Furosemide, 10 mg/ml 2 ml 10 pcs

A “loop” diuretic. Disrupts reabsorption of sodium, chlorine ions in the thick segment of the ascending part of the loop of Genle. Due to the increased excretion of sodium ions, there is a secondary (mediated by osmotically bound water) enhanced excretion of water and increased secretion of potassium ions in the distal part of the renal tubule.

Indications

Edema in chronic congestive heart failure (if treatment with diuretics is necessary);
– Edema in acute congestive heart failure. Edema in chronic renal insufficiency;
– Acute renal insufficiency, including in pregnant women or during childbirth;
– Edema in liver diseases (if necessary, to supplement treatment with aldosterone antagonists);
– Hypertensive crisis (as a supporting agent);
– Support of forced diuresis.

Active ingredient

Furosemide

How to take, the dosage

The dosing regimen is determined by the physician individually depending on the severity of the disorders of water-electrolyte balance, the value of glomerular filtration, the severity of the patient’s condition. During administration of the drug the parameters of water-electrolyte balance should be corrected taking into account diuresis and dynamics of general state of a patient.

The drug Furosemide is administered intravenously only if intravenous administration is inadvisable or ineffective (e.g. if absorption in the gut is impaired) or if rapid effect is required. If intravenous therapy is used, it is recommended that as soon as possible the therapy is switched to oral medication.
Continuous infusion of Furose-Mide is preferred over repeated bolus injections to achieve optimal efficacy and inhibit counter-regulation in general.

When continuous infusion of Furosemide drug is not feasible for further treatment after administration of one or more painful doses, a further treatment regimen with low doses administered at short time intervals (approximately 4 h) is preferred over larger bolus doses administered at longer intervals.

In adults, the recommended maximum daily dose of furosemide is 1500 mg.

In children, the recommended dose of Furosemide for parenteral administration is 1 mg/kg body weight, but the maximum daily dose should not exceed 20 mg.

Special dosing recommendations

The dosing for adults in general is based on the following recommendations.

Oedema in chronic congestive heart failure

The recommended starting dose of the drug for oral administration is 20 mg to 50 mg per day. If necessary, the dose may be adjusted according to the therapeutic response of the patient. It is recommended to take a daily dose divided into 2 or 3 doses.

Oedema in acute congestive heart failure

The recommended initial dose of the drug is 20 to 40 mg and is administered as a bolus injection. If necessary, the dose may be adjusted depending on the therapeutic response of the patient.

Oedema in chronic renal failure

The natriuretic effect of furosemide depends on a number of factors, including the severity of renal failure and sodium balance. Thus, it is not possible to accurately predict the efficacy of the dose. Patients with chronic renal insufficiency should titrate the dose cautiously to ensure gradual initial fluid loss. In adult pa-patients, this means using a dose that results in a daily weight loss of approximately 2 kg (approximately 280 mmol Na+).

In intravenous furosemide can be dosed as follows: treatment starts with a continuous infusion of 0.1 mg for 1 minute; the infusion rate is then increased every half hour depending on patient response.

In acute renal failure, hypovolemia, hypotension and significant electrolyte and acid-base imbalances should be compensated before starting furosemide administration.

The transition from intravenous to oral administration is recommended as soon as possible.

The recommended starting dose is 40 mg and is given as an intravenous injection. If this dose does not produce the desired increase in fluid excretion, furosemide may be given as a continuous infusion, starting at 50 to 100 mg of the drug in 1 hour.

Furosemide is indicated as an adjunct to aldosterone antagonist therapy when aldosterone antagonists alone are insufficient. To prevent complications such as orthostatic hypotension or electrolyte and acid-base imbalances, the dose should be carefully titrated to ensure a gradual initial fluid loss. For adult patients, this means administering a dose that results in a daily weight loss of approximately 0.5 kg. If administration is absolutely necessary, the initial single dose is 20-40 mg.

Hypertensive crisis

The recommended starting dose of 20 to 40 mg is given as an intravenous bolus injection. If necessary, the dose may be adjusted depending on the therapeutic response of the patient.

Support of forced diuresis in case of poisoning

The LS Furosemide is administered intravenously in addition to intravenous infusion of electrolyte solutions. The dose depends on the therapeutic response to furosemide. Fluid and electrolyte loss should be regulated and initiated during treatment as well. In case of poisoning with acidic or alkaline substances, fluid excretion can be accelerated by alkalizing or oxidizing the urine, respectively.

The recommended starting dose is 20 mg to 40 mg and is administered intravenously.

Interaction

Concomitant use with antibiotics of the group of aminoglycosides (including gentamicin, tobramycin) may increase nephro- and ototoxic effects. Furosemide decreases clearance of gentamicin and increases plasma concentrations of gentamicin and tobramycin. When concomitant use with antibiotics of cephalosporin group, which may cause renal dysfunction, there is a risk of increased nephrotoxicity.

Special Instructions

During the course of treatment it is necessary to periodically monitor blood pressure, blood plasma electrolytes (including Na+, Ca2+, K+, Mg2+), acid-base status, residual nitrogen, creatinine, uric acid, liver function and make, if necessary, appropriate treatment adjustments.

Contraindications

Hypersensitivity to the drug (LS) Furosemide or other components of the drug.
Patients with allergies to sulfonamides (e.g. sulfonamide antibiotics or sulfonylureas) may have cross-sensitivity to furosemide.
Hypovolemia or dehydration.
Renal failure in the form of anuria if there is no therapeutic response to furosemide.
Renal failure due to poisoning with nephrotoxic or hepatotoxic drugs.
Severe hypokalemia.
Severe hyponatremia.
Precomatose or comatose states associated with hepatic nocturnal encephalopathy.

Side effects

Cardiovascular system: decreased BP, orthostatic hypotension, collapse, tachycardia, arrhythmias, decreased blood circulation.

Overdose

Symptoms: decreased blood pressure, collapse, shock, hypovolemia, dehydration, hemoconcentration, arrhythmias, acute renal failure with anuria, thrombosis, thromboembolism, drowsiness, confusion, paralysis, apathy.

Pregnancy use

In pregnancy, furosemide may only be used for a short time and only when the anticipated benefit of therapy to the mother exceeds the potential risk to the fetus.