In the article, we consider the form of release of "Furosemide" and instructions for it.
The medicine is made in granules, which are intended for the preparation of oral suspensions, as well as in tablets and in the form of a parenteral solution. The active ingredient is furosemide.
Composition and release forms of "Furosemide": tablets, ampoules
One form of the drug in question is tablets with a dosage of 40 milligrams. Ten or fifty pieces are placed in cell packaging. Pills are also placed in polymer cans for drugs.
Another form of release of "Furosemide" are ampoules with a solution for performing intravenous and intramuscular injections. The medicine has a colorless hue. The active ingredient is the substance of the same name furosemide. Auxiliary ingredients of the drug are chloride and sodium hydroxide, as well as water.
Why is Furosemide needed?
Pharmacological effects
This drug is called a loop diuretic. They disrupt the reabsorption of sodium ions in the thick segment of the ascending region of the Henle loop. Against the background of an increase in sodium ions, a secondary enhanced withdrawal of water is observed with an increase in potassium secretion in the distal region of the renal tubule. At the same time, excretion of calcium or magnesium may increase. The tool has secondary effects, which are caused by the release of mediators, and at the same time, the redistribution of intrarenal blood flow. Against the background of course therapy, they do not weaken.
With heart failure, the drug quickly leads to a decrease in preloads on the organ through the expansion of veins. The medication can have a hypotensive effect due to an increase in the output of sodium chloride and a decrease in the reaction of vascular muscles to vasoconstrictor processes. The action of "Furosemide" occurs after intravenous administration after ten minutes. Against the background of oral administration, the effect is achieved after half an hour, after a maximum of 120 minutes, the duration of the drug is from two to three hours (with reduced kidney function, it usually takes twice as much time).
The period of action of sodium ions increases significantly, but after its termination, the output rate decreases below the initial values. Such a phenomenon is associated with a sharp activation of neurohumoral regulatory links as part of the response to massive diuresis. It is worth noting that this drug stimulates the arginine-vasopressive and sympathetic systems. It decreases the level of natriuretic atrial factor in plasma, vasoconstriction is caused.
Due to the ricochet phenomenon when taken once a day, the medication may not have a significant effect on the daily output of sodium ions and pressure. With intravenous administration, it provokes dilatation of peripheral veins, reducing preload, lowering the filling pressure of one of the ventricles and pulmonary artery along with systemic blood pressure. Diuretic effects develop three or four minutes after intravenous administration and lasts up to two hours. Against the background of oral administration, as a rule, it develops 25 minutes and lasts up to four hours.
What is "Furosemide" for, described in detail in the instructions.
Indications
This medication is prescribed in a number of the following cases:
- Against the background of edematous syndrome of various origins.
- With heart failure of a chronic nature.
- In the case of cirrhosis (with portal hypertension syndrome).
- In the presence of nephrotic syndrome.
- In case of pulmonary edema, cardiac asthma.
- Against the background of cerebral edema, eclampsia, conducting forced diuresis.
- With the development of severe hypertension.
- In the presence of some forms of hypertensive crisis.
- The development of hypercalcemia.
Does this drug have contraindications?
Contraindications
The ban on taking the drug "Furosemide" is appropriate in a number of the following cases:
- Against the background of acute glomerulonephritis.
- With stenosis of the urethra.
- In case of obstruction of the urinary duct with stone.
- With acute liver failure with anuria.
- If the patient has hypokalemia, alkalosis, precomatous conditions.
- Against the background of hepatic and diabetic coma.
- In the case of the development of precomatous conditions.
- The presence of hyperglycemic coma, hyperuricemia, gout, decompensated mitral or aortic stenosis.
- Against the background of hypertrophic obstructive cardiomyopathy.
- With an increase in central venous pressure (for example, more than 10 millimeters of mercury).
- In case of arterial hypotension, acute myocardial infarction, pancreatitis, impaired water and electrolyte metabolism, for example, with hypovolemia, hyponatremia, hypokalemia, hypochloremia, hypocalcemia, hypomagnesemia, digitalis intoxication, hypersensitivity to Furosemide.
Medication and prescription
The dosage of the medication in question is set, as a rule, individually, which depends on the indications, on the clinical situation, and, in addition, on the age of the patient. During therapy, the dosage regimen is adjusted depending on the size of the diuretic response and the dynamics of patients' well-being.
According to the instructions for “Furosemide” in tablets, against the background of oral administration, the initial dosage for adults is from 20 to 80 milligrams per day, then, if necessary, the amount of the substance gradually increases to 600. For children, the single rate, as a rule, is 1 or 2 milligrams per kilogram of mass. The release form of "Furosemide" in tablets is quite convenient for use.
The maximum amount of medication when taken orally for small patients is 6 milligrams per kilogram.
How to take other forms of release of Furosemide?
With jet or intramuscular administration, the dosage for adults ranges from 20 to 40 milligrams once a day. In some cases, the medicine is taken twice a day. For children, the initial daily dosage for parenteral use is one milligram per kilogram.
In the presence of increased pressure in patients with renal failure in combination with other antihypertensive agents (antagonists of the angiotensin system), the usual doses of the drug are recommended, which are from 20 to 120 milligrams a day, once or twice. The change in pressure should be carefully monitored if Furosemide is used in conjunction with other antihypertensive agents, especially during initial treatment. To prevent an excessive decrease in pressure, the volume of other antihypertensive drugs should be reduced by at least 50% if “Furosemide” is added to the main therapy.
The recipe "Furosemide":
Rp: Furosemidi 0.04
Dtd: No. 50 in tabul.
S: Inside 1 table. in the morning 20 minutes before eating.
Rp .: Sol. Furosemidi 1% 2 ml
DS Dilute the contents of the ampoule in 10 ml of isotonic sodium chloride solution and administer slowly. This dosage is applicable to a child at 10 years old (in some cases it is increased or decreased).
With edema
Many people wonder how to take "Furosemide" for edema? Let's figure it out.
If patients have edema of renal, cardiac or hepatic origin, the following dosages of the drug are prescribed:
- With the development of a moderate condition, patients are prescribed one or half tablets per day.
- Against the background of a serious condition, two to three tablets a day are required once or twice, or four tablets in two divided doses.
For weight loss
Also used in some cases, "Furosemide" for weight loss. Reviews and photos will be presented below. This is a medicine designed to remove excess fluid from the body.
To reduce weight, taking diuretic drugs has been popular for a long time, because in a short time this method allows you to get rid of a few extra pounds. The main advantage of “Furosemide” is the ability to instantly start the process of fluid withdrawal, therefore it is classified as an express method. But there is an opinion of experts that “Furosemide” removes not only excess water, but also flushes any liquid from the body’s tissues, and with it iron, calcium, magnesium, potassium. The result of taking "Furosemide" can be not only getting rid of excess fat, but also a general deterioration in health. Therefore, before taking the drug inside, you should consult your doctor.
Side effects
The following adverse reactions are possible that may occur while taking the drug in question:
- The cardiac and vascular system can respond by lowering pressure, orthostatic hypotension, collapse, tachycardia, arrhythmia, and a decrease in bcc.
- The nervous and peripheral systems respond, as a rule, to dizziness, headache, myasthenia gravis, and spasms of the calf muscles. Paresthesia is also possible along with apathy, adynamia, weakness, lethargy, drowsiness, confusion.
- The sensory organs, as a rule, respond to the use of this medicine with visual and hearing impairments.
- Failure in the functioning of the digestive system is accompanied by a decrease in appetite, dry mouth, thirst, nausea, vomiting, constipation or diarrhea, cholestatic jaundice, pancreatitis (exacerbation).
- The genitourinary system is able to respond with oliguria, acute urinary retention (in patients with prostatic hypertrophy), interstitial nephritis, hematuria, and a decrease in potency.
- Failure in the hematopoietic system is accompanied by leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia.
- Problems with water and electrolyte metabolism are usually expressed in hypovolemia, dehydration (risks of thrombosis and thromboembolism), hypokalemia, hyponatremia, hypochloremia, hypocalcemia, hypomagnesemia, metabolic alkalosis.
- On the part of material metabolism, hypovolemia is sometimes observed along with hypokalemia, hyponatremia, hypochloremia, and hypokalemic metabolic alkalosis. The result of these disorders is arterial hypotension, along with dizziness, dry mouth, thirst, arrhythmia, muscle weakness, and seizures. In addition, hyperuricemia (with subsequent exacerbation of gout) and hyperglycemia are possible.
- Allergic reactions include purpura, urticaria, exfoliative dermatitis along with multiforme exudative erythema, vasculitis, necrotizing angiitis, skin itching, chills, fever, photosensitivity, anaphylactic shock, and so on.
- For other side effects, when administered intravenously, thrombophlebitis develops, as well as kidney calcification among premature babies.
Drug interaction
With the simultaneous use of the “Furosemide” release form in ampoules and tablets with antibiotics of the aminoglycoside category (including with “Gentamicin” or “Tobramycin”), an increase in ototoxic effects is possible. The drug reduces the clearance of gentamicin, increasing the concentration in the blood plasma of gentamicin and tobramycin. With the simultaneous use of a class of cephalosporins with antibiotics that can cause impaired renal function, there are risks of increased nephrotoxicity.
With simultaneous treatment with adrenergic agonists (including phenoterol, salbutamol or with terbutaline) and with hormonal drugs, a significant increase in hypokalemia is possible. When combined with hypoglycemic drugs and insulin, a decrease in the effectiveness of hypoglycemic drugs and insulin is possible, since Furosemide has the ability to increase blood glucose.
With simultaneous use with inhibitors, antihypertensive effect is enhanced. Perhaps the development of severe arterial hypotension, especially after taking the first dosage of the drug. Obviously, this occurs due to hypovolemia, leading to a transient increase in the hypotensive effects of inhibitors. The risks of impaired renal function are increased and the development of hypokalemia is not ruled out.
With simultaneous treatment with Furosemide, the effects of non-depolarizing muscle relaxants increase. When combined with indomethacin and other non-steroidal agents, a decrease in the diuretic effect is possible, obviously, as a result of inhibition of prostaglandin synthesis in the kidneys and sodium retention under the influence of indomethacin, which is a non-specific inhibitor. Also, with the use of the described drug, a decrease in antihypertensive effect may be observed.
special instructions
This remedy is used with great caution in case of prostatic hyperplasia, against the background of hypoproteinemia (risks of ototoxicity), diabetes (decrease in glucose tolerance), in the presence of stenosing atherosclerosis of cerebral arteries, during prolonged treatment with cardiac glycosides, among patients with severe atherosclerosis in old age. With caution, this medicine is prescribed during pregnancy (especially in the first half of gestation) and against a background of lactation.
Before starting therapy, electrolyte disturbance should be compensated. During the use of Furosemide, it is necessary to control the pressure along with the level of electrolytes and glucose in the blood serum, and liver and kidney functions. In order to prevent hypokalemia, it is advisable to combine this medicine with potassium-sparing diuretics. With the combined use of the drug with hypoglycemic agents, dosage adjustment of the latter may be required.
It is not recommended to mix the Furosemide solution with any other medications in the same syringe. When using this medication, it is impossible to exclude the possibility of lowering the ability of patients to concentrate, which is extremely important for people who drive vehicles or work with any mechanisms.
Pregnancy and lactation
In the presence of pregnancy, the use of the drug is possible only for a short time and only if the intended benefit of the treatment for the expectant mother outweighs the potential risks to the bearing fetus. Since “Furosemide” is able to be excreted together with breast milk, and, in addition, to suppress lactation, if there is a need for its use during this period, feeding should be stopped.
The instructions "Furosemide" analogues are not described. Consider them below.
Analogs
Now consider the most popular analogues of this medicine. One of them is the Trigrim remedy. Its active ingredient is a substance called torasemide. The drug may have a diuretic effect similar to Furosemide. Pills are available in three types of dosages: 2.5, 5 and 10 milligrams. The daily dosage, as a rule, is for arterial hypertension from 2.5 milligrams. 40 milligrams are taken with congestive kidney and heart failure, as well as against cirrhosis of the liver. In severe cases, the dosage is increased to the maximum, that is, up to 200 milligrams per day.
The drug "Britomar" is an analogue of "Furosemide" in terms of diuretic effects. The active substance in this case is torasemide. The duration of the effect of this medicine is about ten hours. Like all loop diuretics, it is strictly contraindicated for violations of the urinary outflow, in case of acute glomerulonephritis, severe conduction failure of the heart and hypokalemia. Taking pills can trigger exacerbation of gout. This is confirmed by the instruction.
Reviews about "Furosemide"
Patients report that the drug is very effective for edematous syndrome of various origins, and, in addition, in case of chronic heart failure and the presence of nephrotic syndrome.
There are dissatisfied reviews about the use of Furosemide, in which people complain of side effects in the form of dizziness, diarrhea and thirst. In general, based on reviews, we can say that people are satisfied with the effect of therapy when using this medication. But it should be used only after medical prescribing, as well as strictly observing the established dosage.
There are also a large number of comments about taking the drug for weight loss. According to reviews, the loss of kilograms with the liquid can be very significant, however, patients note a general deterioration in well-being. People argue that after the withdrawal of funds, most often, excess weight returns.
We reviewed the instructions for "Furosemide" in tablets and ampoules.