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Furosemide Drug Profile
Furosemide Drug Profile
FUROSEMIDE
INTRODUCTION
Furosemide is a loop diuretic (water pill) that prevents
body from absorbing too much salt, allowing the salt to
instead be passed in urine.
Furosemide treats fluid retention (edema) in people with
congestive heart failure, liver disease, or a kidney
disorder such as nephrotic syndrome. This medication is
also used to treat high blood pressure (hypertension).
Available Brands
Physical properties
Melting Point: 206⁰C
Solubility: poorly water soluble, binary mixtures of
ethanol, propylene glycol, and glycerol from 0% to
100% cosolvent concentrations at 25⁰C.
PHARMACOKINETICS
Absorption: 60–67% absorbed after oral
administration (↓ in acute HF and in renal
failure); also absorbed from IM sites.
Distribution: Crosses placenta, enters
breast milk.
Protein Binding: 91–99%.
Metabolism: Minimally metabolized by
liver, some nonhepatic metabolism.
Excretion: via kidney by glomerular
filtration of tubular secretion.
Half-life: 30–60 min (↑ in renal
impairment).
TIME/ACTION PROFILE
(diuretic effect)
Hypersensitivity
2. Electrolyte depletion
3. Diabetes mellitus
4. Hypoproteinemia
6. Lactation
7. Pedi: Increase risk of renal calculi and patent ductus
arteriosis in premature neonates
8. Geri: Increase risk of side effects, especially hypotension and
electrolyte imbalance at usual doses
Special Considerations
FDA’s pregnancy category Category C
Edema
Orally
Adults: 20- (Children > 1
80mg/day(single mo): Neonates: 1-
dose initially) 2mg/kg(single 4mg/kg/dose q 1-
repeat in 6-8hr dose)increase 1- 2times
2mg/kg q 6-8hr
IM IV
IM: IV: (Adults)20- IM: IV: Children 1- IM: IV: Neonates
40mg q 1-2hr and 2mg/kg/dose q 6- 1-2mg/kg/dose q
increase by 20mg 12hrs CI- 12-24hr
every 1-2hr 0.05mg/kg/hr
Route/Dosage
C-IV infusion:0.1mg/kg
as an initial bolus dose
followed by C-IV
0.1mg/kg/hr doubled q infusion:0.1mg/kg
2hr initial bolus dose
doubled q 2hr
Route/Dosage
Hyperc
CHF Orally:20-80/dose
alcemi
initially-increase
a Oral:10-40mg 4
20-40mg q 1-2min times a day
IM,IV:10-20mg
IV:20-100mg
once q 1-2min-
every 1-2hr over
repeat similar to
1-2min
initial within 2hr
C-IV
infusion:0.1mg/kg-
followed by
0.1mg/kg/dose q
2hr
Dose adjustment in special population
Increase ototoxicity,
Cisplatin nephrotoxicity
Possible electrolyte
Digoxin variations and arrhythmias
Decrease effect of
Phenytoin furosemide
Parenteral
Injection
15–30°C; protect from light. Discard unused
portion
Patient/Family Teaching
Instruct patient to take furosemide as directed. Take missed
doses as soon as possible; do not double doses.
Caution patient to change positions slowly to minimize orthostatic hypotension.
Instruct patient to consult health care professional regarding a diet high in
potassium
Advise patient to contact health care professional of weight gain more than 3
lbs in 1 day.
Instruct patient to notify health care professional of all Rx or OTC medications.
Caution patient to use sunscreen and protective clothing to prevent
photosensitivity reactions.
Advise patient to contact health care professional immediately if rash, muscle
weakness, cramps, nausea, dizziness, numbness, or tingling of extremities
occurs.
Advise diabetic patients to monitor blood glucose closely; may cause increased
blood glucose levels.
Geri: Caution older patients or their caregivers about increased risk for falls
Hypertension: Advise patients on antihypertensive regimen to
continue taking medication even if feeling better. Furosemide
controls but does not cure hypertension.
Instructions for IV
Administrations
Direct IV: Diluent: Administer undiluted (larger doses
may be diluted and administered as intermittent).
Concentration: 10 mg/mL.
Rate: Administer at a rate of 20 mg/min. Pedi:
Administer at a maximum rate of 0.5–1 mg/kg/min (for
doses <120 mg) with infusion not exceeding 10 min.
Intermittent Infusion: Diluent: Dilute larger doses in
50 mL of D5W, D10W, D20W, D5/0.9% NaCl, D5/LR,
0.9% NaCl, 3% NaCl, or LR. Infusion stable for 24 hr at
room temperature. Do not refrigerate. Protect from light.
Concentration: 1 mg/mL.
Rate: Administer at a rate not to exceed 4 mg/min (for
doses > 120 mg) in adults to prevent ototoxicity. Pedi:
not to exceed 1 mg/kg/min with infusion not exceeding
10 min. Use an infusion pump to ensure accurate dose.
Evaluation/Desired Outcomes
Decrease in
Decrease in
abdominal
edema girth and wt
Increase in
Decrease in
urinary
output BP