Why Furosemide is dangerous: adverse reactions, harm to the body, consequences. Furosemide

The diuretic furosemide (Lasix) is one of the most powerful diuretic drugs that is used in medicine - for blood pressure, in bodybuilding and other sports - for "drying the body", and by mere overweight mortals - for weight loss...

Someone once said: “where there is power, there is responsibility.” The high effectiveness of furosemide in weight loss comes at a price - serious side effects.

In this article we will talk about the mechanism of action of furosemide and potential side effects, and also talk about why it is absolutely useless for weight loss.

What are diuretics

The use of diuretics carries a risk of serious health harm, including death.

From some point of view, they can be called one of the most dangerous pharmacological drugs in bodybuilding, even more dangerous than anabolic steroids, growth hormone and insulin.

Most of the deaths of professional athletes that occur on stage during bodybuilding competitions are associated with their use.

Furosemide (or Lasix) - one of the most popular and the most powerful diuretics in sports and bodybuilding, which has the highest risk of dangerous side effects.

What is Furosemide ( Lasix, Lasix)?

Furosemide is the name of one of the most popular diuretic drugs in medicine, sports, and among weight loss drugs, which is distributed under the brand name Lasix (Lasix).

Lasix is currently used to refer to all furosemide analogue products of various brands 3 .

The popularity of furosemide in sports and among those losing weight is explained by its very low price (production is most often located in the third world countries of Mexico and China), its high effectiveness as a diuretic and a means for rapid “weight loss.”

Why is furosemide useless for weight loss?

The mechanism described above explains the reason why furosemide is useless for weight loss. Please note that in its description there is not a word about fats.

Changes in body weight when taking furosemide occur only due to a decrease in the amount of fluid in the body. Moreover: how quickly it is removed, just as quickly it comes back.

Unpleasant consequences of furosemide

Furosemide and some other loop diuretics have one unpleasant consequence of use: after stopping their use, edema forms.

This is explained by the rapid mechanism of action, i.e. rapid removal of fluid from the body. The body's reaction to such water stress is the desire to restore water balance, which occurs after the elimination of furosemide metabolic products. Liquid accumulates in reserve, which manifests itself in edema.

Swelling is felt as a characteristic unpleasant heaviness throughout the body.

One of the unpleasant side effects of furosemide (Lasix) is severe swelling

Cost of using furosemide (Lasix): side effects and effects

The use of diuretics (Furosemide) cannot leave a lasting impact on the body.

There is almost always a price to be paid for this in the form of serious side effects: their use may “wash out” too many ions (electrolytes), since their effect is stronger than the function of the kidneys in maintaining ion balance.

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Furosemide begins to act a few hours after consumption. However, the obvious diuretic effect is not the only one.

Along with the excretion of urine, it almost always occurs. state of internal electrolyte imbalance, deficiency of important micronutrients, which can affect the functioning of the brain, muscles and heart 1,7-10.

When the imbalance is very severe, the heart's rhythm becomes irregular and it may stop. When the heart stops, the body dies... and very quickly.

The main reason for the side effects of furosemide is that it blocks the mechanism for the return of sodium, potassium and chlorides into the blood from filtered urine, and with them calcium and magnesium ions 1,11-13.

Why is this dangerous?

There is a large amount of sodium and chloride in the bloodstream and interstitial fluid, so the loss of these two ions is not immediately felt.

But there is much less potassium there, and it is its lack that causes the side effects or death characteristic of furosemide. Loss of calcium and magnesium can further increase potassium leaching, further increasing the extent of harm.

Let's illustrate with an example.

Side effects of furosemide on the heart and muscles

Have you ever wondered why the heart beats?

The heart contracts due to an electrical impulse that travels throughout the heart muscle through a complex network of nerve fibers.

When an electrical impulse passes through a cell, it causes it to contract. But the most interesting thing is that the contraction and propagation of the impulse is carried out with the direct participation of potassium ions inside and outside the heart muscle cells.

Important: If the potassium level outside the cell becomes too high or too low, it prevents the impulse from propagating, the rhythm is disrupted and the heart may stop 10,14.

This is a very life-threatening condition that can occur suddenly.

Another mineral important for heart health is magnesium, which is also washed out when using Furosemide.

It is probably the simultaneous deficiency of these two “heart” minerals (potassium and magnesium) that explains the extreme degree of the dangerous effect of Furosemide on the heart 13,16.

The main reason for the potential harm of furosemide is that it “washes out” from the body microelements important for life (potassium, calcium, magnesium, etc.), which ensure the contraction of the heart muscle: their deficiency can lead to cardiac arrest and death

Calcium is another ion that is washed out when using Furosemide (Lasix). It is involved in muscle contraction 12. When calcium levels fall, weakness or muscle cramps(the muscle contracts and cannot relax).

Obviously, this can cause serious problems for a bodybuilder when posing on stage.

Ways bodybuilders use to avoid the risk of harm from the diuretic Furosemide

1 Furosemide + potassium-sparing diuretic

Many bodybuilders are aware of the risk of potassium loss associated with Furosemide (Lasix) and try to correct this negative side effect by taking another diuretic, Spironolactone, with it 15 .

What's the point?

Spironolactone is a type of “mild” potassium-sparing diuretic. As the name suggests, taking it does not lead to potassium leaching.

The combination of two diuretics allows you to achieve double diuretic effect, eliminates the risk of using large doses of Furosemide (Lasix) and allows you to preserve potassium in the body.

On the sports nutrition and pharmacology market there are ready-made preparations containing both Furosemide and Spironolactone. One of them is Lasilactone 15.

2 Furosemide + potassium

Another way to avoid the risk of potassium deficiency is to take a potassium supplement. Potassium tablets are often recommended by doctors to patients who have been on diuretic therapy for a long time.

But it is extremely important to understand that Both potassium deficiency and excess are equally dangerous for the heart. Remember this.

To prevent dangerous side effects of furosemide, it is recommended to combine it with potassium-sparing diuretics or take additional potassium as a dietary supplement.

The dangers of long-term use of furosemide for weight loss

All of the side effects listed above can occur even with short-term use of diuretics, as bodybuilders do (they are usually used only in the last week of “cutting” before competitions).

Long-term use of diuretics (for weight loss, for example) is associated with even higher risks of harm, including an even higher risk of death due to cardiac arrest and metabolic disorders 1,10,16,17. This is due to the fact that the body experiences a chronic deficiency of minerals important for life.

In addition to the health hazards listed above, they reduce physical performance and exercise tolerance, interfere with the body’s ability to regulate temperature, and lead to dehydration, weakness, and poor circulation.

With long-term use of furosemide (for weight loss, for example), the risk of harm and death increases many times over

Conclusion

Furosemide (Lasix) is a popular and powerful loop diuretic, which is really capable of quickly removing huge amounts of fluid from the body, giving the body a brutal, sculpted appearance and even creating a quick “weight loss” effect.

Furosemide, like many other diuretics, affects the kidneys by blocking the return of vital mineral ions to the bloodstream, causing more water to be excreted into the urine, which is drawn from the spaces between the cells. It is this intercellular fluid that hides the muscle relief from prying eyes.

The use of Furosemide (Lasix) in bodybuilding results in potassium and magnesium deficiency, which can cause irregular heartbeat And sudden death. Even low doses of the drug in a dehydrated person can increase blood viscosity or poor circulation (usually due to too low blood pressure).

Many bodybuilders find that low doses of Furosemide (Lasix), used with a potassium-sparing diuretic or potassium supplement, prevent cramps and other side effects associated with Furosemide (Lasix).

Important: Furosemide (Lasix) may appear to be a fairly safe medication since it is “just” a diuretic and not a powerful hormone, steroid, or drug. However, it is one of the most dangerous drugs ever used in bodybuilding.

Furosemide may appear to be a safe medication since it is “just” a diuretic and not a powerful hormone, steroid, or drug. However, like all diuretics, it is one of the most dangerous pharmacological drugs in bodybuilding

If you ever decide to try Furosemide or any other diuretic for yourself, always be aware of the enormous risk of serious side effects.

Furosemide, what do these tablets help with? The medicine is a common medicinal diuretic drug for relieving edema syndrome. This product enhances the excretion of water, as well as magnesium and calcium ions from the body. The main indications for Furosemide are: edema syndrome of various etiologies, eclampsia, pulmonary edema, hypercalcemia, cardiac asthma and some forms of hypertensive crisis.

Composition and release form

The medicine is available in the form:

• tablets 40 mg No. 50 (2 packages of 25 tablets or 5 packages of 10 tablets per pack);
• injection solution (ampoules 2 ml, package No. 10).

Furosemide diuretic tablets contain 40 mg of active substance, as well as potato starch, milk sugar, povidone, MCC, gelatin, talc, magnesium stearate, silicon dioxide in colloidal form. The solution for intramuscular and intravenous administration contains the active substance at a concentration of 10 mg/ml. Auxiliary components: sodium chloride, sodium hydroxide, water for injection.

pharmachologic effect

The active component of the drug Furosemide, which has a diuretic effect, promotes increased excretion of water while simultaneously increasing the excretion of calcium and magnesium ions. When Furosemide is used against the background of heart failure, a rapid decrease in preload on the heart occurs, caused by the dilation of large veins. After intravenous administration, the effect of Furosemide occurs quickly - within 5-10 minutes, after oral administration - on average within an hour. The duration of the diuretic effect from taking Furosemide is two to three hours, and with reduced renal function, the effect of the drug can last up to eight hours.

Furosemide tablets: what they help with

The main indication for Furosemide is edema syndrome of various origins. The analyzed agent is used for:

• nephrotic syndrome;
• chronic heart failure of the second and third degree;
• liver cirrhosis.

Furosemide - what are these tablets for?

Tablets are prescribed for:

• edema, the causes of which are kidney pathologies (including nephrotic syndrome), stage II-III CHF or cirrhosis of the liver;
• manifested as pulmonary edema of acute heart failure;
• hypertensive crisis (as monotherapy or in combination with other drugs);
• severe forms of arterial hypertension;
• cerebral edema;
• hypercalcemia;
• eclampsia.

The drug is also used for forced diuresis in case of poisoning with chemicals that are excreted from the body unchanged by the kidneys. With elevated blood pressure developing against the background of chronic renal failure, furosemide is prescribed if the patient is contraindicated in thiazide diuretics, and also if Clcr does not exceed 30 ml per minute).

What does Furasemide in ampoules help with?

The annotation for Furosemide in ampoules contains the same indications for use as for the tablet form of the drug. When administered parenterally, the drug acts faster than when taken orally. Therefore, doctors, when asked “What is the solution for?”, answer that IV administration of Furosemide allows you to quickly reduce pressure (arterial, pulmonary artery, left ventricle) and preload on the heart, which is extremely important in emergency conditions (for example , in hypertensive crisis). When a drug is prescribed for nephrotic syndrome, treatment of the underlying disease should come first.

Contraindications

The use of Furosemide according to the instructions is contraindicated in:

• urethral stenosis;
• acute glomerulonephritis;
• acute renal failure with anuria;
• stone obstruction of the urinary tract;
• hyperuricemia;
• alkalosis;
• In acute myocardial infarction;
• For hypokalemia;
• Against the background of severe liver failure;
• In precomatose states;
• diabetic coma;
• arterial hypotension;
• hepatic coma and precoma;
• hyperglycemic coma;
• decompensated mitral or aortic stenosis;
• gout;
• increased central venous pressure (more than 10 mm Hg);
• hypertrophic obstructive cardiomyopathy;
• digitalis intoxication;
• disturbances of water and electrolyte metabolism, including hyponatremia, hypovolemia, hypochloremia, hypocalcemia, hypokalemia, hypomagnesemia;
• pancreatitis;
• hypersensitivity to Furosemide.

Furosemide is prescribed with caution to elderly people, especially those with severe atherosclerosis, during pregnancy and lactation, as well as against the background of the following diseases:

• Hypoproteinemia;
• Prostatic hyperplasia;
• Diabetes.

Medicine Furosemide: instructions for use

The treatment regimen is determined by a specialist depending on the clinical picture of the pathology. Tablets are taken in a volume of 20 to 80 mg per day. The dosage can be gradually increased, bringing the daily use of the drug to 0.6 g. The amount of Furosemide for children is calculated based on body weight 1-2 mg per kg, no more than 6 mg per kg.

Instructions for the use of Furosemide injections

The volume of intramuscular or intravenous injections should not exceed 0.04 g per day. It is possible to double the dose. Doctors recommend injecting the drug into a vein infectiously within 2 minutes. Injections into muscle tissue are only possible if it is impossible to use tablets and intravenous injections. In acute conditions, injections into the muscle are contraindicated.

Side effects

According to reviews, Furosemide can cause the following side effects:

• Cardiovascular system: decreased blood pressure, arrhythmia, tachycardia, orthostatic hypotension, collapse.
• Nervous system: drowsiness, myasthenia gravis, apathy, weakness, lethargy, confusion, calf muscle cramps, headache, paresthesia, adynamia.
• Sense organs: hearing and vision impairment.
• Gastrointestinal tract: dry mouth, nausea, exacerbation of pancreatitis, thirst, vomiting, decreased appetite, diarrhea or constipation and cholestatic jaundice.
• Genitourinary system: hematuria, interstitial nephritis, acute urinary retention, decreased potency.
• Hematopoietic system: aplastic anemia, agranulocytosis, leukopenia and thrombocytopenia. Water-electrolyte metabolism: hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, hypocalcemia, hypochloremia, hypokalemia.
• Metabolism: hyperglycemia, muscle weakness, cramps, hypotension, hyperuricemia and dizziness.
• Allergic reactions: erythema multiforme exudative, photosensitivity, pruritus, exfoliative dermatitis, urticaria, vasculitis, purpura, fever, chills, necrotizing angitis and anaphylactic shock.

What can replace Furosemide?

Analogues of Furosemide in tablets: Furosemide Sopharma, Lasix. Analogues of the parenteral form of the drug: Furosemide-Darnitsa, Furosemide-Vial, Lasix. Drugs belonging to the same pharmacological subgroup with Furosemide: Bufenox, Britomar, Diuver, Trigrim, Torasemide.

How much do the tablets cost and how much can you buy Furosemide solution for?

The price of Furosemide diuretic tablets in pharmacies is from 20 rubles. The price of ampoules is from 25 rubles.

Furosemide is a fast-acting diuretic used to combat swelling of the respiratory system and brain, as well as disorders of the systemic circulation. It is distinguished by its rapid diuretic effect on the body.

As an active ingredient, the drug contains furosemide in a dosage of 40 mg. The original drug is Lasix, developed by Sanofi. Furosemide is one of the most powerful diuretics, and it is effective in both oral and parenteral forms.

The therapeutic effect is observed within 5-10 minutes if the drug is used in the form of a solution for intravenous injection. When using a tablet formulation, the therapeutic effect is achieved within the first hour.

Clinical and pharmacological group

Diuretic.

Terms of sale from pharmacies

Can buy according to a doctor's prescription.

Price

How much does Furosemide cost in pharmacies? The average price is 25 rubles.

Composition and release form

Tablets: flat-cylindrical, round, chamfered, white with a brownish or yellowish tint, 10 pieces in a blister pack made of polyvinyl chloride film and polymer-coated paper or aluminum foil. 1, 2, 3 or 5 blisters in a cardboard box, 50 tablets in a dark glass jar of the BTS type or a polymer jar of the BP type, with a plastic pull-on lid. 1 can in a cardboard box.

Composition of the tablet:

• active substance: furosemide – 40 mg;
• auxiliary components: lactose monohydrate, potato starch, calcium stearate monohydrate.

Pharmacological effect

The active component Furosemide has a diuretic effect, promoting increased excretion of water while simultaneously increasing the excretion of calcium and magnesium ions.

When Furosemide is used against the background of heart failure, a rapid decrease in preload on the heart occurs, caused by the dilation of large veins. After intravenous administration, the effect of Furosemide occurs quickly - within 5-10 minutes, after oral administration - on average within an hour.

The duration of the diuretic effect from taking Furosemide is two to three hours, and with reduced renal function, the effect of the drug can last up to eight hours.

Indications for use

What does it help with? Furosemide confidently copes with edema of various origins, so its range of use is very wide. It is prescribed for the following problems:

• edema, the causes of which are kidney pathologies (including nephrotic syndrome), stage II-III CHF or cirrhosis of the liver;
• manifested as pulmonary edema of acute heart failure;
• hypertensive crisis (as monotherapy or in combination with other drugs);
• severe forms of arterial hypertension;
• cerebral edema;
• hypercalcemia;
• eclampsia.

The drug is also used for forced diuresis in case of poisoning with chemicals that are excreted from the body unchanged by the kidneys.

With elevated blood pressure developing against the background of chronic renal failure, furosemide is prescribed if the patient is contraindicated in thiazide diuretics, and also if Clcr does not exceed 30 ml per minute).

Can Furosemide be used for weight loss?

There is a lot of advice on the Internet regarding the use of diuretics for weight loss. One of the most accessible drugs in this group is Furosemide.

What does the medicine help with? According to the instructions, Furosemide is used for ascites, edema syndrome, and hypertension. Thus, the manufacturer does not report anything regarding the possibility of using diet pills. However, many women note that with the help of this remedy they were able to quickly lose several kilograms (in some cases, up to 3 kg per night). However, such weight loss cannot be regarded as weight loss: the action of the drug is aimed at removing excess fluid, and not at all at breaking down fat.

Why is Furosemide dangerous?

The use of diuretics for weight loss can cause serious health problems, since by removing water, these drugs also upset the balance of electrolytes in the body. One of the most common side effects is hypokalemia. Potassium deficiency, in turn, leads to muscle cramps, weakness, blurred vision, sweating, loss of appetite, nausea, and dizziness.

A very dangerous side effect is arrhythmia. SOLVD studies have shown that treatment with loop diuretics is associated with increased mortality among patients. At the same time, both the rates of general and cardiovascular mortality and the number of sudden deaths are increasing. Another danger that can result from the uncontrolled use of diuretics for weight loss is impaired kidney function. Moreover, it may take more than one month to restore the function of the kidneys and lymphatic system.

Contraindications

Absolute contraindications:

• hyperuricemia;
• increased central venous pressure (over 10 mm Hg);
• idiopathic hypertrophic subaortic stenosis;
• hepatic coma and precoma;
• decompensated mitral or aortic stenosis;
• disturbances in the outflow of urine of any etiology (including unilateral damage to the urinary tract);
• severe liver failure;
• acute glomerulonephritis;
• acute renal failure with anuria (glomerular filtration rate less than 3–5 ml/min);
• disturbance of water-electrolyte metabolism, as well as acid-base balance (alkalosis, hypokalemia, hypovolemia, hyponatremia, hypomagnesemia, hypocalcemia, hypochloremia);
• digitalis intoxication;
• increased sensitivity to any of the components of the drug.

Additionally for tablets:

• acute myocardial infarction;
• pancreatitis;
• dehydration;
• galactose intolerance;
• precomatose states;
• hyperglycemic coma;
• hypertrophic obstructive cardiomyopathy;
• arterial hypotension;
• glucose-galactose malabsorption or lactase deficiency;
• age up to 3 years.

Patients with allergies to sulfonylureas or sulfonamide antimicrobials are at risk of developing cross-allergy to Furosemide.

Relative contraindications:

• history of ventricular arrhythmia;
• hypoproteinemia (risk of developing ototoxicity);
• diarrhea;
• hearing loss;
• systemic lupus erythematosus;
• arterial hypotension - in the presence of conditions in which an excessive decrease in blood pressure can be especially dangerous (stenotic lesions of the coronary or cerebral arteries);
• acute myocardial infarction (due to an increased risk of developing cardiogenic shock);
• manifested or latent diabetes mellitus (decreased glucose tolerance);
• hepatorenal syndrome;
• disturbances in the outflow of urine (hydronephrosis, narrowing of the urethra, benign prostatic hyperplasia);
• gout;
• prematurity in children (due to the risk of the formation of calcium-containing kidney stones and the deposition of calcium salts in the kidney parenchyma, constant monitoring of kidney function and regular ultrasound examination of the kidneys are necessary).

Additionally for tablets: stenotic lesions of the coronary or cerebral arteries.

Prescription during pregnancy and lactation

The medicine crosses the placental barrier, so it should not be prescribed during pregnancy. If it is necessary to prescribe Furosemide during pregnancy, the ratio of the benefits of using the drug for the mother to the risk for the fetus should be assessed.

Excreted in breast milk. If treatment with the drug is necessary, breastfeeding should be stopped.

Dosage and method of administration

As indicated in the instructions for use, Furosemide tablets should be taken on an empty stomach, without chewing and with a sufficient amount of liquid.

When prescribing Furosemide, it is recommended to use the smallest doses sufficient to achieve the desired effect. The maximum daily dose for adults is 1500 mg. The initial single dose in children is determined at the rate of 1-2 mg/kg body weight/day with a possible increase in the dose to a maximum of 6 mg/kg/day, provided that the drug is taken no more often than every 6 hours. The duration of treatment is determined by the doctor individually depending on from the testimony.

Dosage regimen for adults:

1. . Furosemide can be used in monotherapy or in combination with other antihypertensive drugs. The usual maintenance dose is 20-40 mg/day. When adding furosemide to already prescribed medications, their dose should be reduced by 2 times. In case of arterial hypertension in combination with chronic renal failure, higher doses of the drug may be required.
2. Edema in nephrotic syndrome. The initial dose is 40-80 mg/day. The required dose is selected depending on the diuretic response. The daily dose can be taken at one time or divided into several doses.
3. Edema syndrome in chronic heart failure. The initial dose is 20-80 mg/day. The required dose is selected depending on the diuretic response. It is recommended to divide the daily dose into 2-3 doses.
4. Edema syndrome in chronic renal failure. In patients with chronic renal failure, careful selection of the dose is required, by gradually increasing it so that fluid loss occurs gradually (at the beginning of treatment, fluid loss of up to approximately 2 kg of body weight / day is possible). The recommended initial dose is 40-80 mg/day. The required dose is selected depending on the diuretic response. The entire daily dose should be taken once or divided into two doses. In patients on hemodialysis, the maintenance dose is usually 250-1500 mg/day.
5. Edema syndrome in liver diseases. Furosemide is prescribed in addition to treatment with aldosterone antagonists if they are insufficiently effective. To prevent the development of complications, such as impaired orthostatic regulation of blood circulation or disturbances in electrolyte or acid-base status, careful dose selection is required so that fluid loss occurs gradually (at the beginning of treatment, fluid loss of up to approximately 0.5 kg of body weight/day is possible). The initial dose is 20-80 mg/day.

Adverse reactions

Furosemide may cause the following side effects:.

1. Hematopoietic system: aplastic anemia, agranulocytosis, leukopenia and thrombocytopenia.
2. Water-electrolyte metabolism: hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, hypocalcemia, hypochloremia, hypokalemia.
3. Metabolism: hyperglycemia, muscle weakness, cramps, hypotension, hyperuricemia and dizziness.
4. Cardiovascular system: decreased blood pressure, arrhythmia, tachycardia, orthostatic hypotension, collapse.
5. Nervous system: drowsiness, myasthenia gravis, apathy, weakness, lethargy, confusion, calf muscle cramps, headache, paresthesia, adynamia.
6. Sense organs: hearing and vision impairment.
7. Gastrointestinal tract: dry mouth, nausea, exacerbation of pancreatitis, thirst, vomiting, decreased appetite, diarrhea or constipation and cholestatic jaundice.
8. Genitourinary system: hematuria, interstitial nephritis, acute urinary retention, decreased potency
9. Allergic reactions: erythema multiforme exudative, photosensitivity, pruritus, exfoliative dermatitis, urticaria, vasculitis, purpura, fever, chills, necrotizing angitis and anaphylactic shock.

Overdose

If the recommended dose is exceeded or prolonged uncontrolled use of Furosemide, patients develop signs of overdose, which are clinically manifested by increased side effects described above, paralysis, respiratory depression, cardiovascular depression, development of coma, acute renal failure and shock.

Treatment of overdose consists of correcting the water-electrolyte balance through diffuse infusions of isotonic sodium chloride solution, gastric lavage, replenishment of circulating blood volume, and symptomatic treatment.

special instructions

Before you start using the drug, read the special instructions:

1. The use of furosemide slows down the excretion of uric acid, which can provoke an exacerbation of gout.
2. Patients with hypersensitivity to sulfonamides and sulfonylureas may have cross-sensitivity to furosemide.
3. If azotemia and oliguria appear or worsen in patients with severe progressive kidney disease, it is recommended to suspend treatment.
4. In patients with diabetes mellitus or with reduced glucose tolerance, periodic monitoring of the level of glucose concentration in the blood and urine is required.
5. In unconscious patients with benign prostatic hyperplasia, narrowing of the ureters or hydronephrosis, monitoring of urinary output is necessary due to the possibility of acute urinary retention.
6. This medicine contains lactose monohydrate, therefore patients with rare hereditary problems of galactose intolerance, lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
7. The drug contains wheat starch in an amount that is safe for use in patients with celiac disease (gluten enteropathy).
8. Patients with a wheat allergy (other than celiac disease) should not use this drug.

Before starting therapy with Furosemide Sopharma, the presence of severe disturbances in the outflow of urine should be excluded; patients with partial disturbances in the outflow of urine require careful monitoring. During the course of treatment, it is necessary to periodically monitor blood pressure, the content of blood plasma electrolytes (including sodium, calcium, potassium, magnesium ions), acid-base status, residual nitrogen, creatinine, uric acid, liver function and, if necessary, carry out appropriate treatment adjustment.

In patients receiving high doses of furosemide, in order to avoid the development of hyponatremia and metabolic alkalosis, it is not advisable to limit the consumption of table salt. To prevent hypokalemia, it is recommended to simultaneously administer potassium supplements and potassium-sparing diuretics, as well as adhere to a diet rich in potassium. The selection of a dosage regimen for patients with ascites against the background of liver cirrhosis should be carried out in a hospital setting (violations of water and electrolyte balance can lead to the development of hepatic coma). This category of patients requires regular monitoring of plasma electrolyte levels.

Compatibility with other drugs

When using the drug, it is necessary to take into account interactions with other medications:

1. Furosemide may increase the risk of nephropathy after administration of radiocontrast agents.
2. The combination of the drug with cardiac glycosides increases the risk of developing digitalis intoxication.
3. The effect of Furosemide is reduced when used simultaneously with phenobarbital and phenytoin.
4. The drug is able to increase the concentration of cephalosporin antibiotics and chloramphenicol. At the same time, it increases the risk of developing their nephro- and ototoxic effects. The elimination of aminoglycoside antibiotics slows down when they are combined with Furosemide, which also increases the likelihood of intoxication.
5. Elderly patients often have to take Furosemide and drugs from the group of non-steroidal anti-inflammatory drugs. You should be careful with this combination, as it leads to a decrease in the effectiveness of Furosemide. If salicylates are chosen as NSAIDs, Furosemide may enhance their toxic effect.
6. A weakening of the effect of Furosemide is observed when taken simultaneously with sucralfate. Increased activity - when combined with other diuretics or antihypertensive drugs, especially ACE inhibitors.

Latin name: Furosemide
ATX code: C03CA01
Active substance:
Manufacturer: Borisov plant
medical supplies, Belarus
Conditions for dispensing from a pharmacy: Over the counter

Description of the drug

“Furosemide” refers to modern drugs with strong action. Its task is to help the kidneys, which do not cope well with removing excess fluid from the body. The diuretic effect when administered intravenously appears almost immediately - after a maximum of 10 minutes. The medicine in tablet form takes effect within 30 minutes - this time for diuretics (“Furosemide” belongs to this group) is considered excellent.

The drug quickly saves the body from edema in all tissues, relieves the body of excess sodium chloride and calcium and at the same time reduces blood pressure. Since the effect of use does not last long, a person does not face dehydration. The undoubted benefits of the drug were appreciated by doctors - furosemide has long been included in the list of vital and essential drugs - drugs that are vital and necessary in Russia.

You can find out about the causes of edema and methods of treatment in the article about.

Indications for use

The product confidently copes with edema of various origins, so its range of application is very wide. Furosemide is prescribed for the following problems:

• Heart failure
• Pulmonary edema
• Liver diseases
• Renal pathologies
• Cardiac asthma
• Cirrhosis of the liver.
• Brain edema
• Hypercalcemia
• Eclampsia.

As a winner of high blood pressure, it is used in the relief of hypertensive crises, as well as in the treatment of arterial hypertension.

Release forms and dosages

In Russia, it is produced in two forms: tablets and solution for injection. In both cases, the active substance - furosemide - is combined with auxiliary agents. The product is produced at several pharmacological factories in Russia and abroad. Due to its low prices, the drug is available to a wide range of patients.

The average price of tablets is from 15 to 50 rubles.

Taking pills

Thus, the cost of one jar with 50 tablets (this is a standard package) ranges from 13 to 90 rubles, depending on the specific pharmacy and manufacturer. The tablet contains 40 mg of furosemide. In this form, the drug is prescribed for outpatient treatment.

Usually, the dosage rate for each case of illness is selected individually, adjusting as treatment progresses. Adults at the beginning of treatment take from 20 to 80 mg, that is, from half a tablet to four. The increase goes up to 600 mg (7.5 pieces), you cannot use more than this. For children, the dose is calculated depending on weight: per 1 kg - one to two milligrams. In some cases, the child is given the maximum allowed amount of medication - 6 mg per kg.

The average price of ampoules is from 30 to 60 rubles.

Furosemide injections

When the patient is in a hospital, as well as in case of emergency, a liquid form is used. The volume of one ampoule is 2 ml, it contains 20 mg of furosemide. Usually the patient is given one injection per day, increasing the number to two if absolutely necessary. The injection dosage is the same for intravenous and intramuscular administration: from 20 to 40 mg for an adult and 1 mg for a child.

The price range for this form is also wide. The lowest cost of a package with 10 ampoules is 16 rubles.

Reception scheme

The tablets are usually taken in the morning; the dose can be divided into several doses only with the permission of the attending physician. Take them strictly on an empty stomach and be sure to wash them down with plenty of water or other non-carbonated liquid. The tablets should not be chewed, but should be swallowed whole.

Precautionary measures

During treatment, a lot of fluid comes out, potassium and magnesium leave the body. This loss needs to be replenished by drinking as much healthy liquid as possible: water, juices from vegetables and fruits. Carbonated drinks are prohibited.

The medicine increases the body's sensitivity to sunlight. You should not walk in the sun unless absolutely necessary, much less sunbathe. During this period, you can protect your skin with special creams from UV radiation. If allergic reactions occur on your body, be sure to inform your doctor.

Furosemide distracts attention and reduces the speed of reactions. Drivers and people whose work involves danger should take the drug with caution. Fans of extreme sports should forget about their hobby for a while.

Older people should change body position more slowly. When getting out of bed, first dangle your legs, then sit down, and only then stand up. Sudden movements can cause dizziness.

Contraindications for use

The drug is prohibited for patients if they have the following health conditions:

• Hyperuricemia
• Severe liver failure
• Digitalis intoxication
• Acute glomerulonephritis
• Acute renal failure, if accompanied by anuria
• Decompensated stenosis (aortic or mitral)
• "Liver coma"
• Hypertrophic obstructive cardiomyopathy.

Absolute contraindications are disruptions in the body's water-electrolyte metabolism and problems with urine discharge for any reason. If central venous pressure rises to 10 mmHg, the drug is also not prescribed.

Since the composition includes lactose monohydrate and potato starch, the drug should not be taken by the following people:

• Lactose intolerant
• Allergy sufferers to wheat
• Suffering from glucose-galactose malabsorption syndrome
• With lactose deficiency.

Hypersensitivity to any of the excipients or to the active substance (furosemide) is also a reason to ignore the drug.

Prescription for children and pregnancy

Children under three years old are prohibited from taking the drug in any form. Upon reaching this age, the drug is prescribed in strictly defined doses and under the constant supervision of a doctor.

It has been confirmed that the medicine can penetrate the placental barrier to the fetus, so taking Furosemide is absolutely contraindicated for pregnant women. It is not prescribed to nursing mothers: the drug is transmitted through breast milk. If doctors insist on treatment with the drug, breastfeeding is completely stopped.

Furosemide and alcohol

On the issue of compatibility of alcoholic beverages and the drug, doctors are unanimous: you should not drink while taking the drug. Weakened organisms will not withstand the onslaught of the second diuretic - ethyl alcohol. An increase in urine flow will lead to the leaching of magnesium and potassium, which are responsible for the smooth functioning of the cardiac system. Dehydration of all organs may begin.
Situations are especially dangerous when alcohol is taken a short time after injections or furosemide tablets. A direct threat to life is created, and even resuscitators are not always able to cope with it. It is possible to go into a coma, as well as cardiac arrest.

Overdose and side effects

In some cases, patients may experience undesirable effects of furosemide:

• Itchy skin
• Nausea (including vomiting)
• Urinary retention
• Headache
• General malaise: weakness, drowsiness, chills
• Increased thirst
• Weakness and muscle cramps
• Constipation
• Decreased potency
• Noise in ears
• Hearing and vision impairment
• Diarrhea
• Dizziness.

The drug can greatly reduce blood pressure, cause increased heart rate, and arrhythmia. Sometimes serious problems arise:

• Oliguria
• Fever
• Stevens-Johnson syndrome
• Agranulocytosis
• Hematuria
• Fever
• Anaphylactic shock
• Disturbances of water and electrolyte metabolism
• Thrombocytopenia
• Anorexia.

You won’t be able to cope with an overdose on your own; this condition can only be treated by specialists using a series of manipulations. You can alleviate the patient's condition by inducing vomiting and then giving activated charcoal. Common manifestations of overdose are abnormal heart rhythms, delirium, severe hypotension and confusion.

Storage conditions

For furosemide, choose a place where sunlight and moisture do not penetrate. Storage temperature is below 25 degrees, but above zero. Freezing the drug renders it unusable. The product is suitable for use for two years. After this period, use is prohibited.

Analogues of the product

Generic Furosemide is available in many countries. The drugs have a common “ancestor” - furosemide (this is an international patented name), it is this substance that is active in all analogues.

Sanofi Aventis, France
Price from 8 to 60 rub.

A strong and fast-acting diuretic, which is a sulfonamide derivative. It acts by blocking the reabsorption of sodium and chloride ions in the kidneys. It also increases the excretion of potassium, calcium, and magnesium. Also available in solution and tablet form

pros

• Can be used during pregnancy (but only for a short period of time)
• During a course of treatment, diuretic activity does not decrease

Minuses

• A lower degree of purification of the drug and a different composition of excipients and, as a result, less effectiveness
• Reaction speed may be reduced.

Sopharma JSC, Bulgaria
Price from 16 to 40 rub.

Diuretic, natriuretic agent. Increases the excretion of bicarbonates, phosphates, calcium, magnesium and potassium, increases urine pH. It has secondary effects due to the release of intrarenal mediators and redistribution of intrarenal blood flow.

pros

• Absorbed quickly and fairly completely via any route of administration
• Also effective in heart failure

Minuses

• Long-term use can lead to weakness, fatigue, decreased blood pressure and cardiac output
• Do not use while breastfeeding.

Furosemide and Asparkam: drug interactions

Long-term treatment with furosemide is only possible with simultaneous use of drugs that contain potassium. An ideal option for joint therapy is Asparkam. This tandem reduces the load on the heart, eliminates the threat of seizures and replenishes the lack of potassium in the body.

Instructions for use

Attention! The information is provided for informational purposes only. This instruction should not be used as a guide to self-medication. The need for prescription, methods and doses of the drug are determined exclusively by the attending physician.

general characteristics

international and chemical names: furosemide;
4-chloro-N-(2-furylmethyl)-5-sulfamoylanthranilic acid;
basic physical and chemical properties: tablets are round in shape, white with a yellowish tint, with a biconvex surface;
compound: 1 tablet contains furosemide 40 mg;
Excipients: modified corn starch, microcrystalline cellulose, magnesium stearate, povidone, macrogol 6000, lactose monohydrate.

Release form. Pills.

Pharmacotherapeutic group

Highly active diuretics (Diuretics- medicinal substances that increase the excretion of urine by the kidneys and thereby promote the removal of excess water and sodium chloride from the body). ATS code C03CA01.

Pharmacological properties

Pharmacodynamics. A potent diuretic with a rapidly developing effect, a sulfonamide derivative. The mechanism of action of the drug is associated with blockade (Blockade- slowing down or interrupting the conduction of electrical impulses in any part of the conduction system of the heart or myocardium) reabsorption of sodium and chloride ions in the ascending loop of Henle; also affects convoluted tubules, and this effect is not associated with inhibition of carbonic anhydrase or aldosterone activity. The drug has a pronounced diuretic, natriuretic, chloruretic effect. It also increases the excretion of potassium, calcium, and magnesium. The drug reduces left filling pressure ventricle (Ventricles- 1) Cavities in the central nervous system: 4 in the brain and 1 in the spinal cord. Filled with cerebrospinal fluid. 2) Parts of the human heart), pressure in the pulmonary artery, improves heart function in heart failure; reduces systemic blood pressure.
The drug is equally effective in acidosis (Acidosis- a shift in the body’s acid-base balance towards increasing acidity (decreasing pH)) And alkalosis (Alkalosis– a condition characterized by a violation of the acid-base balance in the body and a shift in pH to the alkaline side). The diuretic effect when taken orally is observed after 20 - 30 minutes, the maximum effect of the drug is after 1 - 2 hours. The duration of the effect after a single dose is 4 hours or more.

Pharmacokinetics. After oral administration, Furosemide is absorbed from the digestive tract, bioavailability (Bioavailability- an indicator of the degree and speed of entry of a medicinal substance into the blood from the total administered dose) is 64%. The maximum concentration of the drug in plasma (Plasma- the liquid part of the blood, which contains formed elements (erythrocytes, leukocytes, platelets). Various diseases (rheumatism, diabetes mellitus, etc.) are diagnosed based on changes in the composition of blood plasma. Medicines are prepared from blood plasma) blood level increases with increasing dose, but the time to achieve it does not depend on the dose and varies widely depending on the patient’s condition.
Linking with proteins (Squirrels- natural high-molecular organic compounds. Proteins play an extremely important role: they are the basis of the life process, participate in the construction of cells and tissues, are biocatalysts (enzymes), hormones, respiratory pigments (hemoglobins), protective substances (immunoglobulins), etc.)(mostly with albumins (Albumin- simple globular proteins contained in blood serum are determined in the laboratory during a biochemical blood test)) is 95%. The drug penetrates the placental barrier and is excreted in breast milk. Metabolized in the liver, turning mainly into glucuronide. Furosemide and its metabolites are rapidly excreted by the kidneys. Half-life (Half-life(T1/2, synonymous with half-elimination period) - the period of time during which the concentration of a drug in the blood plasma decreases by 50% from the initial level. Information about this pharmacokinetic indicator is necessary to prevent the creation of a toxic or, conversely, ineffective level (concentration) of the drug in the blood when determining the intervals between administrations)– 1–1.5 hours. Approximately 50% of the dose taken is excreted in the urine within 24 hours, while during the first 4 hours – 59% of the total drug that is excreted per day. The remaining amount is excreted unchanged in the feces.

Indications for use

Edema syndrome of various origins, including chronic (Chronic- a long, continuous, protracted process, occurring either constantly or with periodic improvements in the condition) heart failure stage IIIB-III, liver cirrhosis (syndrome portal hypertension (Portal hypertension– a pathological condition characterized by increased pressure in the hepatic portal vein system)), nephrotic syndrome; arterial hypertension (Arterial hypertension– a disease characterized by an increase in blood pressure of more than 140/90 mm Hg. Art.); hypertensive crisis (Hypertensive crisis- critical hypertensive condition, accompanied by encephalopathy (headache, vomiting and deeper disorders of brain function), acute left ventricular failure, coronary insufficiency (angina pectoris, myocardial infarction)); premenstrual tension syndrome (Premenstrual tension syndrome(premenstrual syndrome) - a cyclical change in the mood and physical condition of a woman, occurring 2-3 days or more before menstruation, disrupting the usual way of life or work and alternating with a period of remission associated with the onset of menstruation, lasting at least 7-12 days); forced diuresis (Diuresis- the amount of urine excreted over a certain time. In humans, daily diuresis averages 1200-1600 ml), hyperkalemia, hypernatremia, hypercalcemia.

Directions for use and doses

Furosemide is prescribed orally before meals. Doses are selected depending on the severity of the disease and the severity of the effect. Orally (Orally- route of administration of the drug through the mouth (per os)) take 40 mg (1 tablet) 1 time per day in the morning. If the effect is insufficient, the dose is increased to 80 - 160 mg per day (2-3 doses at intervals of 6 hours). After reduction swelling (Edema– tissue swelling as a result of a pathological increase in the volume of interstitial fluid) prescribed in smaller doses with a break of 1-2 days. The maximum daily dose is 160 mg.
For arterial hypertension, the initial dose of the drug for adults is 80 mg per day, divided into 2 doses. It must be appropriate to the patient's condition. If the effect is insufficient, it should be prescribed together with other antihypertensive drugs.
With concomitant heart failure, the daily dose can be increased to 80 mg.
For children aged 3 years and older, the average daily dose taken orally during or after meals is 4–3 mg/kg in 1–4 doses. The drug has the greatest diuretic effect in the first 3 to 5 days of use. After the swelling disappears, they switch to intermittent administration of the drug - every other day or 1 - 2 times a week.
If the child has not previously received Furosemide or other diuretics, the diuretic should not be immediately prescribed at an average daily dose. Initially, it is necessary to use a diuretic in a dose of ¼ - ½ of the average daily dose, and then, if there is no diuretic effect, the dose should be increased. For children, the initial dose is 2 mg/kg; if necessary, it can be increased by 1-2 mg/kg.

Side effect

Possible nausea, vomiting, hypovolemia (Hypovolemia- reduction in the volume of extracellular fluid), dehydration, hyperemia (Hyperemia- plethora caused by increased blood flow to any organ or tissue area (arterial, active hyperemia) or obstructed outflow (venous, passive, congestive hyperemia). Accompanies any inflammation. Artificial hyperemia is caused for therapeutic purposes (compresses, heating pads, cups)), itching (Itching- a modified feeling of pain caused by irritation of the nerve endings of pain receptors) skin, hypotension, cardiac arrhythmias, reversible hearing impairment, vision, paresthesia (Paresthesia(from the Greek par - near, past, outside and isthesis - feeling, sensation) - an unusual sensation of numbness of the skin, “crawling goosebumps”, which occurs without external influence or under the influence of some mechanical factors (compression of a nerve, vessel). Paresthesia can be a manifestation of diseases of the peripheral nerves, less often - of the sensory centers of the spinal cord or brain), interstitial nephritis. Due to increased diuresis, dizziness may occur, depression (Depression- mental disorder: melancholy, depressed mood with pessimism, monotony of ideas, decreased motivation, retardation of movements, various somatic disorders); muscle weakness, thirst, dehydration, hypokalemia, hyponatremia, hypochloremia, metabolic alkalosis; transient hyperuricemia, uricosuria, exacerbation of gout, in some cases hyperglycemia, worsening of obstructive uropathy. As soon as side effects appear, the dose of Furosemide must be reduced or the drug discontinued.

Contraindications

Acute glomerulonephritis (Acute glomerulonephritis– acute immunoinflammatory kidney disease with initial damage to the glomeruli and with further involvement of all renal structures in the process, clinically manifested by renal and extrarenal syndromes), end-stage renal failure, mechanical obstruction of the urinary tract; liver failure, diabetic coma; disturbances of water-salt metabolism (hypokalemia, hyponatremia, dehydration, alkalosis); first half of pregnancy, hypersensitivity to the drug (including sulfonamides (Sulfonamides- a group of antimicrobial drugs, sulfanilic acid derivatives. Used in the treatment of mainly infectious diseases)), anuria, gout, decompensated arterial or mitral stenosis (Mitral stenosis– a heart defect caused by a narrowing of the left atrioventricular orifice, which creates obstacles to the movement of blood from the left atrium to the left ventricle. The causes of mitral stenosis are rheumatism, congenital defects), severe hypotension, pancreatitis, myocardial infarction (Myocardial infarction- ischemic necrosis of the myocardium, caused by a sharp decrease in the blood supply to one of its segments. The basis of MI is an acutely developed thrombus, the formation of which is associated with the rupture of an atherosclerotic plaque), diabetes mellitus with impairment tolerance (Tolerance- a decrease in the reaction to repeated administration of the substance, the body becomes addicted, due to which a larger and larger dose is required to achieve the effect inherent in the substance. They also distinguish between reverse tolerance - a special condition in which a smaller dose is required to achieve a given effect, and cross-tolerance - when taking one substance increases tolerance to taking other substances (usually from the same group or class). Tachyphylaxis is the rapid (literally after the first use) development of tolerance to a drug. Also an immunological state of the body in which it is unable to synthesize antibodies in response to the introduction of a specific antigen while maintaining immune reactivity to other antigens. The problem of tolerance is important in organ and tissue transplantation) To carbohydrates (Carbohydrates- one of the main components of cells and tissues of living organisms. They provide all living cells with energy (glucose and its reserve forms - starch, glycogen), participate in the body's defense reactions (immunity). Among food products, the richest foods in carbohydrates are vegetables, fruits, and flour products. Used as medicines (heparin, cardiac glycosides, some antibiotics). An increased content of certain carbohydrates in the blood and urine is an important diagnostic sign of certain diseases (diabetes mellitus). The daily human need for carbohydrates is 400-450 g), hypertrophic cardiomyopathy (Hypertrophic cardiomyopathy- characterized by pronounced ventricular hypertrophy. A decrease in cardiac output leads to a decrease in blood delivery during physical activity through the coronary vessels (angina), cerebral vessels (fainting), shortness of breath as a result of a rapid increase in pressure in the pulmonary veins) With obstruction (Obstruction- obstacle, obstruction) left ventricular outflow tract, lupus erythematosus (lupus erythematosus– a systemic autoimmune disease in which antibodies produced by the human immune system damage the DNA of healthy cells, mainly connective tissue is damaged). Children under 3 years of age.

Overdose

Symptoms of overdose: dehydration, decreased circulating blood volume, arterial hypotension, electrolyte imbalance, hypokalemia and hypochloremic alkalosis due to the diuretic effect.
Treatment: symptomatic.

Features of application

The drug is prescribed with caution in case of severe cardiovascular insufficiency, with prolonged therapies (Therapy- 1. The field of medicine that studies internal diseases is one of the oldest and main medical specialties. 2. Part of a word or phrase used to indicate the type of treatment (oxygen therapy\; hemotherapy - treatment with blood products)) cordial glycosides (Glycosides- organic substances whose molecules consist of a carbohydrate and a non-carbohydrate component (aglycone). Widely distributed in plants, where they can be a form of transport and storage of various substances), elderly patients with severe atherosclerosis (Atherosclerosis- a systemic disease characterized by damage to the arteries with the formation of lipid (mainly cholesterol) deposits in the inner lining of the vessels, which leads to a narrowing of the lumen of the vessel up to complete blockage). Serious electrolyte disturbances should be compensated for before starting treatment.
During treatment, it is necessary to monitor the level of electrolytes, carbonates, urea (Urea- colorless crystals, the end product of protein metabolism. Formed in the liver and excreted in the urine. In the medical industry it is synthesized and used as a diuretic).
Treatment should be carried out against the background of a potassium-rich diet.
During pregnancy in the first half, the drug is contraindicated; in the second half, Furosemide can only be used according to strict indications and for a short time, as determined by the doctor.
If necessary, take Furosemide during lactation (Lactation- secretion of milk from the mammary gland) Breastfeeding should be discontinued, since the drug can pass into breast milk (and also inhibit lactation).
When using the drug, a decrease in attention cannot be ruled out, which is important for drivers and people working with machinery.
If oliguria persists for 24 hours, the drug should be discontinued.
To avoid rebound syndrome in hypertension, the drug is prescribed at least 2 times a day.

Interaction with other drugs

With simultaneous use of Furosemide with cardiac glycosides, the risk of developing glycoside dysfunction increases. intoxication (Intoxication- poisoning of the body with toxic substances), when combined with glucocorticoids, there is a risk of developing hypokalemia.
Furosemide potentiates the action muscle relaxants (Muscle relaxants- drugs that reduce the tone of skeletal muscles with a decrease in motor activity), antihypertensive drugs. When used simultaneously with aminoglycosides, cephalosporins and cisplatin, their concentrations in the blood plasma may increase, which can lead to the development of nephro- and ototoxic effects.
Nonsteroidal anti-inflammatory drugs may reduce the diuretic effect of Furosemide.
When used simultaneously with Furosemide, the effect of hypoglycemic drugs may be weakened. The simultaneous use of Furosemide with lithium preparations can lead to increased reabsorption of lithium in the renal tubules and the appearance of toxic (Toxic- poisonous, harmful to the body)- "Arterium"

This material is presented in free form on the basis of the official instructions for medical use of the drug.