Drug Class and Mechanism:
Furosemide is a powerful diuretic, i.e. a water pill which is drawn on to reduce the salt and water from a person’s body. It is the kidney where the water, salt (that is composed of chloride and sodium) along with some additional tiny molecules is generally filtered out from a person’s blood which then goes into the kidney tubules. The fluid, that is filtered, eventually turns into urine. A large amount of water, along with the chloride and sodium, which has been filtered out from the blood, is re-absorbed back into the blood prior to the filtered fluid turning into urine and eventually being discarded from the body. The mechanism of Furosemide is such that it blocks the assimilation of water, chloride and sodium from the sieved fluid which is in the tubules of the kidney, causing an intense swell in the production of urine (diuresis). The commencement of action subsequent to oral administration of Furosemide is within 1hour; furthermore, the diuresis goes for approximately 6-8 hours. The commencement of action after a Furosemide injection is 5 minutes, the period of diuresis is about 2 hours. The effect of diuretic Furosemide could lead to diminution of chloride, sodium, water in the body and additional minerals. For that reason, vigilant medical supervision is essential throughout treatment. It was in July 1982 that the FDA agreed, approved and permitted Furosemide.
Furosemide is a potent diuretic and is utilized to treat extreme swelling (edema) and/or an extreme upsurge of fluid in the body that is a result of cirrhosis, heart failure, nephrotic syndrome and unceasing kidney failure. At times, it is used in combination with other pills (meant for blood pressure in order to treat the problem of high blood pressure) and at other times, it is used alone.
Prior To Consuming Furosemide:
*Do not make use of Furosemide in case you are not able to urinate.
Prior to using Furosemide, inform your doctor of the following:
- Kidney ailment
- Liver problem
- Any allergic reactions to sulfa drug.
An adjustment in dosage or perhaps a special test would be required in case you face any of the above mentioned conditions, and only then you will be safe to use Furosemide.
It isn’t certain whether Furosemide medication is unsafe for an unborn child. It is highly recommended that prior to consuming Furosemide- you should inform your doctor in case you are expecting a child or even if you are planning on becoming pregnant in the course of this treatment. It is possible that Furosemide may pass in the breast milk and might be harmful for a nursing infant. In the case where you are breast feeding, at no cost should you use Furosemide until you have consulted with your doctor.
Common Furosemide side effects:
- Changes in vision
- Diarrhea or Constipation
- Sensitivity towards the sun
- Stomach ache
- Burning or a tingly sensation
- Blood pressure (low)
- Electrolyte diminution
Side Effects of Furosemide:
There are certain potentially grave Furosemide side effects that must be immediately reported to your doctor.
- Fainting spell, giddiness, nausea
- Low electrolytes or dehydration
- Dryness of the mouth
- Feeling of thirst
- Feeling of Weakness
- Feeling Drowsy
- Feeling of anxiety and restlessness
- Muscle cramp and ache
- Hypotension or low blood pressure
- Decline in urination
- Queasiness and vomiting
- Hasty heart rate or unbalanced heart rhythm
- Yellowing of the skin or the whites of the eyes (jaundice)
- Ringing in the ears (tinnitus) or hearing problems
- High blood sugar (hyperglycemia)
There are certain signs that indicate an allergic response, these include:
- A mysterious rash
- mysterious swelling
- Difficulty in breathing and/or swallowing
Additional Drugs That Affect Furosemide:
In case you consume Sucralfate (Carafate), you should take it no less than 2 hours prior to/subsequent to your consuming Furosemide.
Prior to taking Furosemide, inform your doctor in case you’re using the subsequent drugs at all:
- Lanoxin (digoxin)
- Any steroids, be it prednisone or others
- Edecrin which is a ethacrynic acid
- Any medicine for cold or a diet pill
- Any medication for blood pressure
- Gentamicin, Amikacin , Netilmicin , Tobramycin, Streptomycin
- Salicylates like aspirin, Doan’s Pills, Disalcid, Salflex , Tricosal, Dolobid
The list is not inclusive and there possibly are some additional drugs that could interact with the drug (Furosemide). Let you doctor know about each and every one of the prescriptions and even the over-the-counter medication that you may be using. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Prior to taking Furosemide, notify your doctor or health care practioner if you’re sensitive to or affected by Furosemide medication; also feel free to mention any additional allergies that you may have to drugs. This drug may hold inactive ingredients that can lead to an allergic reaction or further troubles. Consult the doctor or pharmacist for extra details. Ahead of using the medication, let your doctor know your entire medical history, particularly things such as- kidney troubles, liver troubles, inability to pass urine, lupus or gout.
In case you are a diabetic patient, Furosemide may influence the blood sugar levels for you. It is recommended that you regularly check blood sugar level and share the outcome with the doctor. The doctor, possibly will, adjust the diabetes medication dose for you and may be your diet too.
Furosemide may perhaps lessen the potassium levels in blood. The doctor, in such a case, will advise you to put in potassium-rich food in your diet (for instance orange juice and bananas) or recommend potassium add-on’s to avert the loss of potassium s. it would be wise to ask the doctor for additional details.
You might be prone to sensitivity to the sun when you use Furosemide. Steer clear of prolonged sun contact, sunlamps and tanning booths. Apply sunscreen and wear shielding clothing whenever you are outdoors. Furosemide may also make you feel dizzy and sometimes you might feel that your vision is blurred. It is therefore recommended that you not drive, use machines of any kind, or indulge in activities that require you to be alert; as such things would not be safe for you.
Limit your intake of alcoholic beverages. Severe diarrhea, sweating, or even vomiting can amplify the threat of dehydration. You must state long-drawn-out diarrhea or nausea to the doctor immediately. Follow the doctor’s directions about the quantity of fluids that you should drink. Prior to having a surgery, provide details of all products that you use to your doctor (such as prescription drugs, herbal products and nonprescription drugs).
Elderly people may be sensitive to effects of Furosemide to a greater extent, particularly lightheadedness and mineral/water loss.
All through pregnancy, Furosemide ought to be used when needed. Talk about the benefits and dangers with the doctor. Furosemide may influence milk production, so be careful when you breast feed. Check with the doctor ahead of breast-feeding.
- Oedema: congestive cardiac failure, renal oedema in chronic renal failure and resistant oedema
- Acute pulmonary oedema (acute LVF following MI)
- Cerebral oedema
- Forced dieresis
- Hypersensitive emergencies with blood transfusion in anemia to prevent fluid overload
Mechanism of action:
It inhibits Na+ and Cl- re-absorption in medullary portion of ascending limb of loop of henle. Uric acid excretion is reduced and excretion of K+ and NH3 is increased.
Furosemide reduces blood pressure in hypersensitivity as well as in normotensives. It reduces pulmonary oedema before the onset of diuresis.
- Severe dehydration
- Hypersensitivity to Furosemide
- Precoma associated with liver cirrh.
- Addison’s disease
Onset of effect:
Within 1 hour (tab.)
Within 5 hours (inj.)
Duration of action:
Lesser dose required with antihypertensive. Greater dose required with- NSAIDs, probenecid. Cotrimoxazole given with diuretics causes increased incidence of thrombocytopenia. Less uricosuric action of probenecid on concomitant use. Higher serum lithium levels. Hypokalemia induced by diuretics increases digitalis toxicity and potentiates competitive neuromuscular blockers and reduces sulfonylurea action.
- Acute saline depletion
- Dilutional hyponatraemia
- GI disturbance
- Magnesium depletion
- Noise in ears (in cases of high dosage)
- Muscle cramps
Use cautiously in:
- Chronic renal and hepatic dysfunction
- Prostatic hypertrophy
- Chronic diarrhea
- Long term purgatives