Furosemide tabs 40mg #56

Furosemide instruction

You can buy Furosemide tablets here

Composition

Furosemide diuretic tablets contain 40 mg of active substance, as well as potato starch, milk sugar, povidone, MCC, gelatin, talc, magnesium stearate, silica in colloid form.
In the solution for IM and IV administration, the active substance is contained in a concentration of 10 mg / ml. Auxiliary components: sodium chloride, sodium hydroxide, water d / u.

Form of issue

The medicine is issued in the form:
    tablets 40 mg No. 50 (2 packs of 25 tablets or 5 packs of 10 tablets per pack);
    injection solution (2 ml ampoule, package No. 10).

pharmachologic effect

Diuretic, sodium and chlororetic.

Pharmacodynamics and pharmacokinetics

Furosemide - what is it?

Furosemide is a loop diuretic, that is, a diuretic that acts mainly on the thick segment of the ascending part of the loop of Henle. It is characterized by speed. The diuretic effect is pronounced, but short-lived.

How much does Furosemide work?

After oral administration, the drug begins to act after 20-30 minutes, after infusion into the vein - after 10-15 minutes.
Depending on the characteristics of the body, the effect when using the oral form of Furosemide can persist for 3-4 hours or for 6 hours, the most powerful of which appears after an hour or two after taking the tablet.
After the introduction of the solution into the vein, the effect reaches a maximum in half an hour and persists for 2-8 hours (the more pronounced renal dysfunction, the longer the drug acts).

Pharmacodynamics

The mechanism of action of the drug is associated with a violation of the reabsorption in the tubules of renal nephrons of chlorine and sodium ions. In addition, Furosemide increases the excretion of magnesium, calcium, phosphates and bicarbonates.
The use of the drug in patients with heart failure leads to a decrease in preload on the heart muscle after 20 minutes.
The hemodynamic effect reaches its maximum extent by the 2nd hour of Furosemide action, which is caused by a decrease in the tone of the veins, a decrease in the BCC (the volume of the circulating blood), and also the volume filling the intercellular spaces in the organs and tissues of the fluid.
Reduces blood pressure. The effect develops as a consequence:
    decrease in the reaction of musculature of vascular walls to vasoconstrictor (provoking narrowing of blood vessels and a decrease in blood flow in them);
    decreasing BCC;
    increase the excretion of sodium chloride.
During the period of action of Furosemide, the excretion of Na + ions increases significantly, but after the drug ceases the rate of their removal falls below the initial level (withdrawal or ricochet syndrome). Due to this, when administered once a day does not have a significant effect on blood pressure and daily elimination of Na.
The cause of this effect is a sharp activation of the antisodium urinary links of neurohumoral regulation (in particular, renin-angiotensin regulation) in response to massive diuresis.
The drug stimulates sympathetic and argininvazopressivnuyu system, reduces the plasma concentration of atriopeptin, causes vasoconstriction.

Pharmacokinetics

Absorption from the digestive tract - high, bioavailability (fraction of absorbed drug) with oral intake - from 60 to 70%. The binding of plasma proteins is 98%.
TSmach at reception per os - 1 hour, at infusion into a vein - 0,5 hours.
Furosemide is able to penetrate the placenta and excrete with breast milk.
Biotransformation substance is exposed in the liver. Metabolites are secreted into the lumen of the kidney tubules.
T1 / 2 for the oral form of the drug - from one hour to an hour and a half, for the parenteral - from half an hour to an hour.
From 60 to 70% of the dose taken internally excreted by the kidneys, the rest - with feces. With the introduction of a vein into the kidneys, about 88% of furosemide and its metabolic products are excreted, with feces about 12%.

Indications for Furosemide

Furosemide - from what these tablets?

Tablets are prescribed for:
    edema, the causes of which are kidney pathologies (including nephrotic syndrome), stage II or III CHF, or liver cirrhosis;
    manifested in the form of edema of light acute heart failure;
    hypertensive crisis (as a monotherapy or in combination with other drugs);
    severe forms of hypertension;
    edema of the brain;
    hypercalcemia;
    eclampsia.
Also, the drug is used to carry out forced diuresis during poisoning with chemicals that are excreted from the body by the kidneys in unchanged form.
With elevated blood pressure, which develops against the background of CRF, Furosemide is used if the patient has a contraindicated thiazide diuretics, and if Clcr does not exceed 30 ml per minute).

Indications for use of Furosemide in ampoules

In the annotation for Furosemide in ampoules the same indications for use are given, as for the tablet form of the preparation.
With parenteral administration, the drug acts faster than when ingested. Therefore, the doctors answer the question "What is the solution for?", It is answered that the administration of Furosemide IV allows you to quickly reduce the pressure (arterial, pulmonary artery, left ventricle) and preload on the heart, which is extremely important in emergency conditions (for example , with hypertensive crisis).
In the case where the drug is prescribed for nephrotic syndrome, treatment of the underlying disease should be the first place.

Contraindications to Furosemide

The drug is not prescribed when:
    intolerance of its components;
    ARF, which is accompanied by anuria (if the GFR value does not exceed 3-5 ml / min.);
    stenosis of the urethra;
    severe liver failure;
    hepatic coma;
    hyperglycemic coma;
    prekomatoznyh states;
    obstruction of the urinary tract by concrement;
    decompensated stenosis of the mitral valve or aortic aorta;
    Conditions in which the blood pressure in the right atrium exceeds 10 mm Hg. p.
    gout;
    hyperuricemia;
    myocardial infarction (in acute stage);
    arterial hypertension;
    hypertrophic subaortic stenosis;
    systemic lupus erythematosus;
    violations of water-salt metabolism (hypocalcemia, hypochloraemia, hypomagnesemia, etc.);
    pancreatitis;
    digital intoxication (intoxication caused by the intake of cardiac glycosides).

Relative contraindications to the use of Furosemide:

    benign prostatic hyperplasia (BPH);
    diabetes;
    hypoproteinemia (when taking the drug, the risk of developing ototoxicity increases);
    obliterating cerebral atherosclerosis;
    hepatorenal syndrome;
    hypotension in patients with risk of ischemia (coronary, cerebral or other), which is associated with circulatory insufficiency;
    hypoproteinemia on the background of a nephrotic syndrome (there may be an increase in undesirable side effects of Furosemide (especially ototoxicity) and a decrease in its effectiveness).
Patients at risk should be under constant medical supervision. Violation of KSCH, hypovolemia or dehydration is the basis for reviewing the treatment regimen and, if necessary, temporary discontinuation of the drug.
Diuretics promote the excretion of sodium from the body, therefore, in order to avoid the development of hyponatremia before the start of therapy and subsequently throughout the course of application of Furosemide, it is necessary to monitor the sodium level in the patient's blood (especially in patients with cachexia, cirrhosis, and in elderly people).
The use of loop diuretics can cause sudden hypokalemia. The risk group includes:
    aged people;
    patients who are not receiving adequate food and / or taking several medicines at the same time;
    patients with diagnosed cirrhosis with ascites;
    patients with heart failure.
Hypokalemia increases the cardiotoxicity of digitalis preparations and the risk of cardiac arrhythmia. In the syndrome of QT interval prolongation (congenital or caused by the use of drugs) hypokalemia contributes to the occurrence of bradycardia or potentially life-threatening pirouette tachycardia.
In this regard, it is recommended as often as possible to determine the level of potassium in the patient's blood. The first ionogram should be done within a week after the start of the course.
Diabetics throughout the course of treatment need to systematically monitor the level of sugar.

Additional Information

The drug is not doping, but it is often used to remove banned substances from the body, and as a means of losing weight in sports where the weight of the athlete is important. In this regard, Furosemide is equated to doping drugs and can not be used in athletes.

Side effects of Furosemide

Against the background of the use of the drug, the following side effects can be noted:
    cardiovascular disorders, including orthostatic hypotension, arterial hypotension, arrhythmias, tachycardia, collapse;
    disorders of the nervous system, manifested by dizziness, muscle weakness, headache, tetany, apathy, adynamia, paresthesia, drowsiness, lethargy, weakness, confusion;
    disorders of the sense organs (in particular, hearing and vision impairment);
    disorders of the digestive system, including dry mouth, anorexia, cholestatic jaundice, diarrhea / constipation, nausea, vomiting, exacerbation of pancreatitis;
    disorders of the urogenital tract, including oliguria, interstitial nephritis, acute urinary retention (with BPH), hematuria, impotence;
    hypersensitivity reactions, including exfoliative dermatitis, hives, purpura, necrotizing angiitis, vasculitis, erythema multiforme, chills, pruritus, photosensitivity, fever, anaphylactic shock;
    disorders of the hemopoiesis system, including aplastic anemia, thrombocytopenia, leukopenia, agranulocytosis;
    disorders of water-salt metabolism, including dehydration and, as a consequence, increased risk of thrombosis / thromboembolism, hypovolemia, hypomagnesemia, hypochloremia, hypokalemia, hypocalcemia, hyponatremia, metabolic acidosis;
    changes in laboratory indicators, including hypercholesterolemia, hyperglycaemia, glucosuria, hyperuricemia.
With the administration of Furosemide IV, thrombophlebitis may develop, while in newborn infants, renal calcification may develop.

Instructions for use Furosemide

How to take Furosemide for swelling?

Diuretic tablets are taken orally. The doctor selects the dose individually, depending on the indications and characteristics of the course of the disease.
For adults, with swelling that develops against the background of liver, kidney or heart pathologies, it is prescribed to take ½-1 tablets / day if the condition is assessed as moderate. In severe cases, the doctor can recommend taking 2-3 tablets. 1.p./dut. or 3-4 tablets. in 2 admission.

How to reduce Furosemide pressure?

To reduce elevated blood pressure in patients with CRF, the drug is used in combination with antagonists of the renin-angiotensin system. The recommended dose varies from 20 to 120 mg / day. (½-3 tablets / day). The medicine is taken in one or two doses.

Furosemide for weight loss

Some women use the properties of the drug to reduce weight. Taking Furosemide Furosemide (Furosemide Sopharma) really allows you to get rid of a few pounds, but this weight loss can hardly be called losing weight, because the drug does not remove excess fat in the problem areas, but only removes water from the body.

Instructions for the use of Furosemide in ampoules

The preferred method of administering the solution is a slow intravenous injection (performed within 1-2 min.).
The drug is administered to the muscle in exceptional cases, when the oral or intravenous route of administration is impossible. Contraindications for intramuscular administration of Furosemide are acute conditions (eg, pulmonary edema).
Taking into account the clinical condition of the patient, it is recommended to transfer from the parenteral to the oral route of administration of Furosemide as soon as possible.
The question of the duration of treatment is decided taking into account the nature of the disease and the severity of the symptoms. The manufacturer recommends using the lowest possible dose at which the therapeutic effect will be maintained.
With oedematous syndrome in adults and adolescents over 15 years of age, treatment starts with the introduction of a 20-40 mg Furosemide into the vein (in exceptional cases - into the muscle).
In the absence of a diuretic effect, the drug is continued to be administered every 2 hours in a 50% increased dose. Treatment for this scheme is continued until an adequate diuresis is achieved.
A dose exceeding 80 mg should be injected into the vein by a drip. The rate of administration should not be more than 4 mg / min. The maximum allowable dose is 600 mg / day.
When poisoning to maintain forced diuresis, the patient should be administered 20 to 40 mg of the drug, previously having dissolved the required dose in the infusion solution of electrolytes. Further treatment is carried out depending on the volume of diuresis. Obligatory is the compensation of lost salts and liquid.
The initial dose for hypertensive crisis is 20-40 mg. In the future, it is adjusted taking into account the clinical response.

Injections and pills Furosemide: instructions for use in children

In pediatrics, the dose is selected depending on the weight of the patient. To the child Furosemide in tablets is given at the rate of 1-2 mg / kg / day. The dose can be taken at one time or divided into two doses.
On questions, how often it is possible to drink a drug in this or that case, and also, how long the course of treatment will be, only the attending physician can answer. Unambiguous are only recommendations on what to take Furosemide: as a supplement to diuretics, you should definitely drink potassium preparations.
Intravenous to children under 15 years of age, the drug is administered in a dose of 0.5-1.5 mg / kg / day.

Furosemide tablets: what are they used for in veterinary medicine?

Why is Furosemide Sopharma used in veterinary medicine? In veterinary practice, Furosemide and similar preparations are used as part of complex therapy for the treatment of heart pathologies in dogs.
The use of diuretics allows the withdrawal of fluid that accumulates around the lungs, abdominal or thoracic cavity, and thereby reduce the burden on the heart.
For dogs, the dosage of Furosemide depends on the weight of the animal. Typically, the drug is given 2 times a day at a rate of 2 mg / kg. In addition to treating the dog to compensate for potassium losses, it is recommended to give bananas daily (one per day).

Overdose

Symptoms of Furosemide overdose:
    a sharp drop in blood pressure;
    hypovolemia;
    dehydration;
    collapse;
    hemoconcentration;
    shock;
    arrhythmias (including atrioventricular block and fibrillation (fibrillation) of the ventricles);
    thrombosis;
    thromboembolism;
    confusion of consciousness;
    drowsiness;
    ARF with anuria;
    apathy;
    flaccid paralysis.
To normalize the patient's condition appoint measures aimed at correcting KShR and water-salt metabolism, replenishment of the deficit of BCC. Further treatment is symptomatic.
There is no specific antidote for Furosemide.

Interaction

Furosemide increases the concentration and toxicity (in particular, oto and nephrotoxicity) of Ectric acid, Aminoglycosides, Cephalosporins, Cisplatinum, Chloramphenicol, Amphotericin B.
Strengthens the therapeutic effectiveness of theophylline and dazoxide, reduces the effectiveness of allopurin and hypoglycemic drugs.
Reduces the rate of renal excretion of Li + drugs from the blood, thereby increasing the likelihood of intoxication by them.
Strengthens the neuromuscular blockade and the action of antihypertensive drugs caused by nondepolarizing muscle relaxants (peripheral action relaxants), weakens the action of nondepolarizing relaxants.
In combination with pressor amines there is a mutual decrease in the effectiveness of drugs, with Amphotericin B and GCS - the risk of hypokalemia increases.
The use in combination with cardiac glycosides (SG) can provoke the development of the inherent toxic effects due to a decrease in the level of potassium in the blood (for low- and high-polar SG) and an elongation of the half-life (for low-polar SGs).
Blocking tubular secretion drugs contribute to increased serum furosemide concentrations.
Sucralfate and NSAIDs reduce the diuretic effect of the drug due to suppression of Pg synthesis, changes in plasma renin concentration and aldosterone release.
The use of high doses of salicylates against the background of drug treatment increases the risk of their toxicity, which is due to competitive renal excretion of drugs.
The Furosemide solution introduced into the vein has a slightly alkaline reaction, so it is contraindicated to mix it with medicines whose pH is below 5.5.
Unsuitable combination for a solution
The administration of Furosemide to a vein within 24 hours after chloral hydrate can provoke:
    nausea;
    flushes of blood;
    anxiety;
    increased sweating;
    increased blood pressure;
    tachycardia.
The use of Furosemide with ototoxic agents (for example, with aminoglycosides) can cause irreversible hearing impairment. Such a combination can be used only for vital indications.

Terms of sale

You don't need a prescription to buy Furosemide online.

Storage conditions

Store the drug in a light-shielded place at a temperature of up to 25 ° C.
Shelf life - two years.

special instructions

During the course of treatment it is recommended to avoid occupations potentially life-threatening and health-related activities that require speed of psychomotor reactions and increased attention.
Against the backdrop of course treatment should periodically make an ionogram of blood, as well as control KHRP, blood pressure, uric acid, creatinine, residual nitrogen, liver function. If necessary, the treatment regimen is revised taking into account these indicators.
In the case of high doses of Furosemide, it is not recommended to limit consumption of edible salt, which is associated with a risk of metabolic acidosis and hyponatremia.
In patients with BPH, hydronephrosis, narrowing of the ureters, as well as in patients who are in an unconscious state, urination should be controlled because of the possibility of acute urinary retention.
The tablet form of the drug is contraindicated for people with the syndrome of impaired glucose / galactose absorption, congenital galactosemia, and hypolactasia.

What is better - Lasix or Furosemide?

Lasix is ​​one of the trade names of furosemide. The drug is produced by the Indian company Sanofi India Ltd. and, like its analog, has two dosage forms: a 1% solution of d / and tablets of 40 mg.
Thus, when choosing this or that remedy, one should be guided by subjective sensations. The advantage of Furosemide is its lower price.

Furosemide and alcohol

Patients taking Furosemide, alcohol is contraindicated.

Furosemide for weight loss

On the Internet, a lot of advice on the use of diuretics for weight loss. One of the most available drugs in this group is Furosemide.
What helps the medicine? According to the instructions, Furosemide is used in ascites, edematous syndrome, hypertension. Thus, the manufacturer does not say anything about the possibility of using diet pills.
Nevertheless, many women note that with this tool they were able to quickly lose a few kilograms (in some cases, up to 3 kg per night). However, it is impossible to regard such weight loss as weight loss: the action of the drug is aimed at removing excess fluid, and not at splitting fat.

What is dangerous Furosemide?

The use of diuretics for weight loss can provoke serious health problems, as removing water, these drugs also disrupt the balance of electrolytes in the body. one of the most common side effects is hypokalemia.
Deficiency of potassium in turn leads to the appearance of muscle cramps, weakness, visual impairment, sweating, loss of appetite, nausea, dizziness.
A very dangerous side effect is arrhythmia. SOLVD studies have shown that treatment with loop diuretics is accompanied by an increase in mortality among patients. At the same time, both the rates of general and cardiovascular mortality and the number of sudden deaths increase.
Another danger, which can lead to uncontrolled use of diuretics for weight loss, is a violation of the kidneys. And the recovery of kidney function and lymphatic system can take more than a month.

How to take Furosemide for weight loss?

To remove a few extra pounds, women usually take 2-3 (not more!) Furosemide tablets during the day with an interval of three hours between doses, and then 2 more pills at night.
You can repeat the one-day course not earlier than 2-3 days later.

Furosemide and Asparkam for weight loss

Since one of the side effects of Furosemide is hypokalemia, it is very important to adhere to a certain diet during the use of this drug (it is available in the form of eating foods high in potassium) or additionally take medications that can minimize the side effects of diuretics.
As a rule, Furosemide is recommended in combination with Asparkam (Panangin). What is Asparkam? It is a drug that is used as an additional source of potassium and magnesium. The medicine has an innocuous composition that excludes the possibility of its undesirable interaction with Furosemide.
Recommendations for how to drink with Asparkam diuretics, can only give a doctor. Asparkam tablets, according to the manufacturer's instructions, take 3-6 units per day, dividing the indicated dose into three doses.

How often can I take Furosemide for weight loss?

Optimal - never. In extreme cases, the use of the drug as an emergency aid is allowed, when it is necessary to immediately remove swelling.
Reviews of women trying to lose weight on Furosemide, suggest that taking more than 2 tablets a week is always accompanied by side effects. In addition, often there is another problem - how to "get off" the drug.

Is it possible to drink Furosemide during pregnancy?

When asked whether pregnant women can take diuretics, most doctors give the answer that modern medicine offers much safer methods for the treatment of gestosis and pre-eclampsia.
That is, Furosemide in pregnancy can only be used as an emergency aid, as short as possible, and only if the woman is under strict medical supervision.
According to the FDA classification, the drug belongs to the category C.
Despite all the contraindications, on the forums women often leave feedback on the use of Furosemide in pregnancy.
Practically in all of them it is noted that the drug really quickly removed from the body excess fluid, but it also causes unpleasant side effects (for example, cramps in the legs).
Therefore, all mothers are unanimous in the opinion - you can take Furosemide only by strict indications and only in a non-alternative situation.

Application in lactation

Furosemide penetrates into milk and is able to suppress lactation, therefore its use in lactating women is possible only if the child is transferred to artificial feeding during the treatment of the mother.

Reviews about Furosemide

Furosemide is one of the most effective fast and short-acting diuretics.
The doctors' reviews confirm the fact that the drug plays a key role in the treatment of edematous syndrome in patients with heart failure, as loop diuretics most effectively block the reabsorption of Na + ions in the ascending segment of the Henle loop. In this case, Furosemide retains its activity even in patients with CRF (including at the terminal stage of the disease).
However, the use of short-acting loop diuretics can provoke irreversible damage to the renal tubules, especially in cases where the drug is given in a high dose.
A parallel increase in the delivery of Na + ions to the distal parts of the nephron, where loop diuretics do not function, leads to sodium overload and structural damage to these nephron parts with the development of hyperplasia and hypertrophy.
In addition, after completion of the drug significantly increases the reabsorption of Na + and, as a consequence, develops the "ricochet" effect, which is manifested by an increase in post-diuretic reabsorption.
The feedback that patients leave makes it possible to conclude that the medicine works well against edema and is irreplaceable for hypertensive patients. Disadvantages of the drug are usually called side effects, contraindications and the fact that it is addictive.
Another category of reviews is reviews about Furosemide for weight loss. Despite the fact that the drug really allows you to quickly reduce weight by 3-5 kg, use it for weight loss does not recommend both doctors and themselves losing weight. This is due to the fact that the drug does not remove excess fat, but only displays water (and, together with it, necessary for the body to work properly).
Thus, given that Furosemide is a very powerful remedy, it can be used only with contraindications, not exceeding the prescribed dose and only under the supervision of the doctor (especially during pregnancy). Also, one should not take it for other purposes (for example, with cystitis).
When treating diuretics is very important is the question - with what to drink the drug. Optimal supplement therapy with the use of potassium-rich foods or the intake of potassium preparations.