Edema, a symptom of cardiovascular disease (congestive heart failure), liver and kidneys (including liver cirrhosis and nephrotic syndrome). Hypertension, alone or in combination with other antihypertensive drugs.
Composition:
1 tabl contains 40 mg furosemide. The preparation contains lactose.
Action:
Diuretic from the group of loop diuretics. It inhibits chloride back-resorption in the ascending arm of the nephron loop, increasing the excretion of sodium, potassium, Calcium and Magnesium with water. It stimulates the production of prostaglandins, which may additionally increase diuresis due to vasodilatation and increase renal flow as well as direct inhibition of electrolyte transport in the ascending part of the Henle loop. It reduces blood pressure, initially by reducing plasma volume, extracellular fluids and cardiac output, and later as a result of reducing peripheral resistance. The bioavailability of the drug after oral administration is 60-70% and is reduced in renal insufficiency to 43-46%. In 91-99% it is bound to plasma proteins. It is excreted in the urine, mainly unchanged; 12% of the dose is excreted in faeces. T0,5 is 1-2 hours.
Contraindications:
Hypersensitivity to Furosemide, sulfonamides or other ingredients of the preparation. Anuria. Urinary tract obstruction. Pre-comedic conditions or hepatic coma. Shortages of electrolytes. Pregnancy and breastfeeding.
Precautions:
Use with caution in patients with prostatic hyperplasia and impaired urination. Furosemide is not indicated in patients with diabetes. The use of furosemide with lithium preparations is not recommended; if a simultaneous use is required, a reduction of the lithium dose should be considered. Due to the hypotensive effect of furosemide, it is recommended to reduce the dose of both hypotension and digitalis glycosides. In the case of combination therapy with digitalis and patients with liver cirrhosis, it may be necessary to administer potassium preparations and small doses of potassium-sparing diuretics. In patients treated with furosemide, the use of ACE inhibitor medication should be started with caution, dose reduction or discontinuation of furosemide for 2-3 days prior to administration of the ACE inhibitor. In case of rash, allergy to light, fever, interstitial nephritis or vasculitis, the drug should be discontinued. Due to the lactose content, the preparation should not be used in patients with hereditary galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose.
Pregnancy and lactation:
The drug is contraindicated during pregnancy and breastfeeding.
Side effects:
Disturbances in water-electrolyte and acid-base balance (hypovolaemia with hypotension, hyponatraemia, hypokalaemia, increased calcium loss in the urine, hypochloremic alkalosis). Rare: nausea, stomach upset, increased uric acid and gout, transient increases in creatinine, Glucose and cholesterol in the blood, headache, dizziness, hypotension. Occasional rash, skin hypersensitivity to sunlight, pancreatitis. Furosemide may cause temporary or irreversible hearing disorder. Long-term use may cause hypomagnesaemia and very rarely - tetany.
Dosage:
Orally.edema: initially 40 mg in the morning, then 20 mg in the morning or 40 mg every other day or less often; however, a daily dose of 80 mg or more may be necessary, especially in oliguria.Hypertension: initially 40 mg twice daily, then the dose should be adjusted depending on the patient's response to the drug; in patients who do not achieve a sufficient reduction in blood pressure, an additional antihypertensive drug may be used (the dose of the second drug should initially be reduced by at least 50%).
(C)
