Adult: 40-80 mg daily, alone or in conjunction with other antihypertensives.
Oedema associated with heart failure
Adult: Initially, 20 mg daily or 40 mg every other day for mild cases, or 40 mg once daily adjusted according to response. In some cases, 80 mg or more daily as a single dose or in 2 divided doses may be required. Max: 600 mg daily in severe cases.
Child: 1-3 mg/kg daily. Max: 40 mg daily.
Oedema associated with heart failure
Adult: 20-50 mg IM or slow IV Inj increased by 20-mg increments every 2 hr. Doses >50 mg must be given as IV infusion.
Child: 0.5-1.5 mg/kg daily. Max: 20 mg daily.
Pulmonary oedema
Adult: 40 mg via slow inj. If no adequate response within 1 hr, a further 80 mg may be given via infusion.
Oliguria in acute or chronic renal failure
Adult: GFR: 5-20 ml/min: 250 mg diluted to 250 ml in a suitable diluent to be infused over 1 hr. If urine output is insufficient within the next hr, may follow by 500 mg added to an appropriate infusion fluid to be infused over 2 hr, total volume depends on the patient's state of hydration. If urine output is still unsatisfactory within 1 hr after the 2nd infusion then a 3rd dose of 1 g may be infused over 4 hr. Rate of infusion: ≤4 mg/min. For patients with significant fluid overload, inj may be given without dilution directly into the vein, rate of admin ≤4 mg/min. Patients who do not respond to a dose of 1 g may need dialysis. If the response is satisfactory, the effective dose (of up to 1 g) may be repeated every 24 hr. Subsequently, adjust dose according to patient's response.
Severe sodium and water depletion, hypersensitivity to sulphonamides and furosemide, hypokalaemia, hyponatraemia, precomatose states associated with liver cirrhosis, anuria or renal failure. Addison's disease.
Warnings / Precautions
Prostatic hyperplasia. Hepatic or renal impairment, gout, DM, impaired micturition. Infusion rate should not exceed 4 mg/min to reduce the risk of ototoxicity. Monitor fluid and electrolyte balance and renal function. May lower serum levels of calcium and magnesium, thus serum levels should be monitored. Pregnancy and lactation.
Adverse Reactions
Fluid and electrolyte imbalance. Rashes, photosensitivity, nausea, diarrhoea, blurred vision, dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction. Hyperglycaemia, glycosuria, ototoxicity.
Potentially Fatal: Rarely, sudden death and cardiac arrest. Hypokalaemia and magnesium depletion can cause cardiac arrhythmias.
Overdose Reactions
Symptoms include dehydration, blood volume reduction, hypotension, electrolyte imbalance, hypokalaemia and hypochloraemic alkalosis. Treatment is supportive and consists of replacement of excessive fluid and electrolyte losses. Monitor serum electrolytes, carbon dioxide level and BP regularly. Ensure adequate drainage in patients with urinary bladder outlet obstruction.
Drug Interactions
Analgesics reduce natriuretic action of furosemide. Antagonises hypoglycaemic agents and drugs used for gout. Hyperglycaemia with antihypertensive agent diazoxide. Antagonises muscle relaxants. Increased risk of ototoxicity when used with aminoglycosides especially in renal impairment. May enhance nephrotoxicity of cephalosporins. Effects of antihypertensives enhanced. Action antagonised by corticosteroids. Phenytoin and indometacin may reduce effects of furosemide.
Potentially Fatal: May provoke severe hypotensive response with ACE inhibitors. NSAIDs inhibit diuretic and antihypertensive effects. Increased incidence of premature beats with cardiac glycosides.
See Below for More furosemide Drug Interactions
Mechanism of Actions
Furosemide inhibits reabsorption of Na and chloride mainly in the medullary portion of the ascending Loop of Henle. Excretion of potassium and ammonia is also increased while uric acid excretion is reduced. It increases plasma-renin levels and secondary hyperaldosteronism may result. Furosemide reduces BP in hypertensives as well as in normotensives. It also reduces pulmonary oedema before diuresis has set in.
Absorption: Fairly rapidly absorbed from the GI tract (oral).
Distribution: Crosses the placenta and enters breast milk. Protein-binding: 99%.
Excretion: Via urine (as unchanged); 2 hr (elimination half-life), may be prolonged in neonates and renal and hepatic impairment.
May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)
Storage Conditions
Intravenous: Store at 15-30°C. Oral: Store at 15-30°C. Parenteral: Store at 15-30°C.
ATC Classification
C03CA01 - furosemide ; Belongs to the class of high-ceiling sulfonamide diuretics.
Intravenous: Store at 15-30°C. Oral: Store at 15-30°C. Parenteral: Store at 15-30°C.
Available As
  • Furosemide 10 mg
  • Furosemide 20 mg
  • Furosemide 30 ml
  • Furosemide 40 mg
  • Furosemide 500 mg
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