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Furoscix
furosemide
Adult Dosing .
Dosage forms: INJ (on-body infusor): 80 mg per 10 mL
edema, heart failure-associated
- [30 mg/h SC x1h, then 12.5 mg/h SC x4h]
- Info: switch to PO when possible
edema, renal disease-associated
- [30 mg/h SC x1h, then 12.5 mg/h SC x4h]
- Info: switch to PO when possible
renal dosing
- [see below]
- moderate-severe impairment: consider additional diuretic tx; anuria: contraindicated
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- cirrhosis or ascites: not defined, caution advised
Peds Dosing .
- Dosage forms: INJ (on-body infusor): 80 mg per 10 mL
edema, heart failure-associated
- [>43 kg]
- Dose: 30 mg/h SC x1h, then 12.5 mg/h SC x4h; Info: switch to PO when possible
edema, renal disease-associated
- [>43 kg]
- Dose: 30 mg/h SC x1h, then 12.5 mg/h SC x4h; Info: switch to PO when possible
renal dosing
- [see below]
- moderate-severe impairment: consider additional diuretic tx; anuria: contraindicated
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- cirrhosis or ascites: not defined, caution advised
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to adhesive (on-body infusor form)
- MRI, concurrent (on-body infusor form)
- anuria
- hepatic coma
- electrolyte imbalance
- avoid: sun exposure
- avoid: UV light exposure, artificial
- caution: hypersensitivity to sulfonamides
- caution: ototoxic agent use, concurrent
- caution: elderly patients
- caution: premature neonates
- caution: renal impairment
- caution: renal disease, severe
- caution: ascites
- caution: cirrhosis
- caution: urinary retention
- caution: arrhythmia
- caution: gout history
- caution: SLE
- caution: diabetes mellitus
Drug Interactions .
Overview
furosemide
loop diuretic
- OAT1 substrate
- OAT3 substrate
- antihypertensive agent
- binds to anion exchange resin/polymer
- binds to cation exchange resin/polymer
- binds to polyvalent cations
- bioavailability increased by hydroxypropyl betadex
- decreases renal perfusion/fxn
- diuretic
- fluid/electrolyte loss
- hyperglycemic effects
- hyperuricemic effects
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- ototoxicity
- photosensitivity
- thyroid hormone synthesis/metabolism effects
Contraindicated
Avoid/Use Alternative
Monitor/Modify Tx
Caution Advised
Adverse Reactions .
Serious Reactions
- hypokalemia, severe
- electrolyte imbalance, severe
- arrhythmia
- metabolic alkalosis
- hypovolemia
- dehydration
- ototoxicity
- thrombocytopenia
- hemolytic anemia
- aplastic anemia
- leukopenia
- agranulocytosis
- eosinophilia
- thrombosis
- anaphylaxis
- vasculitis
- interstitial nephritis
- necrotizing angiitis
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- erythema multiforme
- drug reaction with eosinophilia and systemic symptoms
- acute generalized exanthematous pustulosis
- exfoliative dermatitis
- pancreatitis
- cholestatic jaundice
- SLE exacerbation
- nephrolithiasis (chronic use in patients <4 yo)
Common Reactions
- urinary frequency
- dizziness
- nausea
- vomiting
- weakness
- muscle cramps
- hypokalemia
- hypomagnesemia
- hypotension, orthostatic
- ALT or AST elevated
- blurred vision
- anorexia
- abdominal cramps
- diarrhea
- pruritus
- rash
- infusion site reaction (on-body infusor form)
- hyperuricemia
- hyperglycemia
- hypocalcemia
- tinnitus
- paresthesia
- photosensitivity
- cholesterol incr.
- triglycerides incr.
Safety/Monitoring .
Monitoring Parameters
BUN/Cr, serum CO2, electrolytes, uric acid frequently early in tx, then periodically; CBC; Plt; LFTs; urine/blood glucose especially if diabetes or suspected latent diabetes
Look/Sound-Alike Drug Names
furosemide confused with: famotidine; finasteride; fluconazole; FLUoxetine; fosinopril; loperamide; torsemide
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; risk of fetal harm not expected based on limited human data; possible risk of decr. placental perfusion based on drug's mechanism of action
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding, especially in high-risk infants; no human data available, though risk of infant harm not expected based on drug properties; decr. milk production, especially with higher doses, based on limited human data
Pharmacology .
Metabolism: for furosemide: liver minimally; CYP450: unknown
Excretion: for furosemide: urine 88%, bile/feces 12%; Half-life: 2h
Subclass: Diuretics, Loop
Mechanism of Action
for furosemide: inhibits loop of Henle and proximal and distal convoluted tubule sodium and chloride resorption
Formulary .
No Formulary Selected
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