Lasix (furosemide)

Furosemide injection for IV or IM administration is available as the sodium salt; dosage is expressed in terms of furosemide. Furosemide dosage must be adjusted according to the patient's requirements and response.

Furosemide is administered orally (as tablets or oral solution); the drug can also be administered parenterally (by IM or IV injection, or by subcutaneous infusion using an infusor device).

Furosemide 80 mg/mL injection (Furoscix(R)) is administered by subcutaneous infusion via a single-use On-body Infusor; the drug is contained in a prefilled cartridge that is designed to deliver 80 mg of furosemide in 10 mL solution over 5 hours.

Furosemide 80 mg/2.67 mL injection (Lasix(R) ONYU) is administered by subcutaneous infusion via an Infusor; the drug is contained in a prefilled cartridge that is designed to deliver 80 mg of furosemide in 2.67 mL solution over 5 hours. The Infusor consists of a custom Reusable Unit that can be used for close to 50 treatments.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

*Anuria.

*Hypersensitivity to furosemide or any component of the formulations.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

Adverse effects associated with oral administration of furosemide (categorized by body system and listed in order of severity) are: GI system reactions (hepatic encephalopathy in patients with hepatocellular insufficiency, pancreatitis, jaundice (intrahepatic cholestatic jaundice), increased liver enzymes, anorexia, oral/gastric irritation, cramping, diarrhea, constipation, nausea, and vomiting); systemic hypersensitivity reactions (severe anaphylactic or anaphylactoid reactions, systemic vasculitis, interstitial nephritis, necrotizing angiitis); CNS reactions (tinnitus and hearing loss, paresthesias, vertigo, dizziness, headache, blurred vision, xanthopsia); hematologic reactions (aplastic anemia, thrombocytopenia, agranulocytosis, hemolytic anemia, leukopenia, anemia, eosinophilia); dermatologic-hypersensitivity reactions (toxic epidermal necrolysis, Stevens-Johnson Syndrome, erythema multiforme, drug rash with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, exfoliative dermatitis, bullous pemphigoid, purpura, photosensitivity, rash, pruritus, urticaria); cardiovascular reactions (orthostatic hypotension, increase in serum cholesterol and triglycerides); and various other reactions (hyperglycemia, glycosuria, hyperuricemia, muscle spasm, weakness, restlessness, urinary bladder spasm, thrombophlebitis, fever).

The most common adverse effects associated with intramuscular or IV administration of furosemide are related to fluid and electrolyte imbalance.

Common adverse effects associated with subcutaneous administration of furosemide via infusors include administration site and skin reactions, including erythema, bruising, edema, and infusion site pain.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

Safety and efficacy of subcutaneous administration of furosemide via on-body infusor have not been established in pediatric patients.

In premature neonates, diuretic therapy with furosemide during the first weeks of life may increase the risk of persistent patent ductus arteriosus (PDA).

Hearing loss has been reported in neonates receiving furosemide. Therefore, the manufacturer states that parenteral furosemide dosages should not exceed 1 mg/kg per 24 hours in premature neonates with <31 weeks postconception age (gestational age at birth plus postnatal age), because higher dosages may be associated with potentially toxic plasma concentrations of the drug.

Furosemide may precipitate nephrocalcinosis/nephrolithiasis in premature neonates. Nephrocalcinosis/nephrolithiasis has also been observed in patients <=4 years of age with no history of prematurity receiving chronic treatment with furosemide. Monitor renal function and consider renal ultrasonography in pediatric patients receiving furosemide.

Available data from published observational studies, case reports, and postmarketing reports over decades of use have not demonstrated a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes with furosemide use during pregnancy. However, untreated congestive heart failure and hepatic cirrhosis can lead to adverse outcomes in both the mother and fetus. In reproduction studies involving rabbits, administration of furosemide caused unexplained abortions and maternal and fetal deaths. In addition, an increased incidence of hydronephrosis occurred in fetuses of animals treated with the drug.

Furosemide is distributed into human milk; there are no data on the effects on the breast-fed infant or on milk production. Doses associated with clinically significant diuresis may impair milk production. The developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for furosemide and any potential adverse effects on the breast-fed infant from furosemide or from the underlying maternal condition.

The manufacturer makes no specific dosage recommendations for geriatric patients. In general, dosage selection in geriatric patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Clinical studies of furosemide did not include sufficient numbers of patients to determine whether those who were >=65 years of age responded differently from younger patients. Other reported clinical experience has not identified differences in response between geriatric and younger patients. In general, dose selection should be cautious in geriatric patients, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy in this population.

Binding of furosemide to albumin may be reduced in geriatric patients. Furosemide is predominantly excreted unchanged in the urine. Following IV administration, the renal clearance of furosemide is substantially smaller in older healthy male patients (60-70 years of age) compared to younger healthy male patients (20-35 years of age). The initial diuretic effect of furosemide is also generally decreased in geriatric patients relative to younger patients.