Suopinchon

Furosemide

Oedema of various etiology including cardiac & renal oedema. Mild to moderate HTN.

Initially 20-50 mg IM/IV. Larger doses: 20-mg increments not >2-hrly. Max: 1,500 mg daily. Not to exceed 4 mg/min. Childn 0.5-1.5 mg/kg daily. Max: 20 mg daily. Severe renal impairment Not to exceed infusion rate of 2.5 mg/min.

Hypersensitivity to furosemide, sulphonamides. Hypovolaemia or dehydration, anuria, renal failure, hepatic coma, severe hypokalaemia & hyponatraemia, precomatose & comatose states associated w/ hepatic encephalopathy. Lactation.

Not recommended for diuresis against radiocontrast-induced nephropathy. IM inj not suitable for acute conditions eg, pulmonary oedema. Partial urinary outflow obstruction eg, prostatic hypertrophy, impaired micturition; hypotension, at risk from pronounced fall in BP, latent diabetes, gout, hepatorenal syndrome, hypoproteinaemia; high risk for radiocontrast nephropathy. Correct hypotension, hypovolaemia, electrolyte & acid-base disturbances before starting therapy. Monitor serum Na, K & creatinine regularly. May affect ability to drive & use machines. Pregnancy. Not to be used during lactation. Premature infants.

Reduced serum Ca levels, nephrocalcinosis/nephrolithiasis in premature infants, serum cholesterol & triglyceride levels may rise, decreased glucose tolerance, reduced BP, itching, urticaria, rashes or bullous lesions, erythema multiforme, exfoliative dermatitis, purpura, electrolyte & water imbalance. Hypovolaemia & dehydration in elderly. Thrombocytopenia, nausea, malaise or gastric upset, acute urine retention, increased blood creatinine, urea & uric acid serum levels. Local reactions in IM administration.

More pronounced fall in BP w/ cardiac glycosides, diuretics, antihypertensive agents or other BP-lowering drugs. Marked fall in BP & renal function deterioration w/ ACE inhibitors or AIIAs. Increased toxic effects w/ nephrotoxic drugs. Reduced effect by sucralfate, probenecid, MTX. Increased serum lithium levels, salicylate toxicity. Attenuated antidiabetic, pressor agents effects & potentiated salicylates, theophylline, curare-type muscle relaxant effects. Potentiated ototoxicity of aminoglycosides, other ototoxic drugs. Enhanced nephrotoxicity of cisplatin. Attenuated effect by certain NSAIDs eg, indometacin, ASA; phenytoin. Increased risk of hyponatraemia w/ carbamazepine or aminoglutethimide. Corticosteroids may cause Na retention. Increased risk of hypokalaemia w/ corticosteroids, carbenoxolone, liquorice, β₂-sympathomimetics, laxatives, reboxetine, amphotericin. Renal function impairment w/ high doses of cephalosporins. Increased risk of gouty arthritis w/ ciclosporin.

Diuretics

C03CA01 - furosemide ; Belongs to the class of high-ceiling sulfonamide diuretics.

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