A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Lasix Indications, Dosage, Storage, Stability - Furosemide
Lasix Indications, Dosage, Storage, Stability - Furosemide
INDICATIONS
Parenteral therapy should be reserved for patients unable to take
oral medication or for patients in emergency clinical
situations.
Tablets, Injection, and Oral Solution
Edema: Furosemide is indicated in adults and pediatric
patients for the treatment
of edema associated with
congestive heart failure,
cirrhosis of the liver, and renal
disease, including the nephrotic
syndrome. Furosemide is particularly useful when an agent
with greater diuretic
potential is desired.
Tablets and Oral Solution
Hypertension: Oral furosemide
may be used in adults for the treatment
of hypertension
alone or in combination with other antihypertensive agents. Hypertensive
patients who cannot be adequately controlled with thiazides will
probably also not be adequately controlled with furosemide alone.
Injection
Furosemide is indicated as adjunctive therapy in acute
pulmonary edema. The intravenous
administration
of furosemide is
indicated when a rapid onset of diuresis
is desired, e.g., in acute
pulmonary edema.
If gastrointestinal
absorption is impaired
or oral medication
is not practical for any reason, furosemide
is indicated by the intravenous
or intramuscular route. Parenteral use should be replaced with oral
furosemide as soon as practical.
DOSAGE AND ADMINISTRATION
Tablets and Oral Solution
Edema
Therapy should be individualized according to patient
response to gain maximal
therapeutic response
and to determine the minimal
dose needed to maintain
that response.
Adults: The usual initial
dose of furosemide
is 20 to 80 mg given as a
single dose. Ordinarily a prompt
diuresis ensues. If
needed, the same dose can
be administered 6 to 8 hours later or the dose
may be increased. The dose
may be raised by 20 or
40 mg and given not sooner
than 6 to 8 hours after the previous dose
until the desired diuretic
effect has been obtained. This individually determined single dose
should then be given once or twice daily (e.g., at 8 am and
2 pm). The dose of furosemide
may be carefully titrated up to 600 mg/day in patients with clinically
severe edematous states.
Edema may be most efficiently and safely mobilized by giving furosemide
on 2 to 4 consecutive days each week.
When doses exceeding 80 mg/day are given for prolonged periods,
careful clinical observation and laboratory monitoring are particularly
advisable. (See PRECAUTIONS, Laboratory
Tests.)
Pediatric Patients: The usual initial
dose of oral
furosemide in pediatric
patients is 2 mg/kg body weight, given as a single dose. If the
diuretic response
is not satisfactory after the initial
dose, dosage may be increased by 1 or 2 mg/kg no sooner than 6 to
8 hours after the previous dose. Doses greater than 6 mg/kg body
weight are not recommended.
For maintenance therapy in pediatric
patients, the dose should
be adjusted to the minimum
effective level.
Hypertension
Therapy should be individualized according to the patient's response
to gain maximal therapeutic
response and to determine
the minimal dose needed
to maintain the therapeutic
response.
Adults: The usual initial
dose of furosemide
for hypertension is 80 mg, usually divided into 40 mg
twice a day. Dosage should then be adjusted according to response.
If response is not
satisfactory, add other
antihypertensive agents.
Changes in blood pressure
must be carefully monitored when furosemide is used with other antihypertensive
drugs, especially during initial
therapy. To prevent excessive drop
in blood pressure, the
dosage of other agents
should be reduced by at least 50 percent
when furosemide is
added to the regimen. As
the blood pressure
falls under the potentiating effect
of furosemide, a further reduction
in dosage or even discontinuation
of other antihypertensive drugs may be necessary.
Injection
Adults: Parenteral therapy with furosemide
Injection should be used only in patients unable to take
oral medication
or in emergency situations and should be replaced with oral
therapy as soon as practical.
Edema: The usual initial
dose of furosemide
is 20 to 40 mg given as a single dose, injected
intramuscularly or intravenously. The intravenous dose
should be given slowly (1 to 2 minutes). Ordinarily a prompt diuresis
ensues. If needed, another dose
may be administered in the same manner 2 hours later or the dose
may be increased. The dose
may be raised by 20 mg
and given not sooner than 2 hours after the previous dose until
the desired diuretic
effect has been obtained.
This individually determined single dose
should then be given once or twice daily.
Therapy should be individualized according to patient
response to gain maximal
therapeutic response
to determine the minimal
dose needed to maintain
that response. Close medical
supervision is necessary.
If the physician
elects to use high dose
parenteral therapy,
add the furosemide to either
sodium chloride
injection, lactated ringer's injection, or dextrose
(5%) injection after
pH has been adjusted to above
5.5, and administer as a controlled intravenous
infusion at a rate
not greater than 4 mg/min. Furosemide Injection is a buffered alkaline
solution with a pH
of about 9 and the drug
may precipitate
at pH values below 7. Care
must be taken to ensure that the pH
of the prepared infusion
solution is in the
weakly alkaline to
neutral range. Acid
solutions, including other parenteral medications (e.g.,
labetalol, ciprofloxacin, amrinone, and milrinone) must not be administered
concurrently in the same infusion
because they may cause
precipitation
of the furosemide. In addition,
furosemide injection
should not be added to a running intravenous
line containing any of
these acidic products.
Acute Pulmonary Edema: The usual initial
dose of furosemide is 40
mg injected
slowly intravenously (over 1 to 2 minutes). If a satisfactory response
does not occur within 1 hour, the dose
may be increased to 80 mg injected
slowly intravenously (over 1 to 2 minutes).
If necessary, additional therapy (e.g., digitalis, oxygen)
may be administered concomitantly.
Pediatric Patients: Parenteral therapy should be
used only in patients unable to take
oral medication
or in emergency situations and should be replaced with oral
therapy as soon as practical.
The usual initial dose
of furosemide Injection
(intravenously or intramuscularly) in pediatric
patients is 1 mg/kg body weight
and should be given slowly under close medical
supervision. If the diuretic
response to the initial
dose is not satisfactory, dosage
may be increased by 1 mg/kg not sooner than 2 hours after the previous
dose, until the desired diuretic
effect has been obtained. Doses greater than 6 mg/kg body weight
are not recommended.
Furosemide Injection should be inspected visually for particulate
matter and discoloration before administration. Do not use if solution
is discolored.
To insure patient safety,
this needle should be
handled with care and should be destroyed and discarded if damaged
in any manner. If cannula is bent, no attempt should be made to
straighten.
To prevent needle-stick injuries, needles should not be recapped,
purposely bent, or broken by hand.
HOW SUPPLIED
Tablets
Dispense in well-closed, light-resistant containers. Exposure to
light might cause a slight
discoloration. Discolored tablets should not be dispensed.
20 mg Tablets:
Lasix tablets 20 mg are supplied
as white, oval, monogrammed tablets. They are imprinted with "Lasix"
on one side and "Hoechst"
on the other.
40 mg Tablets:
Lasix tablets 40 mg are supplied
as white, round, monogrammed, scored tablets. They are imprinted
with "Lasix" on one side
and the Hoechst logo on the other.
80 mg Tablets:
Lasix tablets 80 mg are supplied
as white, round, monogrammed, facetted edge
tablets. They are imprinted with "Lasix 80" on one side
and the Hoechst logo on the other.
Oral Solution
Store at controlled room
temperature (59°-86°
F). Dispense in light-resistant containers. Discard opened bottle
after 60 days.
Injection
Storage: Store at controlled room
temperature (59°-86°
F).
Do not use if solution
is discolored.
Protect syringes from light. Do not remove syringe
from individual package until time
of use.
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