Lasix

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What is Lasix?

Lasix is a loopback diuretic. The drug suppresses the absorption of ions of chlorine and sodium in the ascending part of the loop of Henle, the distal and proximal tubules of the nephron. The active ingredient is furosemide. The drug is available in tablet form.

Indications for use:

• edema due to chronic congestive heart failure;
• edema with nephrotic syndrome;
• acute renal failure, incl. in pregnant women or during childbirth;
• edema in liver diseases;
• arterial hypertension.

How to take this drug?

Tablets are taken orally (on an empty stomach or during meals). The prescribed dose is taken once a day or every other day. The recommended single initial dose is 40 mg. In severe conditions, it is possible to gradually increase the dose to 600 mg per day. The maximum dose is 1500 mg/day.

Side effects

Patients who used Lasix reported the following adverse reactions:

• Allergic reactions: allergy (chills, chest pain, tremors, urticaria, skin rash), anaphylaxis (manifested by shortness of breath, hypotension, cardiac arrest), dermatitis, exacerbation/activation of systemic lupus erythematosus;
• Metabolic disorders: hyponatremia, hypochloremia, hypokalemia, hypomagnesemia, hypocalcemia, metabolic alkalosis, Barter’s pseudo-syndrome, increased thirst, confusion, convulsions, muscle weakness, hypovolemia;
• Hematological disorders: aplastic anemia, agranulocytosis, thrombocytopenia, hemolytic anemia, eosinophilia, leukopenia, hemoconcentration;
• Neurological disorders: paresthesia, delirium, hepatic encephalopathy;
• Otolaryngological disorders: noise, tinnitus, hearing loss, deafness;
• Cardiovascular disorders: arterial hypotension (dizziness, pressure in the head, headache, feeling of rotation, drowsiness, weakness, blurred vision, dry mouth), orthostatic hypotension, collapse, tendency to thrombosis, vasculitis;
• Digestive disorders: acute pancreatitis, nausea, diarrhea, elevated liver transaminases, intrahepatic cholestasis;
• Dermatological disorders: itching, rash, bullous dermatitis, urticaria, erythema multiforme, Stevens-Johnson syndrome, pemphigoid, toxic epidermal necrolysis, purpura, exfoliative dermatitis, photosensitization, AGEP syndrome, DRESS syndrome;
• Urinary disorders: increase in urine volume, urinary retention, tubulointerstitial nephritis, renal failure, nephrolithiasis, nephrocalcinosis;
• Musculoskeletal disorders: rhabdomyolysis;
• Others: Increased risk of persistent ductus arteriosus when used in premature babies in the first weeks of their lives.

Interactions

Do not take Lasix if you are using any of the medications listed below:

• antibiotics of the aminoglycoside group (including with gentamicin, tobramycin);
• gentamicin and tobramycin;
• cephalosporin antibiotics;
• beta-adrenomimetics (including fenoterol, terbutaline, salbutamol) and GCS;
• hypoglycemic agents;
• insulin;
• ACE inhibitors;
• furosemide;
• indomethacin, other NSAIDs;
• astemizole;
• vancomycin;
• digoxin, digitoxin;
• carbamazepine;
• cholestyramine, colestipol ;
• lithium carbonate;
• probenecid;
• sotalol;
• theophylline;
• phenytoin;
• chloral hydrate;
• cisapride;
• cyclosporine;
• cisplatin.

Contraindications

Lasix is not used in the presence of any of the following conditions:

• renal failure with anuria not responding to the introduction of furosemide;
• hepatic pre-coma and coma;
• severe hypokalemia;
• severe hyponatremia;
• hypovolemia (with or without hypotension) or dehydration;
• pronounced violations of urine outflow of any etiology (including unilateral damage to the urinary tract);
• pregnancy;
• breastfeeding period;
• hypersensitivity to the active substance or to any of the components of the drug;
• sulfonamide allergy (sulfanilamide antimicrobial agents or sulfonylurea drugs).

With caution:

• arterial hypotension;
• conditions in which an excessive reduction in blood pressure is particularly dangerous (stenotic lesions of the coronary and/or cerebral arteries);
• acute myocardial infarction (increased risk of cardiogenic shock);
• latent or manifest diabetes mellitus;
• gout;
• hepatorenal syndrome;
• hypoproteinemia;
• violation of the outflow of urine (prostatic hyperplasia, narrowing of the urethra or hydronephrosis);
• hearing loss;
• pancreatitis, diarrhea;
• ventricular arrhythmias in history;
• systemic lupus erythematosus;
• premature babies.

Pregnancy and breastfeeding

Lasix should not be prescribed for pregnant women unless the treatment is carried out for health reasons. Women should stop breastfeeding during treatment.

Precautions

Before starting treatment with this drug, the presence of pronounced disorders of urine outflow, including unilateral, should be excluded.

Symptoms of an overdose include hypovolemia, hemoconcentration, dehydration, cardiac arrhythmias (AV-block, ventricular fibrillation), severe hypotension, shock, orthostatic hypotension, acute renal failure, delirious states, thrombosis, delirium, apathy, flaccid paralysis, mental confusion. In this case, it is necessary to stop treatment, administer a solution of electrolytes (if necessary). Gastric lavage and the use of sorbents may be indicated.

During treatment, it is recommended eating foods rich in potassium (lean meat, potatoes, bananas, tomatoes, cauliflower, spinach, dried fruits, etc.). In some cases, it’s recommended taking potassium supplements or potassium-sparing drugs.

Since the drug has many side effects, it is necessary to consult a specialist before the first. Do not self-medicate. Before taking the medication, you need to find out the state of the liver and kidneys.

Care must be taken when driving and managing complex mechanisms.

Store the drug away from heat and moisture. Do not use after the expiration date. Keep out of the reach of children.