Furosemide

The recommended adult starting dose for treating edema is 40 mg to 80 mg. If a satisfactory result occurs within 6 hours, the dose may be decreased or kept the same. If edema continues longer than 6 hours, the dose may be increased by 20 mg to 40 mg.

The recommended adult daily dose of furosemide ranges from 20 mg to 200 mg. Once the effective single dose has been determined, it may be taken 1 to 3 times a day.

When treating hypertension (high blood pressure), the dose of furosemide starts at 20 mg to 40 mg twice a day. Doses of 40 mg twice a day are generally considered the maximum dose to treat high blood pressure. If blood pressure hasn't been reduced enough with this dose, other medications may be added to further reduce blood pressure.

For children, the dose of furosemide used is based on body weight. The recommended dose is up to 2 mg per kilogram of body weight each day, divided into 2 to 4 equal doses.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones above, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Furosemide exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Furosemide at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause headaches; it may cause diarrhea; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; it may cause blurred vision; it may lower your blood pressure, which could cause weakness and/or dizziness - use caution when getting up from a lying or sitting position and when driving. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

20 mg
Each white, round, scored tablet contains 20 mg of furosemide.

40 mg
Each yellow, round scored tablet contains 40 mg of furosemide.

80 mg
Each yellow, scored, elongated tablet contains 80 mg of furosemide.

Do not take furosemide if you:

• are allergic to furosemide or any ingredients of the medication
• are allergic to sulfonamide medications
• are an infant suffering from certain diseases (e.g., Rh incompatibility, familial non-hemolytic jaundice)
• are breast-feeding
• are jaundiced (have yellowing of the skin and eye pigments), especially newborn infants
• are suffering from dehydration
• have complete kidney shutdown
• have extremely low blood levels of sodium or potassium
• have hepatic coma or precoma
• have Low Blood Pressure

There may be an interaction between furosemide and any of the following:

• acetylsalicylic acid (Asa)
• Aldesleukin
• Aliskiren
• Allopurinol
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• alpha agonists (e.g., Clonidine, methyldopa)
• amifostine
• aminoglycoside antibiotics (e.g., Amikacin, gentamicin, tobramycin)
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin converting enzyme (ACE) inhibitors (e.g., Lisinopril, Enalapril, Fosinopril)
• angiotensin II receptor antagonists (e.g., Irbesartan, Losartan)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, risperidone)
• antiseizure medication (e.g., Carbamazepine, Phenobarbital, Phenytoin, topirimate)
• barbiturates (e.g., butalbital, pentobarbital phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol, Timolol)
• beta2-agonists (e.g., formoterol, salbutamol, salmeterol)
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• chloral hydrate
• Cholestyramine
• Cisplatin
• Colestipol
• corticosteroids (e.g., Hydrocortisone, Prednisone, fluticasone, budesonide)
• Cyclosporine
• diabetes medications (e.g., Canagliflozin, Glyburide, Rosiglitazone chlorpropamide, glipizide, insulin, Metformin)
• Digoxin
• dofetilide
• Duloxetine
• foscarnet
• Guanfacine
• lithium
• Methotrexate
• Methylphenidate
• Minoxidil
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, rasgiline, Tranylcypromine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., Ibuprofen, Indomethacin, Naproxen)
• Obinutuzumab
• other diuretics (water pills; e.g., furosemide, Hydrochlorothiazide, triamterene)
• Pentoxifylline
• phosphodiesterase-5-inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pramipexole
• sodium phosphates
• risperidone
• Rituximab
• Sucralfate
• Yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than the ones listed above may interact with Furosemide. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Furosemide.

Dehydration: Furosemide is a potent diuretic (water pill) which, if given in excessive amounts, can lead to large amounts of urination resulting in dehydration. Symptoms of dehydration include dry mouth, thirst, decreased urination, reduced tearing, and reduced sweating. Make sure you are drinking an adequate amount of water to prevent these symptoms. You may wish to discuss with your doctor what an appropriate fluid intake is for you.

Dementia: Studies have shown that when furosemide is taken with Risperidone by people who are over 61 years of age there is an increased rate of death. The combination of these two medications should be avoided.

Diabetes: Furosemide may reduce blood sugar control for people with diabetes. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Furosemide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Furosemide, and whether any special monitoring is needed. You may be advised to increase the number of blood glucose checks that you do each day.

Drowsiness/reduced alertness: When you first start taking furosemide, it may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how Furosemide affects you.

Fluid and electrolyte balance: Furosemide can affect the levels of electrolytes such as potassium, sodium, magnesium, chloride, and calcium. Your doctor will periodically check to see if these are in balance. Warning signs or symptoms of fluid and electrolyte imbalance include:

• confusion
• drowsiness
• dryness of mouth
• lethargy
• low blood pressure
• muscle pains or cramps
• muscular fatigue
• nausea and vomiting
• racing heartbeat
• restlessness
• seizures
• thirst
• weakness

During long-term treatment with furosemide, a high-potassium diet is recommended. You may also require potassium supplements. Your doctor will monitor your potassium levels through occasional blood tests.

Gout: An acute gout attack may occur in some patients taking furosemide. Symptoms of an acute gout attack include sudden pain, swelling, and stiffness in the affected joint, often the big toe. You may also experience a fever. If this is your first attack, seek medical attention as soon as possible. If you have had gout attacks before, follow your doctor's instructions for dealing with the attack.

Hearing Loss: Furosemide can cause temporary and permanent hearing loss over time. Permanent hearing loss may be more likely to occur with high, long term doses of furosemide and when Furosemide is taken with other medications that can damage hearing. If you experience a change in your hearing, or a sensation of ringing in the ears, talk to your doctor as soon as possible.

Kidney function: Furosemide works directly on the kidneys and may cause decreased kidney function over time. Kidney Disease or reduced kidney function may cause Furosemide to build up in the body, causing side effects. If you have reduced kidney function, discuss with your doctor how Furosemide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Furosemide, and whether any special monitoring is needed.

Liver function: Decreased liver function can cause Furosemide to build up in the body, increasing the chance of side effects. If you have liver disease or reduced liver function, discuss with your doctor how Furosemide may affect your medical condition, how their medical condition may affect the dosing and effectiveness of Furosemide, and whether any special monitoring is needed.

Sulfa medications: Furosemide is a sulfonamide derivative. Some people who are allergic to sulfonamides (such as sulpha antibiotics) also experience allergic reactions to furosemide. Before you take furosemide, inform your doctor about any previous adverse reactions you have had to medications, especially to other water pills or sulpha antibiotics. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Pregnancy: The effect of taking furosemide on the unborn baby during pregnancy is unknown. Furosemide should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Furosemide, contact your doctor immediately.

Breast-feeding: Furosemide passes into breast milk and may also partially reduce the amount of breast milk produced. If you are a breast-feeding mother and are taking furosemide, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Seniors: Seniors may be more likely to experience increased side effects from furosemide.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. This medication may irritate the stomach, and should be taken with food. It is best to avoid coffee, spicy food or alcohol. Consuming alcohol may modify the effect of this product. Limit alcohol consumption during treatment.