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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
- desmopressin
- isocarboxazid
Avoid/Use Alternative
- abiraterone acetate
- albuterol
- albuterol inhaled
- aldesleukin
- almotriptan
- amikacin
- amikacin inhaled
- aminolevulinic acid topical
- amphetamine
- arformoterol inhaled
- aripiprazole lauroxil
- armodafinil
- arsenic trioxide
- asciminib
- aspirin
- atogepant
- atomoxetine
- axitinib
- benzphetamine
- betamethasone
- bevacizumab
- brigatinib
- budesonide
- bumetanide
- bupropion
- cabozantinib
- caffeine
- caffeine citrate
- cannabis
- carboplatin
- carfilzomib
- clofarabine
- copanlisib
- corticotropin
- cortisone
- cyclosporine
- danazol
- darbepoetin alfa
- deflazacort
- desvenlafaxine
- dexamethasone
- dexmethylphenidate
- dextroamphetamine
- diethylpropion
- dihydroergotamine
- doxapram
- dronabinol
- droxidopa
- eletriptan
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- epinephrine inhaled
- epoetin alfa
- eptinezumab
- erenumab
- ergotamine
- esketamine
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethanol (alcoholic beverage)
- ethinyl estradiol (contraceptive)
- etrasimod
- fenfluramine
- fludrocortisone
- formoterol inhaled
- fostamatinib
- fremanezumab
- frovatriptan
- fruquintinib
- galcanezumab
- gentamicin
- hoodia
- hydrocortisone
- ibrutinib
- ifosfamide
- immune globulin
- iodixanol
- iomeprol
- iopromide
- ioversol
- ketamine
- lanreotide
- leflunomide
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- levothyroxine
- licorice
- liothyronine
- lisdexamfetamine
- lithium
- lofexidine
- lorlatinib
- lumacaftor/ivacaftor
- luspatercept
- mannitol
- mefenamic acid
- methamphetamine
- methoxy polyethylene glycol-epoetin beta
- methylergonovine
- methylphenidate
- methylprednisolone
- methyltestosterone
- metoclopramide
- midodrine
- milnacipran
- mirabegron
- modafinil
- naratriptan
- naxitamab
- neomycin
- neomycin otic
- niraparib
- olodaterol inhaled
- osilodrostat
- oxytocin
- paromomycin
- pazopanib
- pexidartinib
- phendimetrazine
- phentermine
- phenylephrine
- phenylephrine injection
- plazomicin
- ponatinib
- porfimer
- pralsetinib
- prednisolone
- prednisone
- pseudoephedrine
- quetiapine
- ramucirumab
- regorafenib
- rimegepant
- ripretinib
- rizatriptan
- ropinirole
- rotigotine transdermal
- salmeterol inhaled
- selpercatinib
- siponimod
- sorafenib
- streptomycin
- sumatriptan
- sunitinib
- tacrolimus
- tagraxofusp
- terbutaline
- teriflunomide
- testosterone
- thyroid
- tivozanib
- tobramycin
- tobramycin inhaled
- trametinib
- triamcinolone
- ubrogepant
- vadadustat
- vamorolone
- vandetanib
- vasopressin
- venlafaxine
- vilanterol inhaled
- viloxazine
- voclosporin
- yohimbe
- zavegepant
- ziv-aflibercept
- zolmitriptan
Monitor/Modify Tx
- acarbose
- acetazolamide
- acyclovir
- adefovir dipivoxil
- alendronate
- alfentanil
- alfuzosin
- aliskiren
- aloe
- alogliptin
- alprostadil intracavernous
- amantadine
- amifostine
- amiloride
- amitriptyline
- amoxapine
- amphotericin
- anthrax immune globulin
- apomorphine
- apraclonidine ophthalmic
- apremilast
- aripiprazole bimonthly injection
- aripiprazole monthly injection
- aripiprazole oral
- articaine
- asenapine
- asparaginase
- atropine ophthalmic
- auranofin
- avanafil
- azilsartan medoxomil
- balsalazide
- benazepril
- berberine
- betaxolol ophthalmic
- bethanechol
- bexagliflozin
- bismuth subsalicylate
- bortezomib
- botulism immune globulin
- brexpiprazole
- brimonidine ophthalmic
- brimonidine topical
- bromocriptine
- bupivacaine
- bupivacaine liposomal
- buprenorphine
- butalbital
- butorphanol
- cabergoline
- cabotegravir
- calcitonin-salmon
- canagliflozin
- candesartan cilexetil
- capecitabine
- captopril
- carbamazepine
- cariprazine
- carteolol ophthalmic
- cefepime
- cefpodoxime
- cefprozil
- ceftazidime
- cefuroxime sodium
- celecoxib
- cetuximab
- chloroprocaine
- chloroquine
- chlorothiazide
- chlorpromazine
- chlorthalidone
- cholestyramine
- cidofovir
- cilostazol
- cinacalcet
- cisplatin
- citalopram
- cladribine oral
- clindamycin
- clomipramine
- clonidine
- clozapine
- cocaine
- codeine
- coenzyme Q-10
- colesevelam
- colestipol
- colistimethate
- copper histidinate
- creatine
- crizotinib
- cyclophosphamide
- cytomegalovirus immune globulin
- dapagliflozin
- decitabine
- deferasirox
- deferoxamine
- denileukin diftitox
- denosumab
- desflurane
- desipramine
- dexlansoprazole
- dexmedetomidine
- dexmedetomidine injection
- diazoxide
- dichlorphenamide
- diclofenac
- diclofenac topical
- diflunisal
- digoxin
- dihydrocodeine
- dinutuximab
- dipyridamole
- docetaxel
- dofetilide
- doxazosin
- doxepin
- dulaglutide
- duloxetine
- eflornithine
- emapalumab
- empagliflozin
- enalapril
- enalaprilat
- entacapone
- entrectinib
- epoprostenol
- ertugliflozin
- escitalopram
- eslicarbazepine acetate
- esomeprazole
- etelcalcetide
- ethanol injection
- etodolac
- etripamil nasal
- exenatide
- febuxostat
- fenoprofen
- fentanyl
- ferumoxytol
- fexinidazole
- fingolimod
- flaxseed
- flibanserin
- flucytosine
- fludarabine
- fluoxetine
- fluphenazine
- flurbiprofen
- fluvoxamine
- foscarnet
- fosfomycin injection
- fosinopril
- foslevodopa
- ganciclovir
- garlic
- gemfibrozil
- gilteritinib
- glimepiride
- glipizide
- glyburide
- guanfacine
- haloperidol
- hydralazine
- hydrochlorothiazide
- hydrocodone
- hydromorphone
- hydroxocobalamin IV
- ibandronate
- ibuprofen
- ibuprofen lysine
- iloperidone
- iloprost
- imipramine
- indapamide
- indomethacin
- insulin
- iohexol
- iopamidol
- iothalamate meglumine
- irbesartan
- iron sucrose
- isoflurane
- isoproterenol
- isosorbide dinitrate
- isosorbide mononitrate
- isotretinoin
- itraconazole
- ketoprofen
- ketorolac
- landiolol
- lansoprazole
- lenalidomide
- levobunolol ophthalmic
- levodopa
- levorphanol
- lidocaine
- linagliptin
- linezolid
- liraglutide
- lisinopril
- lixisenatide
- lomustine
- losartan
- loxapine
- lubiprostone
- lumateperone
- lurasidone
- lutetium Lu 177 vipivotide tetraxetan
- magnesium citrate
- magnesium salicylate
- magnesium sulfate
- maraviroc
- meclofenamate
- meloxicam
- meperidine
- mepivacaine
- meropenem
- mesalamine
- mesalamine rectal
- metformin
- methadone
- methazolamide
- methohexital
- methotrexate
- methylene blue injection
- metolazone
- midazolam
- mifepristone
- miglitol
- milrinone
- milsaperidone
- mirtazapine
- mitomycin
- moexipril
- molindone
- morphine
- motixafortide
- nabumetone
- nalbuphine
- naphazoline ophthalmic
- naproxen
- nateglinide
- nattokinase
- necitumumab
- niacin (vitamin B3)
- nilotinib
- nitisinone
- nitric oxide
- nitrite
- nitroglycerin
- nitroprusside
- nortriptyline
- nusinersen
- obinutuzumab
- olanzapine
- oliceridine
- olmesartan medoxomil
- olsalazine
- omeprazole
- opicapone
- opium
- oxaliplatin
- oxaprozin
- oxazepam
- oxcarbazepine
- oxycodone
- oxymetazoline nasal
- oxymetazoline ophthalmic
- oxymetazoline topical
- oxymorphone
- ozanimod
- paliperidone
- palopegteriparatide
- pamidronate
- panitumumab
- pantoprazole
- paroxetine
- patiromer
- pegloticase
- pemetrexed
- penicillamine
- pentamidine
- pentazocine
- pentobarbital
- pentostatin
- pentoxifylline
- perindopril
- perphenazine
- phenelzine
- phenobarbital
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pioglitazone
- piroxicam
- polyethylene glycol
- polyethylene glycol/electrolytes
- polymyxin B
- ponesimod
- posaconazole
- pramipexole
- pramlintide
- prazosin
- pretomanid
- primidone
- probenecid
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- protriptyline
- quinapril
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- quinine
- rabeprazole
- ramipril
- rasagiline
- rasburicase
- remifentanil
- remimazolam
- repaglinide
- Rho(D) immune globulin
- riociguat
- risedronate
- risperidone
- rituximab
- rocuronium
- romidepsin
- romosozumab
- ropeginterferon alfa-2b
- ropivacaine
- rosiglitazone
- sacituzumab govitecan
- sacubitril
- safinamide
- salsalate
- saxagliptin
- selegiline
- selegiline transdermal
- selinexor
- semaglutide
- sertraline
- sevelamer
- sevoflurane
- sildenafil
- silodosin
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- sodium benzoate
- sodium ferric gluconate complex
- sodium phenylacetate
- sodium phenylbutyrate
- sodium phosphate rectal
- sodium picosulfate
- sodium polystyrene sulfonate
- sodium thiosulfate
- sodium zirconium cyclosilicate
- sotagliflozin
- sotalol
- sparsentan
- spironolactone
- streptozocin
- succinylcholine
- sucralfate
- sufentanil
- sulfate bowel prep
- sulindac
- tadalafil
- tafasitamab
- tamsulosin
- tapentadol
- taurine
- telavancin
- telmisartan
- temsirolimus
- tenofovir alafenamide
- tenofovir disoproxil
- teprotumumab
- terazosin
- tetrahydrozoline ophthalmic
- thalidomide
- thioridazine
- thiothixene
- timolol ophthalmic
- tiopronin
- tirzepatide
- tizanidine
- tolcapone
- tolmetin
- topiramate
- tramadol
- trandolapril
- tranylcypromine
- trazodone
- treprostinil
- triamterene
- trifluoperazine
- trimethoprim
- trimipramine
- vaborbactam
- vaccinia immune globulin
- valacyclovir
- valganciclovir
- valsartan
- vancomycin
- vardenafil
- vecuronium
- vilazodone
- vinblastine
- vincristine
- vinorelbine
- vonoprazan
- vortioxetine
- vosoritide
- willow bark
- ziprasidone
- zoledronic acid
- zonisamide
Caution Advised
- acitretin
- ginseng, Asian
- methoxsalen
- phenytoin
- verteporfin
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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