section name header

Pronunciation

fur-OH-se-mide

Classifications

Therapeutic Classification: diuretics

Pharmacologic Classification: loop diuretics

Indications

IM:

BEERS REMS


Action

  • Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule.
  • Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium.
  • Effectiveness persists in impaired renal function.
Therapeutic effects:
  • Diuresis and subsequent mobilization of excess fluid (edema, pleural effusions).
  • Decreased BP.

Pharmacokinetics

Absorption: 60–67% absorbed after oral administration ( in acute HF and in renal failure); also absorbed from IM sites; IV administration results in complete availability; 99.6% absorbed after SUBQ administration.

Distribution: Crosses placenta, enters breast milk.

Protein Binding: 91–99%.

Metabolism/Excretion: Minimally metabolized by liver, some nonhepatic metabolism, some renal excretion as unchanged drug.

Half-Life: 30–120 min ( in renal impairment).

Time/Action Profile

(diuretic effect)

ROUTEONSETPEAKDURATION
PO30–60 min1–2 hr6–8 hr
IM10–30 minunknown4–8 hr
IV5 min30 min2 hr
Subcutunknownunknown8 hr



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension

Derm: ERYTHEMA MULTIFORME, photosensitivity, pruritus, rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, urticaria

EENT: hearing loss, tinnitus

Endo: hypercholesterolemia, hyperglycemia, hypertriglyceridemia, hyperuricemia

F and E: dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis

GI: liver enzymes, anorexia, constipation, diarrhea, dry mouth, dyspepsia, nausea, pancreatitis, vomiting

GU: BUN, excessive urination, nephrocalcinosis

Hemat: AGRANULOCYTOSIS, APLASTIC ANEMIA, hemolytic anemia, leukopenia, thrombocytopenia

MS: muscle cramps

Neuro: blurred vision, dizziness, headache, paresthesia, vertigo

Misc: fever

Interactions

Drug-drug:

Route/Dosage

Edema

Hypertension

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Furoscix, Lasix

Pill Image

furosemide_195-9157.jpg

Code

NDC Code