Furosemide

  • Brand Name : Lasix
  • Drug Class : How Do Loop Diuretics Work?, Diuretics, Loop
  • Medical Author : John P. Cunha, DO, FACOEP
  • Medical Reviewer :
  • _eael_post_view_count : 8

What Is Furosemide and How Does It Work?

Furosemide is known as a diuretic (like a “water pill”). It helps your body get rid of extra water by increasing the amount of urine you make. Getting rid of extra water decreases the strain on your heart and blood vessels, thereby lowering high blood pressure and reducing your risk of strokes, heart attacks, and kidney problems. This effect can also improve symptoms such as trouble breathing and swelling (edema). This injectable form of furosemide is used when the drug cannot be taken by mouth, especially in patients with severe medical conditions.

  • Furosemide can also be used to decrease calcium in the blood (hypercalcemia).
  • Furosemide is available under the following different brand names: Lasix.

What Are Dosages of Furosemide?

Dosages of Furosemide:

Adult and Pediatric Dosage Forms and Strengths

Injectable solution

  • 10mg/mL

Oral solution

  • 10 mg/mL

Tablet

  • 20 mg
  • 40 mg
  • 80 mg

Dosage Considerations – Should be Given as Follows:

Edema

Edema associated with congestive heart failure (CHF), liver cirrhosis, and renal disease, including nephrotic syndrome

  • 20-80 mg orally once daily; may be increased by 20-40 mg every 6-8 hours; not to exceed 600 mg/day
  • Alternative: 20-40 mg intravenously/intramuscularly (IV/IM) once; may be increased by 20 mg every 2 hours; individual dose not to exceed 200 mg/dose

Refractory CHF may necessitate larger doses

  • Infants and children: 1-2 mg/kg IV/IM/orally once initially; increased by 1-2 mg/kg every 6-8 hours (orally) or 1 mg/kg every 2 hours (IV/IM); individual dose not to exceed 6 mg/kg

Neonates (younger than 28 days):

  • 0.5-1 mg/kg IV/IM every 8-24 hours; individual dose not to exceed 2 mg/kg

Geriatric:

  • 20 mg/day orally/IV/IM initially; increased slowly until the desired response is obtained

Hypertension, Resistant

  • Adult: 20-80 mg orally divided every 12 hours
  • Children less than 1 year: Safety and efficacy not established
  • Children 1-17 years: 0.5-2 mg/kg orally every 24 hours or every 12 hours; individual dose not to exceed 6 mg/kg/dose

Acute Pulmonary Edema/Hypertensive Crisis/Increased Intracranial Pressure

  • 0.5-1 mg/kg (or 40 mg) intravenously (IV) over 1-2 minutes; may be increased to 80 mg if there is no adequate response within 1 hour; not to exceed 160-200 mg/dose

Hyperkalemia in Advanced Cardiac Life Support (ACLS)

  • 40-80 mg intravenously (IV)

Hypermagnesemia in ACLS

  • 20-40 mg intravenously (IV) every 3-4 hours as needed

Dosing Modifications

  • Acute renal failure: 1-3 g/day may be necessary to attain desired response; avoid use in oliguric states
  • Hepatic impairment: Monitor, especially with high dosages

Dosing Considerations

  • Use for fluid retention refractory to thiazides or impaired renal function

Overdose management

Geriatric:

  • Excessive diuresis may cause dehydration and electrolyte loss in the elderly; lower initial dosages and more gradual adjustments are recommended (e.g., 10 mg/day orally)

An increase in blood urea nitrogen (BUN) and loss of sodium may cause confusion in the elderly; monitor renal function and electrolytes

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