of the heart muscle.
• A specific type of violation of the sensitivity of the skin.
• Reversible hearing and visual impairment.
• Acute or chronic inflammatory process in the interstitial tissue and tubules of the kidneys.

Due to increased urine output, the following undesirable consequences may occur:

• Vertigo.
• Weakness in the body and muscles.
• Irresistible desire to drink water.
• Depressive state.
• Dehydration of the body.
• Deficiency of potassium in the body.
• Lack of sodium in the body.
• Lack of chlorine in the body.
• Pathological accumulation of bases or excessive loss of acids from the body.
• Metabolic disorder with excessive accumulation of uric acid in the blood.
• Exacerbation of gouty arthritis.
• Abnormal increase in blood sugar.
• Deterioration in obstruction of the urinary tract.

If adverse events appear, then immediately reduce the dosage of the pharmaceutical product or completely cancel it.

Compatibility of Furosemide with other medicines

The simultaneous use of a pharmaceutical preparation with cardiac glycosides increases the risk of poisoning with cardiac glycosides. Parallel use of the drug with glucocorticoids can cause a decrease in the content of potassium in the blood.

Furosemide enhances the effect of drugs that reduce the tone of skeletal muscles and normalize blood pressure.

When the drug is used together with aminoglycosides, antibiotics of the cephalosporin group and cisplatin, their concentration in the blood may increase, which is fraught with damage to the hearing and vestibular apparatus or disruption of the kidneys by chemical compounds.

The diuretic effect of the drug decreases with parallel treatment with non-steroidal anti-inflammatory drugs.

Furosemide, used in parallel with drugs that reduce blood sugar, weakens their effect.

The simultaneous use of a pharmaceutical preparation with medicines containing lithium can provoke an increase in the quantitative number of lithium in the blood.

The use of contrast agents containing iodine in higher doses increases the risk of disorders of renal activity, due to excessive loss of fluid from the body. Before using contrast agents containing iodine, it is necessary to compensate for the lost volume of fluid in the body.

Driving a car

During the period of therapy, you should refrain from work, the required clear concentration and driving.

Storage

Away from children and sunlight, at a temperature not exceeding 25°C.

Storage period

No more than 2 years. After the expiration of the period of suitability for use is not allowed.

Vacation by pharmacies

It is sold by pharmacies upon presentation of a prescription sheet.

Analogues

The pharmaceutical product has many drugs that are identical in active substance or the effect of an imported manufacturer:

• Lasix manufactured in India, Aventis Pharma Limited.
• Diusemide is manufactured in Jordan by Arab Pharmaceutical Manufacturing Co Ltd.
• Difurex of Indian origin, Menon Pharma.
• Kinex pharmaceutical from India, Unique Pharmaceutical Laboratories.
• Novo-Semid is manufactured in Canada by Novofarm.
• Tasek of Indian origin, Tata Pharma.
• Tasimaid made in India, Tamilnadu Dadha Pharmaceuticals Ltd.
• Indian-made urix, Torrent Pharmaceuticals.
• Florix medicine from India, Rusan Pharma.
• Fruziks is produced in India by British Pharmaceutical Laboratories.
• Furosemix of French origin, Biogalenique.