Furosemide is a prescription drug that is available at an affordable price. It is an effective diuretic. The drug belongs to the group of loop diuretics. These drugs remove fluid from the body, affecting the filtration ability of the kidneys. Due to the presence of contraindications and the high risk of adverse reactions, the drug should be taken only as prescribed by a doctor.
Furosemide: components and release form
The drug is produced in three forms. The active ingredient in them is furosemide. The most common are round or flat-cylindrical, white or slightly yellowish tablets. They have a chamfer and a risk. Furosemide tablets, the instructions indicate this, contain, in addition to 40 mg of the active ingredient of the same name, auxiliary components: corn and potato starch, cellulose, lactose, etc.
The tablets are placed in blister packaging, for the production of which polyvinyl chloride film and aluminum foil are used. You can also purchase them in plastic polymer jars. In any form, the tablet product, together with instructions for use, is packaged in cardboard boxes.
In addition, you can purchase the drug in other forms:
- In ampoules of 2 ml. They contain 20 mg of active substance. The drug is administered intravenously in cases where it is not possible to use tablets. For example, the need for this may arise in urgent situations. Sometimes intramuscular administration is prescribed, but the effectiveness of the drug decreases.
- In granules for preparing a suspension. This form is used to treat children.
What to do in case of overdose
If a person intentionally took a large dose of furosemide, he must be given first aid. First of all, you should rinse your stomach. Then treatment measures should be carried out in a hospital setting. The patient is injected with a liquid that can fill the volume of circulating blood. To improve the functioning of the cardiovascular system, the patient is prescribed potassium and magnesium.
If blood pressure has dropped, the patient is prescribed a drug that helps increase it. In addition, it is recommended to drink enough fluid to prevent dehydration. At home, you can increase your blood pressure with strong black sweet tea.
If there is a chronic overdose of this drug, the treatment regimen should be reconsidered. If necessary, the dose of the medicine is reduced or it is changed to a drug with a similar effect. The selection of a medication is carried out exclusively by the attending physician, taking into account the main contraindications and the general condition of the patient.
Indications
Furosemide, the instructions focus on this, is prescribed primarily to relieve edema that occurs against the background of the following pathologies:
- Heart and kidney failure.
- Nephrotic syndrome.
- Liver pathologies.
- Arterial hypertension.
- Hypertensive crisis.
Furosemide is also indicated for burns; the instructions for use indicate this. The medicine is prescribed if severe toxicosis occurs in the second and third trimester of pregnancy. It is very often accompanied by swelling and other severe symptoms.
When should you take Furosemide?
Furosemide is a diuretic drug that has a therapeutic effect. The effect appears after a short period of time. If the drug is administered intravenously, the result will be visible within a few minutes. The medicine comes in tablets and injection solutions.
Basically, the drug is prescribed to patients to prevent swelling in diseases of the heart, liver, and lungs. In addition, the use of a diuretic is indicated if intoxication with a chemical component has occurred. In some cases, the use of a diuretic is necessary to lower blood pressure that accompanies hypertension.
Furosemide helps to increase the volume of urine excreted, along with this there is a loss of useful microelements. If you follow the prescribed dosage, the drug will not have a negative effect. However, uncontrolled use of this medication increases the risk of developing dangerous signs of overdose.
Contraindications
It is important to know what furosemide is used for, and to understand what contraindications exist. This will avoid dangerous consequences when using it. It is advisable to consult a doctor before starting to use furosemide; the instructions for use of the tablets emphasize many conditions where caution is necessary. In particular, these are:
- Anuria. With its development, pathological changes in the organs of the urinary system lead to the fact that urine does not enter the bladder.
- Oliguria. This pathology is characterized by a decrease in daily urine production for various reasons.
- Glomerulonephritis. This serious kidney disease is associated with damage to the glomeruli, often due to infection.
- Hyperuricemia. This pathology is characterized by an increased concentration of uric acid in the blood.
You should stop using the drug if you are hypersensitive to the active substance. The drug is not prescribed in the first trimester of pregnancy, since the active substance crosses the placenta. The drug should also be discontinued during lactation, as it suppresses the production of breast milk.
There are also a large number of relative contraindications. In particular, these are diabetes mellitus, low blood pressure, pancreatitis, diarrhea, etc. There are other contraindications that are indicated in the instructions for use.
Instructions for use FUROSEMIDUM
The use of furosemide requires regular medical and laboratory monitoring.
During treatment with the drug, it is necessary to ensure a constant flow of urine.
During treatment, regular monitoring of serum sodium, potassium, calcium, chloride, magnesium and creatinine levels is recommended, especially in patients at high risk of developing electrolyte imbalance or in cases of significant fluid loss (vomiting, diarrhea, intense sweating).
Hypovolemia, dehydration, and any significant disturbances in electrolyte and acid-base balance must be corrected, which may require temporary cessation of furosemide.
When using the drug, patients should be advised to eat foods high in potassium. It should be remembered that when using furosemide, it may be necessary to compensate for potassium loss with medication. Particular care should be taken when prescribing the drug and monitoring the condition:
- patients in whom the latent form of diabetes can become pronounced or patients with diabetes with an increased need for insulin;
- patients with gout. The use of furosemide slows down the excretion of uric acid and can provoke an attack of gout;
- patients with hepatorenal syndrome;
- patients with hypoproteinemia caused by nephrotic syndrome or liver cirrhosis (weaker effect of furosemide, but there is a risk of ototoxicity);
- patients with urinary disorders (prostatic hypertrophy or urinary tract obstruction), who may develop acute urinary retention (while taking the drug, a constant outflow of urine must be ensured);
- patients with arterial hypotension;
- patients who are at particular risk due to a significant decrease in blood pressure, for example, patients with severe stenosis of the coronary arteries or blood vessels supplying blood to the brain.
There have been cases of photosensitivity reactions with the use of thiazide diuretics. If such reactions occur during treatment, it is recommended to stop treatment. If it is necessary to resume use of the drug, measures to protect skin areas exposed to sunlight or artificial UV are recommended.
Athletes
Taking furosemide may result in a false positive test result during doping control.
This medicinal product contains lactose as an excipient and may therefore pose a risk for patients with rare hereditary forms of galactose intolerance, lactase deficiency or glucose-galactose malabsorption.
Children
The drug is not used for children weighing less than 10 kg. The dose for children should be reduced according to body weight.
The ability to influence the reaction rate when driving a vehicle or working with other mechanisms
During treatment with the drug, the ability to concentrate may decrease. Persons driving vehicles and working with dangerous machinery should refrain from using the drug.
Side effects
Side effects when taking the drug can be observed from various systems. The most common disorder of the digestive system is manifested by:
- Dry mouth.
- The occurrence of a strong feeling of thirst
- Nausea and vomiting.
- Diarrhea or constipation.
Dangerous side reactions are allergic reactions. Failures of the cardiovascular system also pose a threat to health. In rare cases, temporary disturbances in vision and hearing are noted during treatment. Headaches, dizziness, and muscle weakness may also occur. In case of any negative reactions, the drug should be discontinued.
How does the disease manifest itself?
The development of symptoms of the disease is gradual. The symptoms are caused by an electrolyte imbalance. Among the initial symptoms are weakness, drowsiness, and dry skin. In addition, the patient's blood pressure drops and his head begins to feel dizzy.
Furosemide-dependent pathology is characterized by potassium deficiency, as a result of which myalgia develops, muscle strength decreases, constipation, tachycardia appear, the patient complains of pain in the heart. Since the kidneys excrete sodium in excessive amounts, headaches and nausea appear, which ends in vomiting. The person becomes emotionally unstable, and there is a state of depression.
Due to the fact that magnesium is present in the body in insufficient quantities, certain muscle groups begin to twitch, convulsions and interruptions in the functioning of the heart appear. If you reduce the dosage of the drug or try to abruptly stop it yourself, there will be a decrease in diuresis (sometimes its complete cessation), a rapid increase in body weight, swelling and shortness of breath will appear and increase. Patients using the drug to lose weight may experience symptoms of addiction.
Dosage according to instructions
The dosage of the drug for the treatment of various pathologies is selected individually. It is recommended to use the minimum doses of the drug that allow you to achieve the desired result. The tablets are swallowed on an empty stomach. When taking them, you need to drink enough water.
According to the instructions, the maximum daily dose for adult patients is 1500 mg. The amount of medication to be taken by a specialist is determined based on an analysis of the body’s diuretic response. When treating edematous syndrome, which is provoked by various pathologies, the initial dose is 20-80 mg/day. It is divided into 2-3 doses. Subsequently it can be increased. For patients on hemodialysis, the dosage may be increased to 1500 mg/day.
The daily dosage for the treatment of children is 1-2 mg/kg body weight. If necessary, the amount of the drug can be increased to 6 mg/kg, but the medicine should be taken at intervals of at least 6 hours. The duration of treatment depends on the indications. It must be agreed with the doctor.
The effectiveness of the drug may change when interacting with other drugs. This must be taken into account when using it. Overdose is also dangerous. It can provoke negative reactions in the body that pose a threat to life.
How does an overdose manifest itself?
After taking a diuretic, the blood vessels dilate, and essential microelements are removed, which contribute to the normal functioning of all organs and systems of the body. The patient's general health deteriorates significantly.
Signs of overdose appear if the exact dosage of the drug is exceeded. The symptoms are:
- Due to the high dose of the drug, the volume of circulating blood decreases, as a result of which tachycardia and arrhythmia develop. Blood clots may form.
- Uncontrolled use of a diuretic provokes a sharp drop in blood pressure. At first, this is expressed in the appearance of dizziness and weakness. If the dose is increased significantly, the person may faint.
- Hearing and vision impairment occurs.
- Hypokalemia is detected.
- The appearance of strong thirst. The cause is dehydration.
What awaits a patient with furosemide-dependent kidney
In most cases, spontaneous diuresis is completely restored. The main condition for this is complete withdrawal of the medication. If there is no qualified and timely treatment, renal function will be irreversibly impaired due to electrolyte imbalance and persistent damage to the renal glomerulus, which is characteristic of chronic glomerulonephritis.
To prevent furosemide-dependent disease, self-medication should not be carried out. In addition, it is forbidden to take the drug for a long time. Electrolyte levels should be monitored. Those patients who are at risk are recommended to take a potassium-sparing or thiazide diuretic.
When should you not take Furosemide?
There are a number of contraindications to the use of this drug. Namely:
- Chronic kidney disease.
- Presence of gout, hypokalemia, hyperuricemia.
- The electrolyte balance is severely disturbed.
- Presence of diabetes mellitus.
- Stomach diseases.
- The patient has a strong sensitivity to the components of the drug.
How is furosemide dependent kidney diagnosed?
A nephrologist can make an accurate diagnosis. This happens without any difficulties, since the patient who has been taking furosemide for a long time has characteristic symptoms and impaired renal excretory function. Difficulty in making a diagnosis occurs at an early stage of the disease. During this period, signs are presented in the form of nonspecific changes that are of a general nature. To diagnose furosemide-dependent kidney, specialists at our medical center can use the following methods:
- Taking a biochemical blood test. According to the results of such a study, it is revealed that sodium, potassium, chlorides, calcium, and magnesium are reduced. If the disease has progressed to a more severe stage, urea and creatine levels may increase. In addition, furosemide-dependent renal dysfunction is characterized by hypoproteinemia.
- Taking a general urine test. Organic kidney damage is characterized by moderate proteinuria, cylindruria, hypoisosthenuria, erythrocyturia, leukocyturia. A biochemical analysis is also carried out, the results of which reveal that potassium, sodium, chlorine, calcium, and magnesium are increased. Excretory and concentration functions are assessed by performing the Zimnitsky test.
- Ultrasonography. The size and shape of the kidneys are determined using sonography. In addition, this method will help to study how the cortex and medulla are structured. The renal parenchyma is also measured, namely how thick it is. If changes in the anatomical structure are detected during an ultrasound examination, this is an unfavorable prognostic sign. If the disease has just begun to develop, ultrasound will be an uninformative method. This is explained by the absence of macroscopic disturbances.
If red blood cells and hemoglobin are reduced, this may indicate that the pathology has reached a severe stage. To determine how functional an organ is, glomerular filtration is assessed, namely its rate. The urinary system can be examined comprehensively. For this purpose, excretory urography, computed tomography, magnetic resonance imaging, and nephroscintigraphy are performed.
