furosemide, Lasix (cont.)

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Medical and Pharmacy Editor:

DOSING: The usual starting oral dose for treatment of edema in adults is 20-80 mg as a single dose. The same dose or an increased dose may be administered 6-8 hours later. Doses may be increased 20-40 mg every 6-8 hours until the desired effect occurs. The effective dose may be administered once or twice daily. Some patients may require 600 mg daily.

The starting oral dose for children is 2 mg/kg. The starting dose may be increased by 1-2 mg/kg every 6 hours until the desired effect is achieved. Doses greater than 6 mg/kg are not recommended.

The recommended dose for treating hypertension is 40 mg twice daily. The dose of other blood pressure medications should be reduced by half when furosemide is added.

DRUG INTERACTIONS: Administration of furosemide with aminoglycoside antibiotics (for example, gentamicin) or ethacrynic acid (Edecrin, another diuretic) may cause hearing damage. Furosemide competes with aspirin for elimination in the urine by the kidneys. Concomitant use of furosemide and aspirin may, therefore, lead to high blood levels of aspirin and aspirin toxicity. Furosemide also may reduce excretion of lithium (Eskalith, Lithobid) by the kidneys, causing increased blood levels of lithium and possible side effects from lithium. Sucralfate (Carafate) reduces the action of furosemide by binding furosemide in the intestine and preventing its absorption into the body. Ingestion of furosemide and sucralfate should be separated by two hours.

When combined with other antihypertensive drugs there is an increased risk of low blood pressure or reduced kidney function.

Nonsteroidal anti-inflammatory drugs (for example., ibuprofen, indomethacin [Indocin, Indocin-SR]) may interfere with the blood pressure reducing effect of furosemide.

PREGNANCY: There are no adequate studies of furosemide in pregnant women.

NURSING MOTHERS: Furosemide is secreted in breast milk. Nursing mothers should avoid breastfeeding while taking furosemide.

Medically Reviewed by a Doctor on 12/10/2013


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