Generic medicine

Furosemide

Furosemide is indicated in- Fluid retention associated with chronic congestive cardiac failure (if diuretic treatment is required). Fluid retention associated with acute congestive cardiac failure. Fluid retention associated with chronic renal failure. Maintenance of fluid excretion in acute renal failure, including that due to pregnancy or burns. ... Read moreFurosemide is indicated in- Fluid retention associated with chronic congestive cardiac failure (if diuretic treatment is required). Fluid retention associated with acute congestive cardiac failure. Fluid retention associated with chronic renal failure. Maintenance of fluid excretion in acute renal failure, including that due to pregnancy or burns. Fluid retention associated with nephrotic syndrome (if diuretic treatment is required). Fluid retention associated with liver disease (if necessary to supplement treatment with aldosterone antagonists). Hypertension. Hypertensive crisis (as a supportive measure). Support of forced diuresis.

Brands

10

Categories

3

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Dose and dosage

Cat

• Start with 1 mg/kg; then increase as needed, within a range of 1–4 mg/kg q8–24h
IV, IM, SQ, or PO.

Horse

As a diuretic:
a) For adjunctive therapy for congestive heart failure: Initially, 1–2 mg/kg IM or IV q6–12h to control edema. Long-term therapy: 0.5–2 mg/kg PO or IM q8–12h (Mogg 1999)
b) For adjunctive therapy of acute renal failure: 2–4 mg/kg q6h (Jose- Cunilleras & Hinchcliff 1999) For epistaxis/EIPH prevention:
a) 500 mg (total dose) 4 hours prior to race. (Hinchcliff et al. 2009)
b) 250 mg IV 4 hours prior to racing (Foreman 1999)

Cattle

a) 500 mg once daily or 250 mg twice daily; 2 grams PO once daily.
Treatment not to exceed 48 hours post-partum (for udder edema). Package
Insert; Lasix®–Hoechst)
b) 2.2–4.4 mg/kg IV q12h (Howard 1986)

Dog

• 2–6 mg/kg q8–12h (or as needed) IV, IM, SQ, or PO. A common initial dose when treating heart failure patients is 2 mg/kg q12h PO; then lower to 1–2 mg/ kg q12h PO.
• In acute cases in which intensive treatment is needed, administer 2 mg/kg IV followed by 2 mg/kg every 30 minutes until improvement is seen.
• CRI: 0.66 mg/kg bolus dose IV followed by 0.66 mg/kg/h for 8 hours. Alternatively, a dose of 2 mg/kg in 5% glucose can be infused over an 8-hour period IV.

Ferrets

For adjunctive therapy for heart failure:
a) 2–3 mg/kg IM or IV initially for fulminant CHF; 1–2 mg/kg PO q12h for long-term maintenance therapy (Hoeffer 2000)
b) 1–4 mg/kg PO, SC, IM or IV 2–3 times a day (Williams 2000)

Reptiles (Large)

For most species:
a) 5 mg/kg IV or IM as needed (Gauvin 1993)

Birds (Other)

As a diuretic:
a) 0.05 mg/300 grams body weight IM twice daily (Note: Lories are very sensitive to this agent and can be easily overdosed) (Clubb 1986)

Small mammals

a) Rabbits: For CHF: 2–5 mg/kg PO, SC, IM or IV q12h; For pulmonary edema: 1–4 mg/kg IV or IM q4–6h (Ivey & Morrisey 2000)
b) Mice, Rats, Gerbils, Hamsters, Guinea pigs, Chinchillas: 5–10 mg/kg q12h (Adamcak & Otten 2000)

Clinical notes

Applications:
  • Tumor lysis syndrome
Indication Notes:
Furosemide is indicated in- Fluid retention associated with chronic congestive cardiac failure (if diuretic treatment is required). Fluid retention associated with acute congestive cardiac failure. Fluid retention associated with chronic renal failure. Maintenance of fluid excretion in acute renal failure, including that due to pregnancy or burns. ... Read moreFurosemide is indicated in- Fluid retention associated with chronic congestive cardiac failure (if diuretic treatment is required). Fluid retention associated with acute congestive cardiac failure. Fluid retention associated with chronic renal failure. Maintenance of fluid excretion in acute renal failure, including that due to pregnancy or burns. Fluid retention associated with nephrotic syndrome (if diuretic treatment is required). Fluid retention associated with liver disease (if necessary to supplement treatment with aldosterone antagonists). Hypertension. Hypertensive crisis (as a supportive measure). Support of forced diuresis.
Avoid In:

N/A

Contraindication Notes:
Furosemide is contraindicated in anuria, electrolyte deficiency and pre-comatose states associated with liver cirrhosis. Hypersensitivity to furosemide or sulphonamides.
Furosemide is a monosulphonyl diuretic. It is an effective diuretic that retains its activity even in low glomerular filtration rate (GFR). Furosemide has a distinctive action on renal tubular function. It affects a peak diuresis far greater than that observed with other agents. Other features are (I) prompt onset of action (II) inhibition of sodium and chloride transport in the ascending limb of the loop of Henle and (III) independence of their action from acid-base balance changes. Furosemide acts primarily to inhibit electrolyte reabsorption in the thick ascending limb of the loop of Henle. Furosemide is readily absorbed from the gastrointestinal tract and considerable proportions are bound to plasma proteins. It is rapidly excreted in the urine. With an hour after intravenous injection, its effect is evident in about 5 minutes and last for about 2 hours.
A marked fall in blood pressure may be seen when ACE inhibitors are added to furosemide therapy. Serum lithium levels may be increased when lithium is given concomitantly with furosemide. The toxic effects of nephrotoxic antibiotics may be increased by concomitant administration of potent diuretics such as furosemide.
As with other diuretics, electrolytes and water balance may be disturbed as a result of diuresis of prolonged therapy. Prolonged use can produce alkalosis. It may also cause uric acid retention and may rarely produce acute gout. Furosemide may provoke hyperglycemia and glycosuria.
Signs and symptoms: The clinical picture in acute or chronic overdose depends primarily on the extent and consequences of electrolyte and fluid loss, e.g. hypovolaemia, dehydration, haemoconcentration, cardiac arrhythmias (including AV block and ventricular fibrillation). Management: No specific antidote to furosemide is known. If ingestion has only just taken place, attempts may be made to limit further systemic absorption of the active ingredient by measures such as gastric lavage or those designed to reduce absorption (e.g. activated charcoal).
Pregnancy category C. Furosemide should be cautiously used in cardiogenic shock complicated by pulmonary oedema and in the first trimester of pregnancy. Blood pressure and pulse during rapid diuresis should be monitored. Caution should be observed in patients liable to electrolyte deficiency. In case of nursing mother, furosemide may inhibit lactation or may pass into breast milk. In that case it should be used with caution.
Patients with prostatic hypertrophy or impairment of micturition have an increased risk of developing acute retention. A marked fall in blood pressure may be seen when ACE inhibitors are added to furosemide therapy. The toxic effects of nephrotoxic antibiotics may be increased by concomitant administration of potent diuretics such furosemide.Driving a vehicle or performing other hazardous tasks: Some adverse effects (e.g. an undesirably pronounced fall in blood pressure) may impair the patient's ability to concentrate and react, and, therefore, constitute a risk in situations where these abilities are of special importance (e.g. operating a vehicle or machinery).

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