Ampoules and diuretic tablets Furosemide: instructions for use, reviews for weight loss, price

Pharmacodynamics and pharmacokinetics

Furosemide - what is it?

Furosemide is a “loop” diuretic, that is, a diuretic that acts primarily on the thick segment of the ascending limb of the loop of Henle. It is fast-acting. The diuretic effect is pronounced, but short-lived.

How long does it take for Furosemide to work?

After oral administration, the drug begins to act within 20-30 minutes, after infusion into a vein - after 10-15 minutes.

Depending on the characteristics of the body, the effect when using the oral form of Furosemide can last for either 3-4 or 6 hours, while it is most powerfully manifested an hour or two after taking the tablet.

After introducing the solution into a vein, the effect reaches a maximum after half an hour and lasts for 2-8 hours (the more severe the kidney dysfunction , the longer the drug lasts).

Pharmacodynamics

The mechanism of action of the drug is associated with impaired reabsorption of chlorine and sodium ions in the tubules of the nephrons of the kidneys. In addition, Furosemide increases the excretion of magnesium, calcium, phosphates and bicarbonates.

The use of the drug in patients with heart failure leads to a decrease in preload on the heart muscle after 20 minutes.

The hemodynamic effect reaches its maximum severity by the 2nd hour of action of Furosemide, which is due to a decrease in the tone of the veins, a decrease in the volume of circulating blood, as well as the volume of fluid filling the intercellular spaces in organs and tissues.

Reduces blood pressure. The effect develops as a consequence:

reducing the reaction of the muscles of the vascular walls to a vasoconstrictor (provoking narrowing of blood vessels and a decrease in blood flow in them) effect;
decrease in BCC;
increasing the excretion of sodium chloride .

During the period of action of Furosemide, the excretion of Na+ ions increases significantly, but after the cessation of the effect of the drug, the rate of their excretion drops below the initial level (withdrawal or rebound syndrome). Due to this, when administered once a day, it does not have a significant effect on blood pressure and daily Na excretion.

The reason for this effect is the sharp activation of antinatriuretic components of neurohumoral regulation (in particular, renin-angiotensin) in response to massive diuresis.

The drug stimulates the sympathetic and arginine vasopressive systems, reduces the plasma concentration of atriopeptin, and causes vasoconstriction.

Pharmacokinetics

Absorption from the digestive tract is high, bioavailability (proportion of absorbed drug) when taken orally is from 60 to 70%. The binding rate to plasma proteins is 98%.

TSmax when taken orally - 1 hour, when infused into a vein - 0.5 hours.

Furosemide is able to cross the placenta and be excreted in breast milk.

The substance undergoes biotransformation in the liver. Metabolites are secreted into the lumen of the renal tubules.

T1/2 for the oral form of the drug - from one hour to one and a half hours, for parenteral - from half an hour to an hour.

From 60 to 70% of the dose taken orally is excreted by the kidneys, the rest - with feces. When administered into a vein, about 88% of furosemide and its metabolic products are excreted by the kidneys, and about 12% with feces.

Furosemide tablets 40 mg No. 10x5

Name

Furosemide.

Description

Tablets are white or almost white, flat-cylindrical, with a bevel.

Main active ingredient

Release form

Pills.

Dosage

40 mg.

special instructions

Pharmacotherapeutic group

Highly active diuretics. Sulfonamides. ATX code: C03CA01.

Pharmacodynamics

"Loop" diuretic; causes a rapidly onset, strong and short-term diuretic effect. The diuretic effect depends on the dose. When taken orally, the onset of action is after 20–30 minutes, reaches a maximum after 1–2 hours, the duration of action is from 3–4 to 6 hours. It inhibits the reabsorption of sodium and chlorine ions mainly in the thick segment of the ascending part of the loop of Henle. Furosemide has a pronounced diuretic, natriuretic, chloruretic effect. In addition, it increases the excretion of potassium, calcium, and magnesium ions. In case of heart failure, after 20 minutes it leads to a decrease in preload on the heart. The maximum hemodynamic effect is achieved by the second hour of action of the drug, which is due to a decrease in the tone of the venous vessels, a decrease in the volume of circulating blood and intercellular fluid. It has a hypotensive effect due to an increase in the excretion of sodium chloride, a decrease in the response of vascular smooth muscles to vasoconstrictor effects and as a result of a decrease in circulating blood volume.

Pharmacokinetics

Absorption is high, the maximum concentration is observed in the blood plasma when taken orally after 1 hour. Bioavailability is 60–70%. The relative volume of distribution is 0.2 l/kg. Connection with blood plasma proteins – 98%. Penetrates the placental barrier and is excreted in breast milk. Metabolized in the liver. It is secreted into the lumen of the renal tubules through the anion transport system existing in the proximal nephron. 60–70% is excreted by the kidneys, the rest by the intestines. The half-life is 1–1.5 hours.

Indications for use

Edema of cardiac or renal origin. Edema of hepatic origin is usually in combination with potassium-sparing diuretics. Arterial hypertension in patients with chronic renal failure for whom the use of thiazide diuretics is contraindicated (especially when creatinine clearance is below 30 ml/min).

Directions for use and doses

Taken orally. The dose depends on the course and severity of the disease. Adults. For edema of cardiac, renal or hepatic origin: - moderate condition: ½-1 tablet per day, - severe condition: 2-3 tablets per day in 1 or 2 doses, or 3-4 tablets per day in 2 doses. For high blood pressure in patients with chronic renal failure: in combination with other antihypertensive drugs (antagonists of the renin-angiotensin system), the usual doses of 20-120 mg per day in one or two doses are recommended. Children For the treatment of edema, a daily dose of 1–2 mg/kg body weight in 1–2 divided doses. Use in Elderly Patients Dose selection and adjustment in elderly patients must be done with caution, usually starting at the lower end of the therapeutic dose range.

Use during pregnancy and lactation

During the first trimester, in the II–III trimesters of pregnancy, it is possible to use furosemide for health reasons. It is excreted in milk in women during lactation, and therefore it is necessary to stop breastfeeding for the period of treatment.

Precautionary measures

Accidental administration of the drug can lead to hypovolemia and dehydration. In case of hepatocellular failure, treatment should be carried out with caution, under strict monitoring of electrolytes, taking into account the risk of hepatic encephalopathy. If necessary, treatment should be stopped immediately. Taking furosemide in case of partial obstruction of the urinary tract can lead to urinary retention. Careful monitoring of urine output should be ensured, especially at the start of furosemide treatment. Patients with hypersensitivity to sulfonamides and sulfonylureas may have cross-sensitization to furosemide. Cases of photosensitivity reactions have been reported with the use of thiazide diuretics. If photosensitivity reactions occur, it is recommended to discontinue furosemide. If necessary, it is recommended to protect exposed skin exposed to sunlight or artificial ultraviolet radiation. Since the drug contains lactose, its use is not recommended for patients with galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome. Electrolyte balance Natremia. It is necessary to monitor sodium levels before starting therapy and regularly monitor them thereafter. Treatment with diuretics may cause hyponatremia. A decrease in sodium levels in the blood is initially asymptomatic; regular monitoring should be more frequent in patients at risk: advanced age, cachexia (malnutrition) or cirrhosis. Kalemia. When using loop diuretics, a decrease in sodium levels with hypokalemia may occur. Risk of sudden hypokalemia (

Interaction with other drugs

Combinations not recommended Co-administration of furosemide and chloral hydrate is not recommended. The ototoxicity of aminoglycosides and other ototoxic drugs may be increased by concomitant use of furosemide. Such combinations should be avoided, since the resulting hearing impairment may be irreversible. The exception is when this combination is used for health reasons. The simultaneous use of furosemide and lithium preparations is not recommended. Combinations requiring special precautions If, during treatment with cisplatin, it is necessary to achieve forced diuresis with furosemide, the latter can be prescribed in a low dosage (up to 40 mg) if renal function is normal and there is no fluid deficiency. Otherwise, the nephrotoxic effect of cisplatin may be enhanced. Treatment with furosemide can lead to severe hypotension and deterioration of renal function, and in some cases to the development of acute renal failure, especially when angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin II receptor antagonists (sartans) are prescribed at the first dose or at higher doses. It is necessary to discontinue furosemide or reduce its dose 3 days before using ACE inhibitors or sartans. Furosemide should be used with caution in combination with risperidone, as there may be an increase in mortality in elderly patients. The need for co-administration must be justified based on the risks and benefits of the combination. The risk of mortality increases with the presence of dehydration. Significant interactions between furosemide and other drugs Co-administration of non-steroidal anti-inflammatory drugs (NSAIDs), including acetylsalicylic acid, may reduce the effect of furosemide. In patients with dehydration or hypovolemia, NSAIDs may cause acute renal failure. The toxic effect of salicylates may be increased. The effectiveness of furosemide may be reduced with simultaneous administration of phenytoin. With the simultaneous use of glucocorticosteroids, carbenoxolone, licorice in large quantities, and prolonged use of laxatives, hypokalemia may increase. Hypokalemia or hypomagnesemia may increase the sensitivity of the myocardium to cardiac glycosides and drugs leading to prolongation of the QT interval. The effect of drugs that lower blood pressure (antihypertensive, diuretic and other drugs) can be enhanced when used simultaneously with furosemide. The simultaneous use of probenecid, methotrexate and other drugs that are eliminated by tubular secretion may reduce the effectiveness of furosemide. Furosemide may result in decreased elimination of these drugs. Their serum levels may increase and the risk of side effects may increase. The effectiveness of hypoglycemic agents and vasoconstrictor amines (epinephrine/adrenaline, norepinephrine/noradrenaline) may be weakened, and theophylline and curare-like agents may be enhanced. Furosemide may enhance the damaging effects of nephrotoxic drugs on the kidneys. In patients simultaneously treated with furosemide and certain cephalosporins in high doses, deterioration of renal function may occur. With simultaneous use of cyclosporine A and furosemide, there may be an increased risk of developing secondary gouty arthritis due to furosemide-induced hyperuricemia and worsening renal excretion of urate caused by cyclosporine. Patients at high risk of developing nephropathy are more susceptible to renal dysfunction when furosemide is used in conjunction with radiocontrast agents. When used together with thiazides, photosensitivity reactions may develop. In the event of an unexpected photosensitivity reaction while taking furosemide, it is recommended to discontinue therapy. If repeated administration is necessary, ultraviolet irradiation or solar insolation should be avoided.

Contraindications

- hypersensitivity to furosemide or to any of the excipients; - acute renal failure; - hepatic encephalopathy; - obstruction of the urinary tract; - hypovolemia or dehydration; - decompensated hypokalemia; - decompensated hyponatremia; — pregnancy, breastfeeding; - combinations with lithium; - galactosemia, glucose-galactose malabsorption syndrome, lactase deficiency; - hepatitis and hepatocellular failure in patients on hemodialysis with severe renal failure (creatinine clearance

Compound

One tablet contains: active ingredient: furosemide – 40 mg; excipients: lactose monohydrate, potato starch, starch 1500 (partially pregelatinized corn starch), magnesium stearate.

Overdose

Symptoms: decreased blood pressure, collapse, shock, hypovolemia, dehydration, hemoconcentration, arrhythmias, acute renal failure with anuria, thrombosis, thromboembolism, drowsiness, confusion, paralysis, apathy, hypokalemia and hypochloremic alkolosis. Treatment: correction of water-salt balance and acid-base status, replenishment of circulating blood volume, symptomatic treatment. There is no specific antidote.

Side effect

From the cardiovascular system: arterial hypotension, orthostatic hypotension, collapse, tachycardia, arrhythmias. From the nervous system: dizziness, headache, muscle weakness, cramps of the calf muscles (tetany), paresthesia, apathy, adynamia, weakness, lethargy, drowsiness, confusion. From the senses: visual and hearing impairment. From the digestive system: anorexia, dry mouth, thirst, nausea, vomiting, diarrhea, constipation, cholestatic jaundice, exacerbation of pancreatitis. From the genitourinary system: oliguria, acute urinary retention (with benign prostatic hyperplasia), interstitial nephritis, hematuria, impotence. Allergic reactions: purpura, urticaria, exfoliative dermatitis, erythema multiforme, vasculitis, necrotizing angiitis, pruritus, chills, fever, photosensitivity, anaphylactic shock. From the hematopoietic organs: leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia. From the side of water and electrolyte metabolism: hypovolemia, dehydration (risk of thrombosis and thromboembolism), hypokalemia, hyponatremia, hypochloremia, hypocalcemia, hypomagnesemia, metabolic alkalosis. Metabolic disorders: hyperglycemia, hypercholesterolemia, hyperuricemia, glycosuria. In newborns and premature infants, long-term use of high doses of furosemide increases the risk of developing nephrocalcinosis and/or nephrolithiasis. Ultrasound monitoring of the kidneys is recommended.

Storage conditions

In a place protected from light, at a temperature not exceeding 25 ° C. Keep out of the reach of children.

Buy Furosemide tablets 40 mg No. 10x5 in the pharmacy

Price for Furosemide tablets 40 mg No. 10x5

Instructions for use for Furosemide tablets 40 mg No. 10x5

Indications for use of Furosemide

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 liver cirrhosis ;
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).

Indications for use of Furosemide in ampoules

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 ).

In the case when the drug is prescribed for nephrotic syndrome , treatment of the underlying disease should come first.

Contraindications for Furosemide

The drug is not prescribed for:

intolerance to its components;
ARF, which is accompanied by anuria (if the GFR value does not exceed 3-5 ml/min.);
urethral stenosis;
severe liver failure;
hepatic coma;
hyperglycemic coma;
precomatose states;
obstruction of the urinary tract with stones;
decompensated stenosis of the mitral valve or aortic orifice;
conditions in which blood pressure in the right atrium exceeds 10 mmHg. Art.;
gout;
hyperuricemia;
myocardial infarction (in the acute stage);
arterial hypertension;
hypertrophic subaortic stenosis;
systemic lupus erythematosus;
disorders of water-salt metabolism (hypocalcemia, hypochloremia, hypomagnesemia, etc.);
pancreatitis;
digitalis intoxication (intoxication caused by taking cardiac glycosides).

Relative contraindications to the use of Furosemide:

benign prostatic hyperplasia (BPH);
diabetes;
hypoproteinemia (taking the drug increases the risk of developing ototoxicity);
obliterating cerebral atherosclerosis;
hepatorenal syndrome;
hypotension in patients at risk of ischemia (coronary, cerebral or other), which is associated with circulatory failure;
hypoproteinemia against the background of nephrotic syndrome (possible increased undesirable side effects of Furosemide (especially ototoxicity) and a decrease in its effectiveness).

Patients at risk should be under constant medical supervision. Violation of the blood sugar balance, hypovolemia or dehydration are grounds for reviewing the treatment regimen and, if necessary, temporarily discontinuing the drug.

Diuretics promote the removal of sodium from the body, therefore, in order to avoid the development of hyponatremia, before starting therapy and subsequently throughout the course of using Furosemide, it is necessary to monitor the level of sodium in the patient’s blood (especially in patients with cachexia , cirrhosis , as well as in the elderly).

The use of loop diuretics may cause sudden hypokalemia . Risk groups include:

aged people;
patients who are undernourished and/or taking multiple medications at the same time;
patients diagnosed with cirrhosis with ascites ;
patients with heart failure .

Hypokalemia increases the cardiotoxicity of digitalis (Digitalis) preparations and the risk of cardiac arrhythmias . In long QT syndrome (congenital or drug-induced), hypokalemia contributes to bradycardia or potentially life-threatening torsade de pointes (TdP ).

In this regard, it is recommended to determine the level of potassium in the patient’s blood as often as possible. The first ionogram should be done within a week after the start of the course.

In diabetics, sugar levels must be systematically monitored throughout the course of treatment.

Additional Information

The drug is not a doping, but it is often used to remove prohibited substances from the body, and also as a means of losing weight in sports where the athlete’s weight is important. In this regard, Furosemide is equated to doping drugs and cannot be used in athletes.

Side effects of Furosemide

The following side effects may occur while using the drug:

cardiovascular disorders , including orthostatic hypotension , arterial hypotension , arrhythmias , tachycardia , collapse ;
dysfunctions of the nervous system , manifested by dizziness, muscle weakness, headache, tetany , apathy , adynamia , paresthesia , drowsiness, lethargy, weakness, confusion;
dysfunction of the sensory organs (in particular hearing and vision impairment);
disorders of the digestive system, including dry mouth, anorexia , cholestatic jaundice , diarrhea/constipation, nausea, vomiting, exacerbation of pancreatitis ;
disorders of the urogenital tract, including oliguria , interstitial nephritis , acute urinary retention (with BPH), hematuria , impotence ;
hypersensitivity reactions, including exfoliative dermatitis , urticaria , purpura , necrotizing angiitis , vasculitis , erythema multiforme , chills, pruritus, photosensitivity, fever , anaphylactic shock ;
disorders of the hematopoietic organ system, including aplastic anemia , thrombocytopenia , leukopenia , agranulocytosis ;
disorders of water-salt metabolism, including dehydration and, as a consequence, an increased risk of thrombosis/thromboembolism , hypovolemia , hypomagnesemia , hypochloremia , hypokalemia , hypocalcemia , hyponatremia , metabolic acidosis ;
changes in laboratory parameters, including hypercholesterolemia , hyperglycemia , glucosuria , hyperuricemia .

When Furosemide is administered intravenously, thrombophlebitis , and in newborn infants, renal calcification .

Possible side effects

Like all medicines, Furosemide can cause side effects, although not everyone gets them.

If you experience any of the following side effects while using this drug, contact your doctor or the nearest hospital immediately:

A severe allergic reaction, which may include skin rash, itching, dermatitis, peeling skin, sensitivity to sunlight or sunlight lamps or fever, swelling of the face, lips, tongue or throat, or difficulty breathing or swallowing.
Blistering or peeling skin around the lips, eyes, mouth, nose, and genitals, flu-like symptoms, and fever that may occur with Stevens-Johnson syndrome.
Inflammation of the blood vessels (vasculitis, which can cause a rash, fever, and joint or muscle pain) or inflammation of the kidneys, which can affect how often you urinate or the presence of blood in the urine. You may have a fever, drowsiness, or swelling of your ankles.
Thrombosis, causing pain, swelling, or tenderness in the legs.

Contact your doctor or pharmacist if you notice any of the following side effects:

Very common: May affect more than 1 in 10 people

Dehydration, changes in body water and electrolyte balance (such as sodium, potassium, chloride, calcium and magnesium) causing dry mouth, weakness, fatigue or drowsiness, restlessness, seizures, muscle pain, lethargy or cramps, hypotension causing low concentration levels and slow reaction times, water retention, fast or irregular pulse, and nausea and vomiting.

Common: May affect less than 1 in 10 people

Decrease in circulating blood volume (hypovolemia).
Increased concentrations of creatinine and urea in the blood (detected by blood test results).

Uncommon: may affect less than 1 in 100 people

Anemia causing fatigue, shortness of breath, unexplained bleeding or bruising.
Changes in blood tests, including cholesterol, glucose, uric acid levels.
Gout.
Blurred vision or xanthopsia.
A state of delirium, a feeling of pressure in the head, headache, drowsiness, fatigue, blurred vision, dry mouth, dizziness.
Irregular heartbeat.
Muscle cramps or weakness.
Changes in the amount and frequency of the urge to urinate.
Fatigue.
Dry mouth, thirst, poor health, intestinal motility disorders, including diarrhea and constipation.
Deafness (sometimes irreversible).

Rare: May affect less than 1 in 1000 people:

Changes in blood picture, such as changes in white blood cell count, decreased platelets, which causes rash, fever, sweating, fatigue, and weight loss.

Your doctor will need to do periodic blood tests to make sure there are no changes in your blood.

Mental disorders causing delusions, hallucinations, speech disorders.
Tingling sensation in the limbs.
Confusion, headache, fatigue, general feeling unwell, fever.
Tinnitus, hearing loss, usually reversible.
Symptoms of shock such as changes in heart rate, shortness of breath, cold and clammy skin.
Inflammation of the pancreas, causing abdominal or back pain and nausea.
Liver problems that cause yellowing of the skin or sclera of the eyes.
Skin rash.

Very rare: may affect less than 1 in 10,000 people:

Dyskinesia.
Kidney inflammation or kidney failure, which may cause back pain or changes in the amount or frequency of the urge to urinate.

The frequency of adverse reactions is unknown:

Deterioration of the condition in the presence of water and electrolyte balance in the body.
Acute generalized exanthematous pustulosis (AGEP) (acute drug-induced skin lesions).
Dizziness, fainting and loss of consciousness caused by symptomatic hypotension.
Hypokalemia.

Additional adverse reactions observed in children:

Increased risk of development or persistence of patent ductus arteriosus in premature infants.
Nephrolithiasis in infants.

Side Effect Reporting:

If you notice any side effects, tell your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects by going to the website www.arpimed.com and filling out the appropriate form “Report a side effect or ineffectiveness of a drug” and to the Scientific Center for Expertise of Medicines and Medical Technologies named after. Academician E. Gabrielyan by going to the website www.pharm.am to the “Report a side effect of a drug” section and fill out the form “Card of reporting a side effect of a drug.” Scientific center hotline phone number: +37410200505; +37496220505.

How to store Furosemide

Store out of reach of children, protected from moisture and light at a temperature of 15-250C.

Shelf life – 3 years. Do not take Furosemide after the expiration date indicated on the drug packaging. When indicating the expiration date, we mean the last day of the specified month.

Medicines should not be disposed of in wastewater or sewer systems. Ask your pharmacist how to dispose of any medicine you no longer need. These measures are aimed at protecting the environment.

Package contents and additional information

What Furosemide contains

One tablet contains:

active substance: furosemide – 40 mg;

excipients: microcrystalline cellulose, lactose monohydrate, magnesium stearate, sodium starch glycolate, povidone, corn starch.

What Furosemide looks like and contents of the pack

White, flat tablets with inclusions and a score on one side.

Description of packaging

40 tablets in blister packs (PVC/aluminum). 1 blister pack (40 tablets) together with the leaflet are placed in a cardboard package.

10 tablets in a blister pack (PVC/aluminum). 4 blister packs (40 tablets) together with an insert leaflet are placed in a cardboard package.

Vacation conditions

Dispensed by prescription.

Instructions for use of Furosemide

How to take Furosemide for edema?

Diuretic tablets are taken orally. The doctor selects the dose individually depending on the indications and characteristics of the course of the disease.

An adult with edema that has developed against the background of pathologies of the liver, kidneys or heart is prescribed to take ½-1 tablet/day if the condition is assessed as moderate. In severe cases, the doctor may recommend taking 2-3 tablets. 1.r./day or 3-4 tablets. in 2 doses.

How to lower blood pressure with Furosemide?

To reduce high blood pressure in patients with chronic renal failure, the drug is used in combination with antagonists of the renin-angiotensin system. The recommended dose varies from 20 to 120 mg/day. (½-3 tablets/day). The medicine is taken in one or two doses.

Furosemide for weight loss

Some women use the properties of the drug for weight loss. Taking Furosemide tablets (Furosemide Sopharma) really allows you to get rid of several kilograms, but this weight loss can hardly be called weight loss, since the drug does not remove excess fat in problem areas, but only removes water from the body.

Instructions for use of Furosemide in ampoules

The preferred method of administering the solution is a slow intravenous injection (performed over 1-2 minutes).

The drug is administered into the muscle in exceptional cases when oral or intravenous administration is not possible. Contraindications for intramuscular administration of Furosemide are acute conditions (for example, pulmonary edema ).

Taking into account the clinical condition of the patient, it is recommended to transfer Furosemide from parenteral to oral administration as soon as possible.

The question of the duration of treatment is decided taking into account the nature of the disease and the severity of symptoms. The manufacturer recommends using the lowest possible dose at which the therapeutic effect will be maintained.

For edematous syndrome in adults and adolescents over 15 years of age, treatment begins with the injection of 20-40 mg of Furosemide into a vein (in exceptional cases, into a muscle).

In the absence of a diuretic effect, the drug is continued to be administered every 2 hours at a dose increased by 50%. Treatment according to this regimen is continued until adequate diuresis is achieved.

A dose exceeding 80 mg should be administered into a vein by drip. The rate of administration should not be more than 4 mg/min. The maximum permissible dose is 600 mg/day.

In case of poisoning, to maintain forced diuresis, the patient should be administered from 20 to 40 mg of the drug, having previously dissolved the required dose in an infusion solution of electrolytes. Further treatment is carried out depending on the volume of diuresis. It is mandatory to replace the salts and fluids lost by the body.

The initial dose for hypertensive crisis is 20-40 mg. It is subsequently adjusted based on clinical response.

Furosemide injections and tablets: instructions for use in children

In pediatrics, the dose is selected depending on the patient’s weight. Furosemide tablets are given to a child at a rate of 1-2 mg/kg/day. The dose can be taken in one dose or divided into two doses.

Only the attending physician can answer questions about how often you can take the drug in a given case, as well as how long the course of treatment will be. The only clear recommendations are as to what to take Furosemide with: in addition to diuretics, you should definitely take potassium supplements.

The medicine is administered intravenously to children under 15 years of age at a dose of 0.5-1.5 mg/kg/day.

Furosemide tablets: what are they used for in veterinary medicine?

Why is Furasemide Sopharma used in veterinary medicine? In veterinary practice, Furosemide and similar drugs are used as part of complex therapy for the treatment of heart pathologies in dogs.

The use of diuretics allows you to remove fluid that accumulates around the lungs, abdominal or chest cavity, thereby reducing the load on the heart.

For dogs, the dosage of Furosemide depends on the weight of the animal. As a rule, the drug is given 2 times a day at a rate of 2 mg/kg. As an addition to treatment, it is recommended to give your dog bananas daily (one per day) to compensate for potassium losses.

Furosemide dosage

The dosages of furosemide for specific pathologies will be presented below. This will help you write a prescription for furosemide more correctly.

For hypertension

When prescribing furosemide in patients with arterial hypertension, the following recommendations must be adhered to:

can be prescribed in two forms intravenously or orally;
it is necessary to start with small doses of 20 – 40 mg twice a day;
it is necessary to gradually increase the dosage in the future to achieve the desired effect;
the daily dose in this case is no more than 320 mg per day.

Therefore, it is advisable to first write a prescription for furosemide at a dosage of 20 or 40 mg 1 - 2 times a day, and then increase the dose to achieve the desired effect. You can see examples below.

For swelling

When prescribing furosemide to patients with edema, the following rules must be followed:

Furosemide is prescribed for edema parenterally or orally;
you need to start taking the drug with small doses of 20 – 80 mg per day in the morning;
then it is necessary to increase the dose every 8 hours until the desired effect is achieved;
The maximum dose per day can be no more than 600 mg.

Therefore, it is advisable to write a prescription for furosemide at a dosage of 20–80 mg per day orally, and then increase the dose every 8 hours until the desired effect is achieved. You can see examples below.

In pediatrics for edema, 0.5–2 mg per kg body weight orally or parenterally every 6–12 hours (maximum 6 mg per kg per administration). Intravenous drip of 0.05 mg per kg, increasing the dose until the desired result is achieved.

For pulmonary edema

Furosemide is indicated for pulmonary edema at a dose of 40 mg intravenously over 20 minutes, then this dose can be repeated within 1 hour of treatment.

More often, this condition is treated in a hospital, so there is no need to write out a prescription for furosemide, but examples are given below.

For renal failure

When prescribed to patients with renal failure, it is necessary:

prescribe the patient furosemide orally at a dosage of 80–2500 mg per day, frequency of administration 1–4;
or intravenously 40–1000 mg per day, in which case the frequency will be 1–8 doses;
large doses are administered slowly over 30 minutes.

Therefore, it is advisable to write a prescription for furosemide orally at a dose of 80–2500 mg per day in 1–4 doses.

Overdose

Symptoms of Furosemide overdose:

a sharp drop in blood pressure;
hypovolemia;
dehydration;
collapse;
hemoconcentration;
shock;
arrhythmias (including atrioventricular block and ventricular fibrillation);
thrombosis;
thromboembolism;
confusion;
drowsiness;
acute renal failure with anuria ;
apathy;
flaccid paralysis

To normalize the patient’s condition, measures are prescribed aimed at correcting CSR and water-salt metabolism, replenishing the deficit of blood volume. Further treatment is symptomatic.

Furosemide does not have a specific antidote.

Interaction

Furosemide increases the concentration and toxicity (in particular, oto- and nephrotoxicity) of Ethacrynic acid , Aminoglycosides , Cephalosporins , Cisplatin , Chloramphenicol , Amphotericin B.

Enhances the therapeutic effectiveness of Theophylline and Dazoxide , reduces the effectiveness of Allopurine and hypoglycemic drugs .

Reduces the rate of renal excretion of Li+ drugs from the blood, thereby increasing the likelihood of intoxication with them.

Strengthens the neuromuscular blockade caused by non-depolarizing relaxants (peripheral relaxants) and the effect of antihypertensive drugs , weakens the effect of non-depolarizing relaxants .

In combination with pressor amines, there is a mutual decrease in the effectiveness of the drugs; with Amphotericin B and GCS, the risk of developing hypokalemia .

Use in combination with cardiac glycosides (CGs) may provoke the development of the latter's inherent toxic effects due to a decrease in the level of potassium in the blood (for low- and high-polarity CGs) and an extension of the half-life (for low-polarity CGs).

Drugs that block tubular secretion help increase the serum concentration of furosemide.

Sucralfate and NSAIDs reduce the diuretic effect of the drug due to suppression of Pg synthesis, changes in plasma renin and aldosterone .

The use of high doses of salicylates during treatment with the drug increases the risk of their toxicity, which is caused by competitive renal excretion of the drugs.

The Furosemide solution injected into a vein has a slightly alkaline reaction, so it is contraindicated to mix it with drugs whose pH is below 5.5.

Not recommended combinations for the solution

Administration of Furosemide into a vein within 24 hours after chloral hydrate can provoke:

nausea;
flushes of blood;
anxiety;
increased sweating;
increased blood pressure;
tachycardia.

The use of furosemide with ototoxic drugs (for example, aminoglycosides ) can cause irreversible hearing damage . This combination can only be used for health reasons.

Furosemide

Increases the concentration and risk of developing nephro- and ototoxic effects of cephalosporins, aminoglycosides, chloramphenicol, ethacrynic acid, cisplatin, amphotericin B (due to competitive renal excretion).

Increases the effectiveness of diazoxide and theophylline, reduces the effectiveness of hypoglycemic drugs, allopurinol.

Pressor amines and furosemide mutually reduce effectiveness.

Drugs that block tubular secretion increase the concentration of furosemide in the blood serum.

With the simultaneous use of glucocorticosteroids, amphotericin B, the risk of developing hypokalemia increases, with cardiac glycosides - the risk of developing digitalis intoxication increases due to hypokalemia (for high- and low-polarity) and prolongation of the half-life (for low-polarity).

Reduces the renal clearance of lithium drugs and increases the likelihood of intoxication.

Non-steroidal anti-inflammatory drugs, sucralfate, reduce the diuretic effect due to inhibition of prostaglandin synthesis, disturbance of the level of renin in the blood plasma and excretion of aldosterone.

Strengthens the hypotensive effect of antihypertensive drugs, neuromuscular blockade of depolarizing muscle relaxants (suxamethonium) and weakens the effect of non-depolarizing muscle relaxants (tubocurarine).

Concomitant use of large doses of salicylates during furosemide therapy increases the risk of their toxicity (due to competitive renal excretion).

Prescribing angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists to patients previously treated with furosemide may lead to a deterioration in renal function, and in some cases, to the development of acute renal failure.

It is recommended to discontinue furosemide or reduce the dose of furosemide 3 days before starting therapy with ACE inhibitors or angiotensin II receptor antagonists. Concomitant use of probenecid or methotrexate may reduce the effectiveness of furosemide (same secretion route). On the other hand, furosemide may lead to decreased renal elimination of these drugs.

Cyclosporine A - when combined with furosemide, the risk of developing gouty arthritis increases due to hyperuricemia caused by furosemide and the impairment of urate excretion by the kidneys by cyclosporine.

Patients at high risk for contrast media nephropathy who received furosemide had a higher incidence of renal dysfunction compared with patients at high risk for contrast media nephropathy who received only intravenous hydration before contrast media administration.

special instructions

During the entire course of treatment, it is recommended to avoid activities that potentially threaten life and health, which require rapid psychomotor reactions and increased attention.

During the course of treatment, you should periodically do a blood ionogram, as well as monitor blood pressure levels, blood pressure, uric acid, creatinine, residual nitrogen, and liver function. If necessary, the treatment regimen is revised taking into account these indicators.

When using high doses of Furosemide, it is not recommended to limit the consumption of table salt, which is associated with the risk of developing metabolic acidosis and hyponatremia .

In patients with BPH, hydronephrosis , narrowing of the ureters , and in patients who are unconscious, urinary output should be monitored due to the possibility of acute urinary retention.

The tablet form of the drug is contraindicated for people with glucose/galactose malabsorption syndrome, congenital galactosemia, hypolactasia .

Description of the drug FUROSEMIDE

When used simultaneously with aminoglycoside antibiotics (including gentamicin, tobramycin), nephro- and ototoxic effects may be enhanced.

Furosemide reduces the clearance of gentamicin and increases plasma concentrations of gentamicin and tobramycin.

When used simultaneously with cephalosporin antibiotics, which can cause renal dysfunction, there is a risk of increased nephrotoxicity.

When used simultaneously with beta-agonists (including fenoterol, terbutaline, salbutamol) and corticosteroids, hypokalemia may increase.

When used simultaneously with hypoglycemic agents and insulin, the effectiveness of hypoglycemic agents and insulin may decrease, because furosemide has the ability to increase plasma glucose levels.

When used simultaneously with ACE inhibitors, the antihypertensive effect is enhanced. Severe arterial hypotension is possible, especially after taking the first dose of furosemide, apparently due to hypovolemia, which leads to a transient increase in the hypotensive effect of ACE inhibitors. The risk of renal dysfunction increases and the development of hypokalemia cannot be excluded.

When used simultaneously with furosemide, the effects of non-depolarizing muscle relaxants are enhanced.

When used simultaneously with indomethacin and other NSAIDs, the diuretic effect may be reduced, apparently due to inhibition of prostaglandin synthesis in the kidneys and sodium retention in the body under the influence of indomethacin, which is a nonspecific COX inhibitor; decrease in antihypertensive effect.

It is believed that furosemide interacts with other NSAIDs in a similar way.

When used simultaneously with NSAIDs, which are selective COX-2 inhibitors, this interaction is much less pronounced or practically absent.

When used simultaneously with astemizole, the risk of developing arrhythmia increases.

When used simultaneously with vancomycin, oto- and nephrotoxicity may increase.

When used simultaneously with digoxin and digitoxin, an increase in the toxicity of cardiac glycosides is possible, associated with the risk of developing hypokalemia while taking furosemide.

There are reports of the development of hyponatremia when used simultaneously with carbamazepine.

When used simultaneously with cholestyramine and colestipol, the absorption and diuretic effect of furosemide decreases.

When used simultaneously with lithium carbonate, the effects of lithium may be enhanced due to an increase in its concentration in the blood plasma.

When used simultaneously with probenecid, the renal clearance of furosemide decreases.

When used simultaneously with sotalol, hypokalemia and the development of ventricular arrhythmias are possible.

When used simultaneously with theophylline, a change in the concentration of theophylline in the blood plasma is possible.

When used simultaneously with phenytoin, the diuretic effect of furosemide is significantly reduced.

After intravenous administration of furosemide during therapy with chloral hydrate, increased sweating, a feeling of heat, instability of blood pressure, and tachycardia are possible.

When used simultaneously with cisapride, hypokalemia may increase.

It is assumed that furosemide may reduce the nephrotoxic effect of cyclosporine.

When used simultaneously with cisplatin, the ototoxic effect may be enhanced.

How to 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 .

What is better - Lasix or Furosemide?

Lasix is one of the trade names for furosemide. The drug is produced by the Indian company Sanofi India Ltd. and, like its analogue, has two dosage forms: a one-percent d/i solution and 40 mg tablets.

Thus, when choosing one or another remedy, one should be guided by subjective feelings. The advantage of Furosemide is its lower price.

Furosemide 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.

How to take Furosemide for weight loss?

To remove a few extra pounds, women usually take 2-3 (no more!) Furosemide tablets during the day with an interval of three hours between doses, and then 2 more tablets at night.

You can repeat the one-day course no earlier than after 2-3 days.

Furosemide and Asparkam for weight loss

Since one of the side effects of Furosemide is hypokalemia , it is very important during the period of use of this drug to adhere to a certain diet (this means eating foods high in potassium) or additionally take medications that can minimize the side effects inherent in diuretics .

As a rule, Furosemide is recommended to be taken in combination with Asparkam (Panangin) . What is Asparkam ? This is a drug that is used as an additional source of potassium and magnesium. The medicine has a harmless composition, which eliminates the possibility of its unwanted interaction with Furosemide.

recommendations on how to take diuretics with Asparkam . Asparkam tablets , according to the manufacturer's instructions, are taken 3-6 pieces per day, dividing the indicated dose into three doses.

How often can you take Furosemide for weight loss?

Optimally - never. As a last resort, the drug can be used as an emergency remedy when swelling is urgently needed.

Reviews from women who tried to lose weight on Furosemide indicate that taking more than 2 tablets per week is always accompanied by side effects. In addition, another problem often arises - how to “get off” the drug.

FUROSEMIDE SOPHARMA

Interaction

When used simultaneously with phenobarbital and phenytoin, the effect of furosemide is reduced.
Increases the concentration and risk of developing nephro- and ototoxic effects of cephalosporins, cisplatin, amphotericin B (due to competitive renal excretion).

With the simultaneous use of aminoglycosides with furosemide, the elimination of aminoglycosides is slowed down and the risk of developing their ototoxic and nephrotoxic effects increases. For this reason, the use of this combination of drugs should be avoided unless it is necessary for health reasons, in which case an adjustment (reduction) of doses of aminoglycosides is required.

Increases the effectiveness of diazoxide and theophylline, reduces the effectiveness of hypoglycemic agents (oral antidiabetic agents, insulin), allopurinol. Medicines with nephrotoxic effects - when combined with furosemide, the risk of developing nephrotoxic effects increases. Glucocorticosteroids, corticotropin and amphotericin B lead to potassium loss. When combined with furosemide, this may result in a severe decrease in plasma potassium levels. Carbenoxolone, liquoris, beta2-sympathomimetics in high doses, long-term use of laxatives, reboxetine may increase the risk of developing hypokalemia.

When used simultaneously with cardiac glycosides, the risk of developing digitalis intoxication increases against the background of water and electrolyte disturbances (hypokalemia or hypomagnesemia), causing long QT interval syndrome.

Strengthens the neuromuscular blockade of depolarizing muscle relaxants (suxamethonium) and weakens the effect of non-depolarizing muscle relaxants (tubocurarine).

Nonsteroidal anti-inflammatory drugs (NSAIDs) (including indomethadine and acetylsalicylic acid) in combination with furosemide may cause a transient decrease in creatinine clearance and an increase in serum potassium and reduce the diuretic and antihypertensive effects of furosemide. In patients with hypovolemia and dehydration (including while taking furosemide), NSAIDs can cause the development of acute renal failure. Furosemide may enhance the toxic effect of salicylates (due to competitive renal excretion).

Sucralfate reduces the absorption of furosemide and weakens its effect (these drugs should be taken at least 2 hours apart).

Combined use with carbamazepine may increase the risk of hyponatremia, and with corticosteroids, on the contrary, it may cause sodium retention. Antihypertensives, diuretics or other agents that can lower blood pressure, when combined with furosemide, can lead to a more pronounced antihypertensive effect.

Prescribing angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists to patients previously treated with furosemide may lead to an excessive decrease in blood pressure with deterioration of renal function, and in some cases to the development of acute renal failure, so three days before starting treatment with inhibitors ACE inhibitors or angiotensin II receptor antagonists, or increasing their dose, it is recommended to discontinue furosemide or reduce its dose.

Probenecid, methotrexate and other drugs, which, like furosemide, are secreted in the renal tubules, can reduce the effect of furosemide (the same route of renal secretion); on the other hand, furosemide can lead to a decrease in the excretion of these drugs by the kidneys. Concomitant use with metolazone (thiazide diuretic) may cause increased diuresis.

Lithium salts - under the influence of furosemide, the excretion of lithium decreases, thereby increasing the serum concentration of lithium and increasing the risk of developing its toxic effects, including damaging effects on the heart and nervous system. Therefore, monitoring of serum lithium concentrations is required when using this combination.

Concomitant use of cyclosporine A and furosemide increases the risk of developing gouty arthritis due to hyperuricemia caused by furosemide and the impairment of urate excretion by the kidneys by cyclosporine.

Pressor amines (epinephrine, norepinephrine) and furosemide mutually reduce effectiveness.

Radiocontrast agents—Patients at high risk of developing contrast agent nephropathy who received furosemide had a higher incidence of renal dysfunction compared with patients at high risk of developing contrast agent nephropathy who received only intravenous hydration before administration of radiocontrast agent.

The use of diuretics is considered potentially dangerous when used concomitantly with risperidone. In placebo-controlled trials with risperidone in elderly patients with dementia, higher mortality was observed in patients treated with both furosemide and risperidone compared with patients treated with furosemide or risperidone alone, therefore special caution is required when furosemide is used concomitantly with risperidone in such patients.

As a combination or concomitant treatment, such therapy can only be used after assessing the benefit/risk ratio.

There are no reports of increased mortality among patients taking other diuretics (mostly low-dose thiazide diuretics) as concomitant treatment with risperidone.

Patients prescribed cholestyramine. This drug should be taken at least 1 hour after taking furosemide.

Is it possible to drink Furosemide during pregnancy?

When asked whether pregnant women can take diuretics , most doctors answer that modern medicine offers much safer methods of gestosis and preeclampsia

That is, Furosemide during pregnancy can only be used as an emergency aid, for the shortest possible course and only on condition that the woman is under strict medical supervision.

According to the FDA classification, the drug belongs to category C.

Despite all the contraindications, women quite often leave reviews on forums about the use of Furosemide during pregnancy.

Almost all of them note that the drug really quickly removed excess fluid from the body, but it also caused unpleasant side effects (for example, leg cramps).

Therefore, all mothers are unanimous in their opinion - Furosemide can be taken only according to strict indications and only in a situation without alternative.

Use during lactation

Furosemide penetrates into milk and is capable of suppressing lactation, so its use in nursing women is possible only if the child is transferred to artificial feeding during the mother's treatment.

Reviews of Furosemide

Furasemide is one of the most effective diuretics with fast and short action.

Reviews from doctors confirm the fact that the drug plays a key role in the treatment of edema syndrome in patients with heart failure , since loop diuretics most effectively block the reabsorption of Na+ ions in the ascending segment of the loop of Henle. At the same time, Furosemide retains its activity even in patients with chronic renal failure (including at the terminal stage of the disease).

However, the use of loop diuretics may cause irreversible damage to the renal tubules, especially when the drug is prescribed in high doses.

A parallel increase in the delivery of Na+ ions to the distal nephron, where loop diuretics , leads to sodium overload and structural damage to these parts of the nephron with the development of hyperplasia and hypertrophy .

In addition, after the end of the drug’s action, Na+ reabsorption increases significantly and, as a result, a “ricochet” effect develops, manifested by an increase in post-diuretic reabsorption.

Reviews left by patients allow us to conclude that the medicine helps well against edema and is indispensable for hypertensive patients. The disadvantages of the drug are usually side effects, contraindications and the fact that it is addictive.

Another category of reviews is reviews of Furosemide for weight loss. Despite the fact that the drug really allows you to quickly reduce weight by 3-5 kg, both doctors and those losing weight do not recommend using it for weight loss. This is due to the fact that the drug does not remove excess fat, but only removes water (and with it substances necessary for the body to function normally).

Thus, given that Furosemide is a very powerful drug, it can only be used taking into account contraindications, not exceeding the prescribed dose and only under the supervision of a doctor (especially during pregnancy). Also, you should not take it for other purposes (for example, for cystitis ).

When treating with diuretics, a very important question is what to take the drug with. It is optimal to supplement therapy by eating potassium-rich foods or taking potassium supplements.

Furosemide, 40 mg, tablets, 20 pcs.

When used simultaneously with phenobarbital and phenytoin, the effect of furosemide is reduced.

Increases the concentration and risk of developing nephro- and ototoxic effects of cephalosporins, chloramphenicol, ethacrynic acid, cisplatin, amphotericin B (due to competitive renal excretion).

Increases the effectiveness of diazoxide and theophylline, reduces the effectiveness of hypoglycemic agents, allopurinol.

Drugs that block tubular secretion increase the concentration of furosemide in the blood serum. Medicines with nephrotoxic effects - when combined with furosemide, the risk of developing nephrotoxic effects increases.

GCS and carbenoxolone when combined with furosemide increase the risk of hypokalemia.

When used simultaneously with cardiac glycosides, the risk of developing digitalis intoxication increases against the background of water and electrolyte disturbances (hypokalemia or hypomagnesemia).

Strengthens the neuromuscular blockade of depolarizing muscle relaxants (suxamethonium) and weakens the effect of non-depolarizing muscle relaxants (tubocurarine).

NSAIDs (including indomethacin and acetylsalicylic acid) in combination with furosemide may cause a temporary decrease in creatinine clearance and an increase in serum potassium and reduce the diuretic and antihypertensive effects of furosemide. In patients with hypovolemia and dehydration (including while taking furosemide), NSAIDs can cause the development of acute renal failure. Furosemide may enhance the toxic effect of salicylates (due to competitive renal excretion).

Sucralfate reduces the absorption of furosemide and weakens its effect (these drugs should be taken at least 2 hours apart).

Combined use with carbamazepine may increase the risk of hyponartaemia.

Antihypertensive drugs, diuretics or other agents that can lower blood pressure, when combined with furosemide, may lead to a more pronounced antihypertensive effect.

Prescribing ACE inhibitors to patients previously treated with furosemide can lead to an excessive decrease in blood pressure with deterioration of renal function, and in some cases to the development of acute renal failure, therefore, three days before starting treatment with ACE inhibitors or increasing their dose, it is recommended to discontinue furosemide, or reducing its dose.

Probenecid, methotrexate and other drugs, which, like furosemide, are secreted in the renal tubules, can reduce the effect of furosemide (the same route of renal secretion), on the other hand, furosemide can lead to a decrease in the renal excretion of these drugs.

Lithium salts - under the influence of furosemide, the excretion of lithium is reduced, thereby increasing the serum concentration of lithium and increasing the risk of developing the toxic effects of lithium, including its damaging effects on the heart and nervous system. Therefore, monitoring of serum lithium concentrations is required when using this combination.

Concomitant use of cyclosporine A and furosemide increases the risk of developing gouty arthritis due to hyperuricemia caused by furosemide and disruption of urate excretion by cyclosporine at night.

Pressor amines (epinephrine, norepinephrine) and furosemide mutually reduce effectiveness.

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

The price of Furosemide in injection form in Ukraine is from 14 UAH. The price of Furosemide in tablets is from 5.5 UAH.

The price of Furosemide diuretic tablets in Russian pharmacies is from 15 rubles. The price of ampoules is from 22.5 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Furosemide sol.
for i.v. and i.m. input. amp. 10 mg/ml 2 ml 10 pcs. Borisov Medical Preparations Plant OJSC 31 rub. order
Furosemide tablets 40 mg 50 pcs. Ozon LLC
31 rub. order
Furosemide tab. 40 mg 56 pcs Renewal JSC "PFK Obnovleniye" RU
44 RUR order

Pharmacy Dialogue

Furosemide tablets 40 mg No. 50BZMP
24 RUR order
Furosemide (tab. 40 mg No. 50) Ozone LLC
33 rub. order
Furosemide ampoules 1% 2ml No. 10BZMP
33 rub. order
Furosemide (amp. 1% 2ml No. 10) BZMP OJSC
30 rub. order
Furosemide ampoules 1% 2ml No. 10DHF JSC
50 rub. order

Pharmacy24

Furosemide-Darnitsa 1% 2 ml No. 10 solution for injection PrAT" Pharmaceutical company "Darnitsa", Ukraine
19 UAH. order
Furosemide-Darnitsa 0.04 No. 50 tablets PrAT” Pharmaceutical company “Darnitsa”, Ukraine
8 UAH order
Furosemide 4 mg No. 50 tablets PAT "Kievmedpreparat", Ukraine
13 UAH order
Furosemide 40 mg No. 20 tablets AT "Sopharma", Bulgaria
13 UAH order
Furosemide 40 mg No. 50 tablets PAT NEC "Borshchagivsky HFZ", m.Kiev/TOV "Agrofarm", Kiev region.
7 UAH order

PaniPharmacy

Furosemide tablets Furosemide tablets 40 mg No. 50 Ukraine, OZ GNTsLS LLC
9 UAH order
Furosemide tablets Furosemide tablets. 40 mg No. 20 Bulgaria, Sopharma
14 UAH order
Furosemide ampoule Furosemide solution d/in. 1% amp. 2ml No. 10 Ukraine, Darnitsa ChAO
22 UAH order
Furosemide tablets Furosemide tablets 0.04g No. 50 Ukraine, Kievmedpreparat OJSC
15 UAH order
Furosemide tablets Furosemide tablets 40 mg No. 50 Ukraine, Darnitsa ChAO
9 UAH order