Adult Dosing
Edema
- Start 20-40 mg IM/IV x 1; increase 20 mg q2 hrs until desired response obtained
- Alt: 0.1 mg/kg IV x 1, then 0.1 mg/kg/hr, then double dose q2 hrs up to 0.4 mg/kg/hr
Acute pulmonary edema
- Start 40 mg IV (over 1-2 mins) x 1. If response not satisfactory within 1 hr, increase to 80 mg
Hypercalcemia [Not FDA approved]
Reduction of intracranial pressure [Non-FDA Approved]
Pediatric Dosing
Edema
- Start 1 mg/kg IM/IV x 1; may increase 1 mg/kg q2 hrs until desired response obtained
- Max: 6 mg/kg/dose (infants/children); 1 mg/kg/day (neonates)
Hypercalcemia [Not FDA approved]
Reduction of intracranial pressure [Non-FDA Approved]
[Outline]
Renal Dose Adjustment
- Renal impairment: No dose adjustments
- Anuria: Contraindicated
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Cirrhosis/ascites: Use with caution
Reduction of intracranial pressure [Non-FDA Approved]
- Furosemide is a potent diuretic. Intense diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism. Hypokalemia may develop, especially with brisk diuresis, inadequate electrolyte intake, in presence of cirrhosis, prolonged use of laxatives, concomitant use of corticosteroids & ACTH. observe patients for signs and symptoms of fluid and electrolyte imbalance
- When treating edema, give second dose of bid schedule in mid afternoon to avoid nocturia
- Use in premature infants with respiratory distress syndrome, especially in first few weeks of life may increase incidence of patent ductus arteriosus
- For patients with hepatic cirrhosis and ascites, therapy should be initiated in a hospital setting under strict observation. Sudden alterations of fluid and electrolyte balance may precipitate hepatic coma. Potassium chloride and an aldosterone antagonist may help preventing hypokalemia and metabolic alkalosis
- Discontinue use if increasing azotemia and oliguria occurs during treatment of severe progressive renal disease
- Asymptomatic hyperuricemia can occur; gout may rarely be precipitated during therapy
- Systemic lupus erythematosus may be exacerbated or activated
- Cases of ototoxicity (deafness, tinnitus, vertigo) have occurred and have been associated with rapid injection severe renal impairment, doses larger than recommended doses, concomitant therapy with aminoglycosides, ethacrynic acid or other ototoxic drugs. Ototoxicity is usually reversible within 1 to 24 hrs, but may be permanent in some patients. Infusion rates not exceeding 4 mg/min may reduce risk
- Monitor for possible occurrence of blood dyscrasias and liver damage
- Monitor urine and blood glucose if diabetes or suspected latent diabetes
- Monitor serum electrolytes, magnesium, calcium, CO2, uric acid, and BUN/serum creatinine at baseline and periodically thereafter during active diuresis
- Allergy to sulfonamides, use with caution may also be allergic to furosemide
Cautions: Use cautiously in
- Hepatic impairment
- Severe renal impairment
- Acute MI
- Gestational hypertension
- Diabetes mellitus
- Arrhythmias
- SLE
- Hearing impairment
- Concurrent ototoxic agents
- Hx of pancreatitis
- Hx of gout
- Elderly patients
Pregnancy Category:C
Breastfeeding: Safety unknown. Since intense diuresis might decrease lactation, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 15 July 2010).
Pricing data from www.DrugStore.com in U.S.A.
- Furosemide 10 MG/ML SOLN [Vial] (HOSPIRA)
2 ml = $11.99
6 ml = $13.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
