Treatment of swelling, in adults and children, associated with congestive heart failure, cirrhosis and kidney disease, when the use of diuretics with a strong and fast action is indicated. Hypertension in adults, mainly in combination with other antihypertensive drugs.
Composition:
1 tabl contains 40 mg furosemide.
Action:
Diuretic from the group of loop diuretics. It inhibits chloride back-flow resorption in the ascending arm of the nephron loop, increasing the excretion of sodium. Increases the excretion of potassium, Calcium, Magnesium and phosphates. It reduces the excretion of uric acid. It lowers blood pressure and reduces the tension of the walls of blood vessels. Bioavailability is 60-70% and decreases in severe renal insufficiency to 36-44%. The onset of action occurs in the first hour after administration, the diuretic effect persists for 6-8 h. Plasma protein binding is approximately 95%. Furosemide is excreted mainly unchanged. T0,5 in the blood is 1-1.5 hours and may be prolonged in patients with impaired liver function. It passes through the placenta barrier and into breast milk.
Contraindications:
Hypersensitivity to the preparation ingredients or sulfonamides. Anuria, disturbances of water and electrolyte balance. Pre-somatic states caused by cirrhosis of the liver.
Precautions:
In patients with renal insufficiency, treatment with azotemia and oliguria should be discontinued. Patients with prostatic hypertrophy or voiding disorders have an increased risk of acute urinary retention. Excessive dehydration may cause cardiovascular collapse and increase the incidence of thromboembolic complications. Patients with liver cirrhosis initiating furosemide therapy should be hospitalized; to prevent hypokalemia and metabolic alkalosis, potassium chloride or potassium-sparing diuretics (eg aldosterone antagonists) should be given during furosemide therapy. In patients with liver cirrhosis, both treated with ACTH or with systemic corticosteroids, the risk of hypokalemia may increase in case of rapid dehydration or insufficient supply of electrolytes. In patients with severe renal insufficiency using Furosemide, hearing damage is more common, manifesting in ringing or tinnitus and hearing loss, which usually disappears after discontinuation of the preparation. In diabetic patients, furosemide may exacerbate its symptoms, and in patients with latent diabetes may accelerate its manifestation.
Pregnancy and lactation:
Safety in pregnancy: category C. The drug can be used during pregnancy only if the anticipated benefits to the mother outweigh the potential risk to the fetus, apply for a short time. Use cautiously during breastfeeding - furosemide is excreted in breast milk, may inhibit lactation.
Side effects:
Furosemide is generally well tolerated. Side effects are usually moderate in severity and are only occasionally the cause of discontinuation of the drug. There may be gastrointestinal side effects (nausea, vomiting, constipation, diarrhea, abdominal pain, anorexia, jaundice, gastric irritation, sporadic acute pancreatitis), o.u.n. (tinnitus, headache and dizziness, blurred vision, seeing in yellow, paresthesia), immune system (exfoliative dermatitis, purpura, erythema multiforme, urticaria, rash, photosensitivity, pruritus, interstitial nephritis, vasculitis). In case of hypersensitivity reactions, the treatment should be discontinued. Blood disorders and systemic Absorbent: anemia, hemolytic anemia and rarely aplastic anemia, thrombocytopenia, leukopenia, hyperglycaemia, increase in uric acid in the blood, rarely agranulocytosis.In addition, orthostatic hypotension, hypovolaemia, hypovolemia, hyponatraemia, hypokalaemia, hypocalcemia, hypermalaemia, hyperglycemia, glucosuria, anxiety, weakness, fever, pollakiuria, jaundice, inhibition of lactation may occur.
Dosage:
Orally. Adults: a single starting dose is usually 40-80 mg, administered in the morning; if necessary, the initial dose can be increased or decreased. In long-term edema treatment, the maintenance dose is usually 40-80 mg / day; administered 1-2 times / day, every other day or for 2-4 consecutive days each week. In the treatment of severe edema, the maximum daily dose is 600 mg, administered in 3-4 doses. In chronic renal failure doses up to 4 g / day were used. Elderly furosemide is more slowly eliminated from the body, which may require a change in dosage. Children: usually 1-3 mg / kg / day. The maximum daily dose, regardless of the child's weight, is 40 mg. For long-term treatment, the lowest effective dose should be used.
(C)
