With edematous syndrome, one cannot do without a diuretic drug. This is Furosemide. He effectively copes with the task, but has many contraindications, which you need to familiarize yourself with before starting treatment.

Description of release forms and composition

The active substance is furosemide. Its concentration differs depending on the form of release, of which there are only two. For oral use, tablets are available. In 1 pc - 40 mg of furosemide. For injection, there is a solution that is supplied in 2 ml ampoules. 1 ml contains 10 mg of the active ingredient.

The composition of excipients also depends on the form of release. The solution contains water, sodium chloride and hydroxide, in tablets - lactose, gelatin, starch, povidone, talc, silicon dioxide and magnesium stearate.

Pharmacological action, pharmacodynamics and pharmacokinetics

This diuretic belongs to loop diuretics. It accelerates the elimination of fluid from the body, bicarbonates, phosphates, sodium chloride, calcium and magnesium ions. Due to the diuretic effect, the load on the heart is reduced with heart failure. And also the drug has a hypotensive effect.

Furosemide tablets begin to act within an hour after administration, the duration of diuretic exposure is 2-3 hours. With reduced renal function, the therapeutic effect can be up to 6-8 hours.In newborns, the half-life reaches 20 hours.

Note. The oral form of the drug has a low bioavailability, only 65%.

With intravenous administration, the peak of diuretic action occurs in 2-3 minutes, with intramuscular injection in 10-15 minutes. The active substance is processed by the liver, excreted by the digestive tract and urinary system.

What helps furosemide?

Indications for use are ascites and edematous syndrome.

Tablets are often prescribed for the following diseases:

  • chronic heart failure;
  • severe liver damage, in particular cirrhosis;
  • acute or chronic renal failure;
  • nephrotic syndrome;
  • arterial hypertension

The advantage of using the drug is that it is effective at a low glomerular infiltration rate, so patients with kidney failure can use it. Of course, in this case, the rate of excretion of furosemide is reduced.

Note. Ascites, which arose not against the background of cirrhosis, is treated only in a hospital setting.

Furosemide in ampoules is used in the treatment of conditions that require immediate medical attention. This can be acute heart failure, pulmonary or cerebral edema, cardiac asthma, hypertension, hypertensive crisis, chemical poisoning, hypercalcemia and eclampsia. The fastest effect is achieved through injections.

The drug is rarely used as an independent tool, more often it is a component of complex therapy.

Instructions for the use of tablets and injections

The dosage of Furasemide depends on the indications, the severity of the patient's condition, his age, as well as on the form of release of the drug.

The solution is most often used precisely for intravenous administration. Its dose depends on diuresis. Initially, 40 mg is administered. If the desired effect is not achieved, then after 2 hours a dose increased by 50% is administered. Dosage can be increased to 6 mg / kg in children and 2 g for adults.

The norm is as follows:

  • children - 0.5-1.5 mg / kg;
  • adults - 40–80 mg.

The solution is administered within 1-2 minutes.

Instructions for use of tablets:

  • children - 1-2 mg / kg per day;
  • adults - 20–80 mg per day (with low efficiency, a dosage increase to 120–160 mg is possible).

In most cases, 1-2 tablets per day are sufficient. They need to be taken on an empty stomach in the morning. If necessary, multiple doses, the interval between the use of the drug should not be less than 6 hours. When diuresis is achieved, the dose can be reduced. It is enough to take 1 tablet every other day.

Important. Exceeding the permissible doses does not lead to an increase in diuresis, but poses a threat to the patient's health.

For the treatment period, it is important to limit the consumption of table salt. To prevent violations from the water-electrolyte metabolism, it is worth taking potassium preparations at the same time. It is necessary to adhere to dietary nutrition, the diet table is determined by the doctor.

During pregnancy and lactation

The active substance crosses the placental barrier, penetrates not only the bloodstream, but also breast milk. It is harmful to the baby, and also reduces the amount of breast milk in nursing. Pregnancy and lactation are a contraindication to use.

Note. Diuretic causes placental ischemia.

Despite this, the drug is still used in pregnant women if there are reasonable indications, but not to eliminate physiological edema.

Alcohol compatibility

The drug is a powerful diuretic, but it also has a lot of side effects. Alcohol has a toxic effect on the body, an additional burden on the liver, kidneys and other organs. The outcome of the interaction of alcohol and medication may be unforeseen, so you can not combine them.

If you use a diuretic with alcohol, adverse reactions will occur, the most severe are heart, liver and kidney diseases. Alcohol enhances the diuretic effect, which can lead to overdose and death.

Drug interaction

Furosemide not only reduces the therapeutic effect of other drugs, but in combination with medicines, ototoxicity can increase.

Prohibited funds include:

  • Ethacrylic acid;
  • salicylates;
  • aminoglycosides;
  • Cisplatin;
  • Amphotericin B;
  • Astemizole;
  • Digitoxin;
  • cephalosporins.

The drug reduces the effectiveness of hypoglycemic agents, insulin. Phenytoin, Colestipol and NSAIDs, on the contrary, reduce the diuretic effect of the diuretic.

Taking other medications must be agreed with your doctor, otherwise treatment can lead to complications.

Contraindications, side effects and overdose

Diuretic violates the state of water-electrolyte balance, so many ailments are a contraindication to its use.

The drug is prohibited for use by patients with such diseases:

  • severe hepatic and acute renal failure with glomerular infiltration of less than 3-5 million / min;
  • hepatic encephalopathy;
  • hypersensitivity to any substance in the composition, allergy to sulfonamides;
  • lactase deficiency;
  • autoimmune diseases;
  • violation of the outflow of urine (stenosis of the urinary tract, prostate adenoma);
  • hepatic coma;
  • glomerulonephritis in the acute stage;
  • gout;
  • pancreatitis
  • diarrhea;
  • hyperuricemia
  • arterial hypotension;
  • hyperglycemic coma;
  • myocardial infarction;
  • children's age up to 3 years (for tablets).

This is a list of absolute contraindications, but there are also relative ones. For example, with diabetes mellitus, prostatic hyperplasia, hepatitis, as well as kidney diseases in which the patient is forced to undergo hemodialysis, the medicine can be taken only under the supervision of a doctor and with a dose adjustment.

Doses of the medication should not be exceeded. This can lead to undesirable reactions. In connection with the individual characteristics of the body, a diuretic can cause side effects from the cardiac, nervous, digestive system, sensory organs. The most common - lowering blood pressure to critical levels, dehydration, collapse, thrombosis or thromboembolism, paralysis, confusion, convulsions.

A manifestation of an overdose can be a violation of heart rhythm, kidney function, vision, hearing, acute urinary retention. The overall health of the patient is deteriorating. A person quickly gets tired, there are problems with sleep, a headache, a depressive mood prevails.

With hypersensitivity, the likelihood of an allergy to the substances in the composition increases. An allergic reaction is manifested by rashes on the body, itching, fever, as well as more severe symptoms - dermatitis, vasculitis or anaphylactic shock.

With prolonged use, the likelihood of side effects increases. To improve well-being, it is worthwhile to carry out symptomatic treatment, to restore the water-salt balance.

Diuretic analogues

Furosemide is cheap, so it is unlikely to find a cheaper drug. For the active substance, Lasix may become a substitute.

Other analogues of furosemide:

  • Torasemide Canon. It is also a torasemide loop diuretic.
  • Diuver. Israeli-made tablets.
  • Britomar. The drug is a prolonged action, the effect lasts up to 10 hours.
  • Trigrim. The medication has a high bioavailability, up to 90%.
  • Lotonel. Tablets have a prolonged effect, the diuretic effect lasts up to 18 hours.

Torasemide-based medicines are not used for children under 18 years of age, pregnant and lactating.

This loop diuretic is used only for severe diseases that lead to the accumulation of fluid in the body. But it does not fit with bags under the eyes or swelling of the legs due to fatigue.The consequences of this technique can be negative.

Similar:More from the author: