Indication

Furosemide is a diuretic recommended for use in all indications where a prompt and effective diuresis is required.

1) The treatment of oedema associated with congestive heart failure, cirrhosis of the liver, renal disease including nephrotic syndrome and pulmonary oedema.

2) The treatment of peripheral oedema due to mechanical obstruction, venous insufficiency, mild to moderate hypertension.

Dosage And Adminstration

Usage: Oral

1.Adults and children over 12 years:

Oedema: Initially 40mg daily in the morning; ordinarily a prompt diuresis ensues and the starting dose can then be maintained or even reduced. Diuresis lasts for approximately four hours following administration and hence the time of administration can be adjusted to suit the patient's requirements. Maintenance dose is 20mg daily or 40mg on alternate days, increased in resistant oedema to 80mg daily.

2.Hypertension: 20-40mg twice daily; if 40mg twice daily does not lead to a clinically satisfactory response, the addition of other antihypertensive agents, rather than an increase in the dose of furosemide should be considered.

3.Children under 12 years: A more suitable dosage form should be used in this age group.

4.Elderly: Furosemide is generally eliminated more slowly. The dosage should be titrated until the required response is achieved.

Precautions & Warning:

1.Hypotension and/or hypovolaemia.

2.Dose titration/adjustment

3.Impaired hepatic function

4.Impaired renal function and hepato-renal syndrome diabetes mellitus

5.Elderly patients:difficulty with micturition/potential obstruction in the urinary tract including prostatic hypertrophy (increased risk of acute retention); gout (increased risk of hyperuricaemia);patients at risk of pronounced falls in blood pressure

Contraindications:

1.Furosemide is contraindicated in the following circumstances

•Hypersensitivity to furosemide, any of its excipients, sulphonamides, sulphonamide derivatives/amiloride

•Anuria and impaired renal function (creatinine clearance below 30mL/min per 1.73 m2 body surface area) and renal failure resulting from poisoning by nephrotoxic and/or hepatotoxic agents

•Electrolyte disturbances (severe hyponatraemia: severe hypokalaemia, hypovolaemia), dehydration and/or hypotension

Adverse Reactions:

1.Metabolism and nutritional disorders: dehydration, hyponatraemia, hypochloremic metabolic alkalosis, hypocalcaemia, hypomagnesemia (incidences of the last three are reduced by triamterene), nephrocalcinosis in infants; Hypovolaemia, hypochloraemia;  impaired glucose tolerance (by hypokalaemia) hyperuricaemia, gout, reduction of serum HDL-cholesterol, elevation of serum LDL-cholesterol, elevation of serum triglycerides, hyperglycaemia

2.Blood and lymphatic system disorders:aplastic anaemia

3.Eye disorders: visual disturbance, blurred vision, yellow vision.

4.Cardiac disorders: orthostatic intolerance, cardiac arrhythmias, increased risk or persistence of patent ductus arteriosus in premature infants.

5.Vascular disorders: decreased blood pressure, (which, if pronounced may cause signs and symptoms such as impairment of concentration and reactions, light- headedness, sensations of pressure in the head, headache, dizziness, drowsiness, weakness, disorders of vision, dry mouth, orthostatic intolerance). hypotension, hypovolaemia

6.Investigations: creatinine increased, blood urea increased

Storage instructions:

Store in the original package in order to protect from light. This medicinal product does not require any special temperature storage conditions