What is the minimum dosage for furosemide. Furosemide tablets: instructions for use

As you know, the problem of obesity in recent decades is very acute. This is also supported by official statistics World Health Organization WHO. In addition, it is no secret to anyone that parting with these unfortunate kilograms is very difficult.

Many of us, perhaps due to a weakness of character, and maybe due to a number of other reasons, are simply not able to somehow reverse the current situation, once and for all deciding to love ourselves as they are.

I take into account the complexity of elimination extra pounds, it is not surprising that many of the suffering, dare to very sophisticated ways to lose weight. What "hotheads" do not come up with, here is the use of various cleansing procedures that can cause monstrous harm to health, and the use of potent medications and many other bizarre methods.

How is Furosemide useful for weight loss?

Today I will talk about a fairly new method of reducing body weight, generated either by a desperate person or by an absolute ignoramus. This method is based on regular use a diuretic drug called furosemide.

To begin with, you should pay your attention to the phrase weight loss. It was not in vain that I used it, since this effect, nevertheless, will be achieved, but at the expense of what. To begin with, a few words about what kind of drug is at the heart of this technique.

How to take Furosemide for weight loss?

The authors of the method recommend drinking the drug once a day in the morning - 1 tablet (40 mg). Those who are not satisfied with the results can increase the number of doses up to two per day. And this, as soon as the weight begins to decrease, the number of doses and the number of tablets must be reduced.

Mechanism of action of Furosemide

As I said, furosemide is a diuretic drug. What does it mean? It is prescribed for the forced removal of fluid from the body. In the populist literature, you can find the term diuretic, which, in fact, is synonymous with the word diuretic. How does it affect the human body?

When using furosemide, reabsorption, or reuptake of sodium ions in the kidney tubules, decreases. Taking into account the fact that this element retains water, excessive loss of it leads to increased excretion of fluid. Depending on the dosage of the drug, the volume of the latter can greatly increase, sometimes up to 6 - 8 liters per day.

Side effects of Furosemide

It is not surprising that with such a loss of water, the body will part not only with liquid, but also with vital minerals. I'm talking about potassium and magnesium. If we talk about the use of furosemide for medical reasons, it should be mentioned that its use is often combined with the introduction of electrolytes into the body.

Many methods of forcing diuresis involve such restorative therapy, but this is if we are talking about professionals. If we talk about self-medication, and the use of this drug cannot be called by another word, many "home-grown doctors" do not know about it at all. And therefore they risk getting very grave consequences.

First of all, we are talking about a violation of the heart rhythm. The thing is that potassium is vital for the normal transmission of electrical impulses in cardiomyocytes.

If there is a shortage of it, about normal heartbeat you can forget. Violations can be of a different nature: in the mildest cases it will be tachycardia, in severe cases - more severe symptoms, sometimes even life-threatening.

Magnesium deficiency inevitably leads to side effects nervous system... In the mildest cases, this can be expressed in the appearance of unmotivated weakness, strong apathy, depression.

V severe cases can join convulsions in calf muscles ah, confusion, coma and death. The fact is that magnesium is necessary for the normal transmission of nerve impulses. It is clear that with him acute deficiency, the work of the central and peripheral nervous system will be grossly disrupted.

Even dehydration by itself is incredibly detrimental to the body. As you know, the water content varies greatly with age. According to various sources, our body consists of about 65 - 75 percent of this substance.

The older a person is, the less fluid in his body, but, nevertheless, this indicator cannot fall below a certain limit, upon crossing which irreversible processes can begin in the body. Unless immediate rehabilitation therapy is carried out, no doctor will undertake to predict the ending of such a story.

A little bit of common sense

Of course, body weight will be reduced, but due to what? The only mechanism leading to this effect is fluid loss. The amount of adipose tissue in the body remains unchanged throughout the entire period of taking the drug.

As you know, the human body is a self-regulating system, which means that at the slightest opportunity the body will try to compensate for the missing volumes. Therefore, the weight loss is only temporary.

Immediately after you stop taking furosemide, life-giving moisture will return to proper place, and with it the lost kilograms will be restored. Alas, this is indeed the case. Putting on the other side of the scale the risk of potential side effects, a very reasonable question arises: why all this is necessary?

To be honest, I have no answer to this question. The only thing that can force a person to arbitrarily use furosemide is complete medical illiteracy.

Conclusion

Of course, taking Furosemide without medical indications is evil in its purest form. You should never and under no circumstances do this. Be realistic, this will not solve the problem of obesity, but it can create several new ones.

Furosemide is a so-called "loop" diuretic. Loop, because the violation of the reverse absorption of sodium and chlorine ions caused by it is localized in the ascending part of Henle's loop. Due to an increase in the excretion of sodium ions, an enhanced, osmotically related excretion of water and ions of potassium, calcium and magnesium occurs. With insufficient heart function, the drug quickly reduces the preload on the myocardium by increasing the lumen of large veins. It has an antihypertensive effect due to the intensive excretion of sodium and chlorine ions, a decrease in the volume of circulating blood and a decrease in the sensitivity of the vascular walls to vasoconstrictor factors. The effect of the drug after intravenous administration occurs within 5-10 minutes, after oral administration - after 30-60 minutes. The peak of furosemide activity is noted after 1-2 hours, the duration of action is 2-3 hours (with renal failure- up to 8 hours). The drug is characterized by a withdrawal syndrome: after the cessation of its action, the rate of excretion of sodium ions decreases below entry level... This pharmacological "rebound" is due to a sharp increase in the activity of antinatriuretic neurohumoral links, including the renin-angiotensin link, which occurs in response to abundant diuresis. Due to the withdrawal syndrome when taken once a day, the drug may not have a significant effect on the daily excretion of sodium ions and the indicator blood pressure.

Furosemide is available in the form of tablets and solution for intravenous and intramuscular administration. The dosage regimen of the drug is established by the doctor individually, taking into account the indications, the nature of the course of the disease and the age of the patient. During pharmacotherapy, the dose and frequency of administration of the drug are adjusted depending on the therapeutic response and general condition the patient. The diuretic (diuretic) effect of furosemide directly depends on its dose, while reaching a certain therapeutic "ceiling" is practically impossible.

Among the pharmacokinetic disadvantages of furosemide, we should mention too wide "spread" of the bioavailability of the drug when taken orally. In different clinical situations, it can vary from 11 to 90%.

Since furosemide has a fast and at the same time powerful antihypertensive effect, it is often used in the relief of hypertensive crises. For crises of 1 degree, furosemide is administered orally at 40-80 mg, with crises of 2 degrees, it is administered intravenously or intramuscularly in the same dose. At the same time, the use of furosemide in long-term therapy arterial hypertension seems to be irrational, because a sharp decline the volume of circulating blood and vasodilation caused by the drug cause reflex sympathetic and renin-angiotensin activation, which neutralizes the antihypertensive effect. Fursemide can be used in acute heart failure. So, in case of acute failure of the left ventricle under the action of the drug, the volume of circulating blood (BCC) decreases, which reduces the work of the myocardium to pump blood from a small circle to a large one. On the other hand, a decrease in the BCC and the expansion of the vessels of the small circle entails a decrease in pressure in the latter, as a result of which the release of blood plasma into the lung and an increase in edema stops. Furosemide is used to reduce total edema in congestive heart failure. The use of other diuretics does not allow achieving such pronounced effect due to a violation of their absorption in digestive tract due to edema internal organs... After the elimination of massive edema, the use of furosemide is impractical, because further excretion of fluid from the body activates the sympathetic renin-angiotensin-aldosterone system. The drug is also used in acute renal failure. It increases the excretion of urine, regulates the excretion of potassium ions, and in case of poisoning, "flushes" the renal tubules.

Pharmacology

"Loop" diuretic. Violates the reabsorption of sodium and chlorine ions in the thick segment of the ascending part of the loop of Henle. Due to the increase in the release of sodium ions, a secondary (mediated osmotically bound water) increased excretion of water and an increase in the secretion of potassium ions in the distal renal tubule. At the same time, the excretion of calcium and magnesium ions increases.

Has secondary effects due to the release of intrarenal mediators and redistribution of intrarenal blood flow. On the background course treatment there is no weakening of the effect.

In heart failure, it quickly leads to a decrease in the preload on the heart through the expansion of large veins. It has a hypotensive effect due to an increase in the excretion of sodium chloride and a decrease in the reaction of vascular smooth muscles to vasoconstrictor effects and as a result of a decrease in the BCC. The effect of furosemide after intravenous administration occurs in 5-10 minutes; after oral administration - after 30-60 minutes, maximum action - after 1-2 hours, duration of effect - 2-3 hours (with reduced renal function - up to 8 hours). During the period of action, the excretion of sodium ions increases significantly, however, after its termination, the rate of excretion decreases below baseline("ricochet" or "cancellation" syndrome). The phenomenon is caused by a sharp activation of the renin-angiotensin and other antinatriuretic neurohumoral regulation links in response to massive diuresis; stimulates arginine-vasopressive and sympathetic system... Reduces the level of atrial natriuretic factor in plasma, causes vasoconstriction.

Due to the phenomenon of "rebound" when taken 1 time / day may not have a significant effect on the daily excretion of sodium ions and blood pressure. When administered intravenously, it causes dilatation of peripheral veins, reduces preload, reduces left ventricular filling pressure and pressure in pulmonary artery, as well as systemic blood pressure.

The diuretic effect develops 3-4 minutes after intravenous administration and lasts 1-2 hours; after oral administration - after 20-30 minutes, lasts up to 4 hours.

Pharmacokinetics

After oral administration, absorption is 60-70%. At serious illnesses renal or chronic heart failure, the extent of absorption is reduced.

V d is 0.1 l / kg. Plasma protein binding (mainly albumin) - 95-99%. Metabolized in the liver. It is excreted by the kidneys - 88%, with bile - 12%. T 1/2 in patients with normal function kidney and liver is 0.5-1.5 hours. With anuria, T 1/2 can increase to 1.5-2.5 hours, with combined renal and hepatic failure - up to 11-20 hours.

Release form

2 ml - dark glass ampoules (10) - cardboard packs.
2 ml - dark glass ampoules (5) - contoured plastic packaging (1) - cardboard packs.
2 ml - dark glass ampoules (5) - contoured plastic packaging (2) - cardboard packs.

Dosage

Set individually, depending on the indications, clinical situation, age of the patient. In the course of treatment, the dosage regimen is adjusted depending on the magnitude of the diuretic response and the dynamics of the patient's condition.

For oral administration, the initial dose for adults is 20-80 mg / day, then, if necessary, the dose is gradually increased to 600 mg / day. For kids single dose is 1-2 mg / kg.

The maximum oral dose for children is 6 mg / kg.

With i / v (jet) or i / m administration, the dose for adults is 20-40 mg 1 time / day, in some cases - 2 times / day. For children, initial daily dose for parenteral administration - 1 mg / kg.

Interaction

With simultaneous use with antibiotics of the aminoglycoside group (including with gentamicin, tobramycin), an increase in nephro- and ototoxic action is possible.

Furosemide reduces the clearance of gentamicin and increases plasma concentrations of gentamicin, as well as tobramycin.

With simultaneous use with antibiotics of the group of cephalosporins, which can cause impaired renal function, there is a risk of increased nephrotoxicity.

With simultaneous use with beta-adrenergic agonists (including fenoterol, terbutaline, salbutamol) and with corticosteroids, hypokalemia may increase.

With simultaneous use with hypoglycemic agents, insulin, it is possible to reduce the effectiveness of hypoglycemic agents and insulin, because furosemide has the ability to increase plasma glucose.

With simultaneous use with ACE inhibitors, the antihypertensive effect is enhanced. Severe arterial hypotension is possible, especially after taking the first dose of furosemide, apparently due to hypovolemia, which leads to a transient increase in the hypotensive effect ACE inhibitors... The risk of renal dysfunction increases and the development of hypokalemia is not excluded.

With simultaneous use with furosemide, the effects of non-depolarizing muscle relaxants are enhanced.

With simultaneous use with indomethacin, other NSAIDs, a decrease in the diuretic effect is possible, apparently due to inhibition of the synthesis of prostaglandins in the kidneys and sodium retention in the body under the influence of indomethacin, which is a nonspecific COX inhibitor; decrease in antihypertensive action.

It is believed that In a similar way furosemide also interacts with other NSAIDs.

With simultaneous use with NSAIDs, which are selective inhibitors of COX-2, this interaction is expressed to a much lesser extent or practically absent.

With simultaneous use with astemizole, the risk of developing arrhythmias increases.

With simultaneous use with vancomycin, an increase in oto- and nephrotoxicity is possible.

With simultaneous use with digoxin, digitoxin, an increase in the toxicity of cardiac glycosides is possible, associated with the risk of hypokalemia while taking furosemide.

There are reports of the development of hyponatremia with simultaneous use with carbamazepine.

When used simultaneously with cholestyramine, colestipol, the absorption and diuretic effect of furosemide decreases.

With simultaneous use with lithium carbonate, it is possible to enhance the effects of lithium due to an increase in its concentration in blood plasma.

With simultaneous use with probenecid, the renal clearance of furosemide decreases.

With simultaneous use with sotalol, hypokalemia and development of ventricular arrhythmias type "pirouette".

With simultaneous use with theophylline, it is possible to change the concentration of theophylline in blood plasma.

With simultaneous use with phenytoin, the diuretic effect of furosemide is significantly reduced.

After intravenous administration of furosemide against the background of chloral hydrate therapy, increased sweating, fever, instability of blood pressure, tachycardia are possible.

With simultaneous use with cisapride, hypokalemia may increase.

It is assumed that furosemide can reduce the nephrotoxic effect of cyclosporine.

With simultaneous use with cisplatin, an increase in the ototoxic effect is possible.

Side effects

From the side of cardio-vascular system: decrease in blood pressure, orthostatic hypotension, collapse, tachycardia, arrhythmias, decreased BCC.

From the side of the central nervous system and peripheral nervous system: dizziness, headache, myasthenia gravis, cramps of the calf muscles (tetany), paresthesia, apathy, weakness, weakness, lethargy, drowsiness, confusion.

From the senses: visual and hearing impairment.

From the side digestive system: decreased appetite, dry mouth, thirst, nausea, vomiting, constipation or diarrhea, cholestatic jaundice, pancreatitis (exacerbation).

From the side genitourinary system: oliguria, acute urinary retention (in patients with prostatic hypertrophy), interstitial nephritis, hematuria, decreased potency.

From the hematopoietic system: leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia.

From the side of water and electrolyte metabolism: hypovolemia, dehydration (risk of thrombosis and thromboembolism), hypokalemia, hyponatremia, hypochloremia, hypocalcemia, hypomagnesemia, metabolic alkalosis.

Metabolic disorders: hypovolemia, hypokalemia, hyponatremia, hypochloremia, hypokalemic metabolic alkalosis (as a consequence of these disorders - arterial hypotension, dizziness, dry mouth, thirst, arrhythmia, muscle weakness, convulsions), hyperuricemia (with possible exacerbation of gout), ...

Allergic reactions: purpura, urticaria, exfoliative dermatitis, exudative erythema multiforme, vasculitis, necrotizing angiitis, itchy skin, chills, fever, photosensitivity, anaphylactic shock.

Others: with intravenous administration (additionally) - thrombophlebitis, renal calcification in premature babies.

Indications

Edema syndrome of various origins, incl. with chronic heart failure stage II-III, liver cirrhosis (portal hypertension syndrome), nephrotic syndrome. Pulmonary edema, cardiac asthma, cerebral edema, eclampsia, forced diuresis, arterial hypertension severe course, some forms of hypertensive crisis, hypercalcemia.

Contraindications

Acute glomerulonephritis, stenosis urethra, obstruction of the urinary tract with stones, acute renal failure with anuria, hypokalemia, alkalosis, precomatous states, severe hepatic failure, hepatic coma and precoma, diabetic coma, precomatose states, hyperglycemic coma, hyperuricemia, gout, decompensated mitral or aortic stenosis, hypertrophic obstructive cardiomyopathy, increased central venous pressure (more than 10 mm Hg), arterial hypotension, acute heart attack myocardium, pancreatitis, violation of water and electrolyte metabolism (hypovolemia, hyponatremia, hypokalemia, hypochloremia, hypocalcemia, hypomagnesemia), digitalis intoxication, hypersensitivity to furosemide.

Application features

Application during pregnancy and lactation

During pregnancy, the use of furosemide is possible only for a short time and only if the intended benefits of therapy for the mother exceed potential risk for the fetus.

Since furosemide can be excreted with breast milk, as well as suppress lactation, if necessary, use during lactation, breastfeeding should be discontinued.

Application for violations of liver function

Contraindicated in severe hepatic impairment, hepatic coma and precom.

Application for impaired renal function

Contraindicated in acute glomerulonephritis, acute renal failure with anuria.

special instructions

Use with caution in prostatic hyperplasia, SLE, hypoproteinemia (risk of ototoxicity), diabetes mellitus (decreased glucose tolerance), with stenosing atherosclerosis of the cerebral arteries, against the background of prolonged therapy with cardiac glycosides, in elderly patients with severe atherosclerosis (especially pregnancy first half), lactation period.

Electrolyte disturbances should be compensated for before starting treatment. During the period of treatment with furosemide, it is necessary to control blood pressure, the level of electrolytes and glucose in the blood serum, liver and kidney function.

For the prevention of hypokalemia, it is advisable to combine furosemide with potassium-sparing diuretics. With the simultaneous use of furosemide and hypoglycemic drugs, a dose adjustment of the latter may be required.

Influence on the ability to drive vehicles and use mechanisms

When using furosemide, the likelihood of a decrease in the ability to concentrate cannot be ruled out, which is important for people who drive vehicles and work with mechanisms.

Photo of the drug

Latin name: Furosemide

ATX code: C03CA01

Active substance: Furosemide

Producer: Borisov plant of medical preparations (Republic of Belarus), Novosibkhimpharm, Dalkhimfarm, Biochemist, Binnopharm CJSC, Ozon Pharm LLC (Russia), Mangalam Drugs & Organics Ltd, Ipca Laboratories (India)

Description up to date on: 01.11.17

Furosemide is a diuretic medication for relieving edema. This tool enhances the excretion of water from the body, as well as magnesium and calcium ions.

Active substance

Furosemide (Furosemide).

Release form and composition

Available in the form of tablets and solution for intramuscular and intravenous administration.

Indications for use

The main indication is edematous syndrome. of various origins... The tool is shown when:

• nephrotic syndrome;
• chronic heart failure of the second and third degree;
• cirrhosis of the liver.

It is used for the following pathological conditions:

• pulmonary edema;
• swelling of the brain;
• cardiac asthma;
• eclampsia;
• hypercalcemia;
• severe arterial hypertension;
• some forms of hypertensive crisis.

The above medication is used when carrying out forced diuresis.

Contraindications

Contraindicated in:

• acute glomerulonephritis;
• stenosis of the urethra;
• hyperuricemia;
• obstruction of the urinary tract with a stone;
• acute renal failure accompanied by anuria;
• alkalosis;
• hypokalemia;
• acute myocardial infarction;
• severe liver failure;
• diabetic coma;
• hepatic precoma and coma;
• arterial hypotension;
• gout;
• decompensated aortic and mitral stenosis;
• hyperglycemic coma;
• hypertrophic obstructive cardiomyopathy;
• high central venous pressure;
• digitalis intoxication;
• pancreatitis;
• violation of water and electrolyte metabolism (hypomagnesemia, hypocalcemia, hyponatremia, hypochloremia, hypokalemia, hypovolemia);
• hypersensitivity to the drug;
• in precomatose states.

With extreme caution, women are prescribed during pregnancy and breastfeeding, elderly people, as well as patients suffering from severe atherosclerosis, hypoproteinemia, diabetes mellitus and prostatic hyperplasia.

Instructions for use of Furosemide (method and dosage)

The dosage and form of the drug is selected individually, depending on the indications, the severity of the disease and the patient's age. If necessary, the dosage can be adjusted during therapy.

Tablets

Furosemide tablets are taken orally in morning time before breakfast.

The initial dosage for adults is 20-40 mg per day. If necessary, the dose is increased to 80-160 mg per day, which are taken in 2-3 doses with an interval of 6 hours. The maximum daily dosage is 600 mg. After elimination of puffiness, the dosage is reduced and the drug is taken at intervals of 1-2 days.

For the treatment of puffiness in CHF, 20-80 mg of furosemide per day is prescribed. The recommended dose is divided into 2-3 doses at equal intervals.

To eliminate edema with CPP, the initial dosage is 40-80 mg per day. The drug is taken once or divided into 2 equal doses. In the future, the dosage is adjusted depending on the diuretic response. Maintenance therapy for patients on hemodialysis is 250-1500 mg per day.

For the treatment of arterial hypertension, 20-40 mg per day are prescribed. To achieve the maximum effect, Furosemide should be combined with antihypertensive drugs.

With nephrotic syndrome, 40-80 mg per day is prescribed. In the future, the dosage is adjusted depending on the body's response to the therapy.

The starting dosage for children is 1–2 mg per kilogram of body weight. The maximum allowable dose is 6 mg / kg.

Injection

With intravenous jet or intramuscular injection the recommended dose of the drug for adult patients is 20-40 mg per day. In rare cases, it is possible to increase the dosage by 2 times, which are administered twice a day.

Side effects

Furosemide can cause the following side effects:

• Cardiovascular system: lowering blood pressure, arrhythmia, tachycardia, orthostatic hypotension, collapse.
• Nervous system: drowsiness, myasthenia gravis, apathy, weakness, lethargy, confusion, calf muscle cramps, headache, paresthesia, weakness.
• Sense organs: hearing and vision impairment.
• Gastrointestinal tract: dry mouth, nausea, worsening pancreatitis, thirst, vomiting, decreased appetite, diarrhea or constipation, and cholestatic jaundice.
• Genitourinary system: hematuria, interstitial nephritis, acute urinary retention, decreased potency.
• Hematopoietic system: aplastic anemia, agranulocytosis, leukopenia and thrombocytopenia.
• Water and electrolyte metabolism: hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, hypocalcemia, hypochloremia, hypokalemia.
• Metabolism: hyperglycemia, muscle weakness, convulsions, arterial hypotension, hyperuricemia and dizziness.
• Allergic reactions: exudative erythema multiforme, photosensitivity, pruritus, exfoliative dermatitis, urticaria, vasculitis, purpura, fever, chills, necrotizing angiitis and anaphylactic shock.

Overdose

In case of overdose, there is a pronounced decrease in blood pressure, collapse, shock, hypovolemia, dehydration, hemoconcentration, arrhythmias, acute renal failure with anuria, thrombosis, thromboembolism, drowsiness, confusion, flaccid paralysis, apathy.

Treatment requires normalization of water-electrolyte balance and acid-base state, replenishment of circulating blood volume, gastric lavage, intake activated carbon, symptomatic treatment... There is no specific antidote.

Analogs

Analogues of Furosemide according to the ATC code: Lasix, Furon, Furosemide injection, Fursemide.

Do not make the decision to change the drug yourself, consult your doctor.

pharmachologic effect

The active component of this medication has a diuretic effect, helping to increase the excretion of water from the body with magnesium and calcium ions.

The use of furosemide in heart failure leads to a rapid decrease in the preload on the heart caused by the expansion of large veins.

The action of the drug after intravenous administration comes very quickly - after five to ten minutes, and after oral use - after an hour. The duration of the diuretic action of Furosemide varies from two to three hours. With reduced kidney function therapeutic effect medication lasts up to eight hours.

special instructions

Before starting treatment, you should make sure normal functioning urinary system and in the absence of a violation of the outflow of urine.

Patients undergoing treatment with Furosemide require periodic monitoring of blood pressure, uric acid, plasma electrolytes, creatinine, kidney and liver function, glucose levels.

While taking the drug, you should stop driving and work with complex mechanisms requiring increased concentration and the reaction rate.

Furosemide solution for intravenous or intramuscular administration should not be mixed in the same syringe with other drugs.

During pregnancy and breastfeeding

Furosemide is contraindicated during pregnancy and breastfeeding.

In childhood

Contraindicated in children under 3 years of age.

In old age

It is prescribed with caution to elderly patients.

With impaired renal function

Patients with chronic renal failure require careful selection of the dosage of the drug. Furosemide is contraindicated in acute glomerulonephritis and acute renal failure with anuria.

For violations of liver function

With extreme caution, it is prescribed to patients with severe liver dysfunction. Selection of the dosage of the drug is required. Furosemide is contraindicated in patients with severe liver failure, with hepatic coma and precoma.

Furosemide is a powerful loop diuretic for active elimination of stagnant urine, reduction of edema in renal pathologies, arterial hypertension. Diuretic tablets and injection solution are prescribed for severe conditions, accompanied by pronounced swelling, a sharp increase in pressure, and acute intoxication.

Furosemide is a potent diuretic agent. Misuse of the medication can be harmful. The instruction contains data on the properties, side effects of the drug, describes the rules for taking pills, administering a solution in / in and in / m, the effectiveness of therapy.

Compound

Furosemide is an active substance of a diuretic. It is important to know that loop diuretics act on the Gengle loop - a special renal tubule responsible for the reabsorption of fluid with solutes.

Release form

The drug Furosemide is marketed in two forms - for oral administration and injection:

• Furosemide tablets with a diuretic effect. Content active substance each loop diuretic tablet contains 40 mg. Additional ingredients are also added: milk sugar, colloidal form of silicon dioxide, gelatin, potato starch and others. Pharmacy chains receive packages No. 20 and 50;
• injection. The concentration of furosemide in 1 ml of a diuretic is 10 ml. Additional substances: sodium hydroxide and chloride, water for injection. Each ampoule contains 2 ml of the drug, the package contains 10 containers with the drug.

Action

A potent diuretic affects the ascending part of the Gingle loop (thick segment). A characteristic feature is a fast but short-term diuretic effect.

Against the background of taking pills, the diuretic effect appears in a third of an hour, after intravenous injection- after 10-15 minutes. Maximum effect develops after 60 minutes, persists for three to four hours, rarely up to six hours.

Furosemide not only removes excess fluid and stagnant urine, but also flushes out chlorine and sodium salts. For this reason it is important to apply carefully potent remedy, with light and moderate hypertension, renal pathologies, poisoning use thiazide or osmotic diuretics. The optimal type of diuretic is selected by a urologist, nephrologist. In case of diseases of the heart and blood vessels, a consultation with a cardiologist is required.

Diuretic Furosemide undergoes metabolism in the liver, the processed substance enters the renal tubules. After oral administration, up to 70% is excreted by the kidneys, 30% - with feces, with intravenous administration, the percentage changes - 88 and 12%, respectively.

Indications for use

A diuretic is prescribed for the following pathologies and severe conditions:

• hypertensive crisis;
• puffiness against the background of the second and third degree, nephrotic syndrome, liver cirrhosis;
• increased calcium accumulation;
• edema of the brain;
• acute heart failure, accompanied by pulmonary edema;
• eclampsia;
• acute toxicosis on later dates pregnancy (only a short course as prescribed by a doctor);
• poisoning with pronounced signs of intoxication for the speedy elimination of poisons.

Important:

• during the course of therapy, a sharp decrease in the level of potassium is possible. At risk are patients with cirrhosis of the liver, heart failure, taking a large amount of various medications;
• you need to regularly (once a week) take a blood test to control the level of potassium in the elderly, with a poor diet. The first ionogram is required 7 days after taking the first diuretic tablet;
• against the background of hypokalemia, bradycardia, cardiac arrhythmia, life-threatening pirouette tachycardia develop. These points should be taken into account by the doctor, who selects the optimal diuretic for patients at risk.

On a note! The diuretic Furosemide is prescribed for chronic renal failure, if creatinine clearance is not higher than 30 ml / minute, it is forbidden to use thiazide diuretics. Intravenous administration of the solution is indicated when hypertensive crisis, for active lowering of pressure at high stress on the heart. If the patient suffers from nephrotic syndrome, then it is imperative to treat the underlying pathology that provokes severe kidney damage.

Contraindications

Important to remember: Furosemide is a powerful diuretic. Improper use or use of a medicine without taking into account the restrictions provokes dangerous complications.

The list of contraindications is quite long, there are temporary and absolute restrictions. It is forbidden to use injection solution and tablets for nursing mothers.

Relative contraindications for prescribing the drug Furosemide:

• low blood pressure against the background of insufficient blood circulation, risk different types ischemia;
• diabetes;
• hyperplasia of the prostate (benign form);
• hepatorenal syndrome;
• cerebral atherosclerosis (obliterating variety);
• low levels of proteins in the body.

The doctor selects another diuretic if there are absolute contraindications:

• acute stage of myocardial infarction;
• renal failure (severe);
• hyperglycemic and hepatic coma;
• moderate degree of hypertension;
• urethral stenosis;
• anuria (a sharp decrease in the volume of urine excreted);
• hypersensitivity to furosemide or excipients;
• hyperuricemia;
• deviations in the water-salt balance, increase / decrease in the level of calcium, potassium, magnesium;
• excess pressure in the right atrium up to 10 mm. rt. Art. and higher;
• intoxication caused by taking cardiac glycosides;
• deposition of uric acid salts;
• occlusion of the urinary tract calculus;
• systemic lupus erythematosus;
• precomatose states;
• aortic stenosis either mitral valve(decompensated form);
• pancreatitis.

Instructions for use and dosage

How to take Furosemide? Loop diuretics have many side effects. Excess one-time or daily dosage the drug Furosemide is fraught with complications. You can take pills with the permission of your doctor. Injections for severe conditions are carried out only by health workers.

Tablets

At moderate pathologies, half or a whole tablet of Furosemide is prescribed twice a day. At serious condition the norm is increased to two or three units of the drug, the frequency of use is 1 or 2 times a day.

Patients with high pressure against the background of chronic renal failure, Furosemide is prescribed in combination with drugs that lower blood pressure. The rate of a loop diuretic per day is from 20 to 120 mg.

Injections

The best way to use a powerful diuretic is intravenous administration, necessarily, slow, for one or two minutes. In case of pulmonary edema, intramuscular use is prohibited; in most cases, a diuretic solution is injected into a vein.

At a dosage of Furosemide above 80 ml, droppers are prescribed. In case of poisoning, hypertensive crisis, the initial dose is 20 to 40 mg. Maximum daily rate active substance - 600 mg (in exceptional cases).

Go to the website and read about medication for treating kidney inflammation.

Possible side effects

Negative manifestations are possible depending on the individual characteristics of the organism. varying degrees gravity:

• oliguria, acute urinary retention;
• a sharp drop in blood pressure, arrhythmia, collapse, tachycardia;
• impaired vision and hearing;
• aplastic anemia, leukopenia, thrombocytopenia;
• hyperglycemia, increased cholesterol levels, glucosuria, excessive urine production;
• different kinds allergic reactions, photosensitivity, anaphylactic shock, urticaria;
• constipation, exacerbation of pancreatitis, cholestatic jaundice, nausea, dry mouth, diarrhea;
• increased risk of thrombosis, metabolic acidosis, dehydration;
• muscle weakness, confusion, apathy, headaches, lethargy, dizziness;
• thrombophlebitis (when administered intravenously).

Important! A long list of side effects shows how actively furosemide affects organs and systems. Any dosage adjustment is done as directed by your doctor. Uncontrolled reception on the recommendation of non-specialists can cause life-threatening complications. The drug is dispensed only with a prescription.

Overdose

It is impossible to exceed the optimal rate for each type of pathology. The optimal dosage is prescribed by the doctor. Excess furosemide negatively affects the body. It's important to know: the drug does not have a specific antidote; if the rules are violated, it is quite difficult to return the indicators to normal.

Overdose signs:

• dehydration;
• thrombosis;
• arrhythmia;
• a sharp decrease in blood pressure;
• collapse;
• thromboembolism;
• drowsiness;
• flaccid paralysis;
• confusion of consciousness;
• acute renal failure, a sharp decrease in the volume of excreted urine;
• hypovolemia (decrease in the volume of circulating blood).

What to do: call an ambulance for urgent action to restore water-salt balance, cardiac disorders, decrease in fluid deficiency.

Cost and storage conditions

Furosemide is an effective and cheap diuretic. The cost of tablets and solution for injection varies slightly depending on the manufacturer.

Average price of Furosemide:

• tablets, package No. 20 - from 25 to 45 rubles;
• tablets, package number 50 - from 30 to 65 rubles;
• ampoules 1% solution, package No. 10 - from 30 to 85 rubles.

The cost of Lasix - 10 ampoules - 350 rubles, 50 capsules - 460 rubles.

Place the diuretic in a dark place. Indoor temperature - no more than + 25C.

Use an open ampoule immediately. There should be no dampness in the room. Keep the diuretic away from children.

Furosemide: analogues

Identical preparations for oral administration:

• Lasix.
• Furosemide Sopharma.

Intravenous analogs:

• Furosemide Vial.
• Lasix.
• Furosemide-Darnitsa.

Furosemide has long been renowned for its diuretic effect. This drug is widely used for circulatory disorders, when the metabolism weakens and an excessive amount of fluid accumulates in the body. Consider what side effects of Furosemide may occur, how to properly take and dose the drug for various pathologies.

The main purpose of Furosemide is to have a strong diuretic effect.

Furosemide is a drug belonging to a group of drugs that "inhibit" the reabsorption of salts and water, thereby increasing their excretion along with urine. That is, this remedy has a strong diuretic effect.

It is produced in several dosage forms - in tablets, in suspension granules (used for children under five years old) and in ampoules for intravenous use.

pharmachologic effect

The main task of Furosemide is to provide primary and secondary excretion of salts and water during urination. It is widely used in cardiology when, since it significantly reduces the load on the heart muscle by expanding large blood vessels... That is, in addition to a diuretic, this agent also has a vasodilating effect.

The diuretic effect depends on the dosage. The first effect appears within 30-40 minutes after taking the first pill. The most "striking" effect is observed in the first two hours. The general effect is observed within 8 hours after taking the drug.

When the drug is administered intravenously, the result manifests itself already in the first 15-20 minutes, but at the same time it lasts much less than with tablets. This is due to the fact that the "tablet" form is absorbed longer and excreted from the body more slowly.

To say exactly what dosage form better - it is impossible, since the active components are the same and their effect on the body is identical.

The drug is very popular in many countries around the world due to its advantages and pharmacokinetics:

• The drug is absorbed very quickly, although not completely. The highest concentration in the blood is observed one hour after ingestion. During a meal, the effect slows down, but does not decrease.
• In blood plasma, furosemide binds to proteins by 97-98%. If the patient has renal impairment, then the binding is reduced (depending on the severity of the renal pathology).
• Furosemide is partially excreted from the body - through the gastrointestinal tract and through the genitourinary system. That is why it is necessary to make sure that there are no pathologies on their part before using it.
• In older patients, the drug does not cause such an immediate reaction as in a younger organism.
• In patients with renal failure, oral bioavailability is significantly reduced.

In addition, Furosemide has a minimum amount side effects usually seen with diuretics.

Indications for use

The use of furosemide is indicated for varicose veins veins

If a violation occurs from at least one organ, this leads to dysfunctions of other organs and systems. Any problems arising in vascular system cause circulatory disorders.

As you know, blood performs a transport function and carries oxygen throughout the body and all necessary substances for full-fledged life processes. If the blood supply deteriorates, the organs begin to "starve" and various pathologies develop.

Thus, we can conclude that Furosemide is necessary for the following diseases:

• Chronic, arising in the background vascular diseases, or at
• Pulmonary edema resulting from heart failure or diabetes mellitus
• Cerebral edema
• face and limbs during pregnancy
• Some forms

Some patients use this drug for weight loss, that is, to remove excess fluid. On my own, without preliminary consultation it is categorically impossible to do this with a specialist.

Furosemide in heart disease has positive effect: when absorbed, it promotes the elimination of excess fluid in the body and vasodilation. Thanks to this, the heart muscle is in a state of calm and the risk of ischemia, hypertension and many chronic pathologies decreases significantly.

How to take Furosemide

Due to contraindications, the drug Furosemide cannot be taken without a doctor's prescription.

In each individual case the specialist should adjust the dose. It directly depends on the nature and severity of the disease.

With, which occurs as a result of diseases of the lungs, kidneys, liver and heart in an average condition, adults are recommended to take 1 tablet once a day, preferably in the morning and on an empty stomach. For severe disease, 2-3 tablets several times a day

For swelling in children, the dose is determined depending on the weight of the baby. The calculation should be done based on the norm of 1 mg per kg of weight.

Contraindications and restrictions for use

Like everyone else medications, Furosemide has some contraindications, which is why it cannot be taken without a doctor's prescription:

• individual intolerance to one of the components of the composition
• allergic reactions
• anuria and renal failure
• severe hepatic pathologies
• recomatous state
• alkalosis
• arterial hypotension
• diabetic coma
• children up to those years (tablet form)
• violation of the outflow of urine
• aortic
• pancreatitis

In addition, there are a number of diseases in which you need to take Furosemide with extreme caution:

• hypotension, which can affect the coronary arteries
• myocardial infarction
• , more precisely (a type of arrhythmia in which the heart rate is significantly underestimated - less than 60 beats per minute), which can lead to cardiogenic shock
• bone and cartilage tissue disease, arthritis, arthrosis, gout
• diabetes
• prostatic hypertrophy

In the presence of such pathologies, a thorough examination by a specialist is required before taking the drug.

Application during pregnancy

During pregnancy, swelling occurs very often. This is due to the changes that take place in the body. There is a lack of vitamins and minerals, as a result of which the work of many organs and systems is disrupted, in connection with this, metabolism worsens.

Thus, the liquid is not completely drained. Often there is swelling of the legs, arms, face. This is the result of excess fluid in the body. You cannot drink Furosemide on your own, but you need to initially see a specialist.

The doctor can prescribe a pregnant woman to take Furosemide only if the risk of side effects is less than the harm from the pathology that must be eliminated. In the first trimester, when the fetus is just beginning to form, the drug is strictly prohibited.

If, nevertheless, a pregnant woman takes this drug, it is necessary to regularly monitor the condition and development of the fetus. In case of any violations, taking this drug should be stopped immediately.

The result of exposure to Furosemide was studied in experimental animals - rabbits and mice. This issue was not considered in humans, because of this there is no accurate results negative impact on the human body.

Side effects of Furosemide

As adverse reaction the use of furosemide may cause an allergic rash

1. The cardiovascular system can be affected by excessive amounts of this drug... In some patients, there is an increase, the occurrence of arrhythmias (tachycardia and bradycardia), blood clots, anemia (lack of hemoglobin protein).
2. Sometimes patients experience malfunctions in the gastrointestinal tract. In this case, there is an upset stomach, vomiting, diarrhea, flatulence. Rarely - there is a feeling of thirst, dry mouth. Such symptoms are more often associated with an overdose.
3. Allergic reaction, redness skin, the appearance of itching, pain... Such reactions most often occur due to individual intolerance to the components of the composition.
4. Metabolism may slow down, which increases the risk and automatically increases the risk of disease vascular pathologies... For example, thrombosis or.
5. With damage to the central nervous system, the patient may feel dizziness, darkening in the eyes, a desire to sit or lie down. Light dizziness, impaired hearing, vision, smell - this is a small part.
6. Chills and fever.

If such difficulties arise during the use of Furosemide, it is necessary to notify the attending physician about this and stop taking the drug. In this case, it is recommended to replace the drug with an analogue that is suitable for this particular patient. The doctor prescribes only those medicines that will maximize effective result in this particular case.

When taking Furosemide, it is important to know that its main error lies in the fact that it excretes in the urine useful acids from the body and calcium.

Thus, it is important to take the drug in parallel to normalize metabolism. It has proven to be excellent, which normalizes the amount of potassium, magnesium and calcium in the body.

For more information on the possible side effects of diuretics, see this video:

Interaction with other drugs

Furosemide is combined with many drugs, however, there are those that are strictly forbidden to take together:

• The combination with chloral hydrate is not recommended. In the case of taking drugs at the same time, a number of side effects can occur - increased blood pressure, sweating, nausea, vomiting, increased anxiety.
• When taken simultaneously with cyclosporine, renal failure begins to develop.
• The interaction of this diuretic with NSAIDs can lead to metabolic disorders, the development of renal failure.

In addition, there are a number of prohibitions that depend on many factors. It follows from this that self-medication can be harmful to health. The drug can be taken only as directed by a doctor, who is based on the facts - test results, anamnesis, the severity of the disease.

Overdose and precautions

At overuse Furosemide may appear false urge to urinate

When taking a diuretic drug, it is important to observe the dosage recommended by the doctor. In case of overdose, the following symptoms may occur:

• heart rhythm disorder
• problems of the genitourinary system
• false desires for little need
• drowsiness, constant lethargy tiredness after sleep
• violation of blood pressure
• thromboembolism, thrombosis,
• psychological disorders, apathy

To treat the above symptoms, you need complex therapy, aimed at improving the functioning of the genitourinary system, removing excess active ingredients, normalization of heart rate. In order to avoid the development of pathologies, it is important to observe the dosage.

In summary, it can be noted that Furosemide is an excellent fast acting diuretic. It can be used in complex treatment of cardio-vascular system. The main effect is to improve metabolism, and as a result, the elimination of excess fluid naturally... Before you take this medicine, it is important to consult a doctor to confirm or rule out the presence of contraindications.

Since Furosemide has a specific effect on the body, it must be additionally taken with Asparkam, which blocks Negative influence and prevents the flushing of calcium, magnesium, fluoride and other substances that are necessary for the full functioning of organs and systems. If health problems arise during the admission process, you should immediately seek help from a specialist.