Furosan

Furosemide.

Each ampoule contains: Furosemide 10 mg.

Pharmacology: Pharmacokinetics: Furosemide is fairly rapidly absorbed in the gastro-intestinal tract; bioavailability has been reported to be about 60 to 70% but absorption is variable and erratic. The half-life of furosemide is up to about 2 hours although it is prolonged in neonates and in patients with renal and hepatic insufficiency. It is up to 99% bound to plasma albumin, and is mainly excreted in the urine, largely unchanged. There is also some excretion via the bile and non-renal elimination is considerably increased in renal impairment. Furosemide crosses the placental barrier and is distributed into breast milk. The clearance of furosemide is not increased by haemodialysis.

Furosemide is a potent diuretic with a rapid action. Like the other loop or high-ceiling diuretic it is used in the treatment of edema associated with heart failure, including pulmonary edema, and with renal and hepatic disorders and may be effective in patients unresponsive to thiazide diuretics. It is also used in high doses in the management of oliguria due to renal failure or insufficiency. Furosemide is also used in the treatment of hypertension either alone or other antihypertensives.
Furosemide inhibits the reabsorption of sodium and chloride ions from renal tubules. And commonly used in the treatment of various types of edema and acute pulmonary edema.

Alternatively, it may be administered intramuscularly or intravenously as the sodium salt; doses are expressed in terms of furosemide base. The manufacturers recommend that whether by direct intravenous injection or by infusion the rate of intravenous administration should not exceed 4 mg per minute although some authorities advise that a single dose of up to 80 mg may be given more rapidly. In treatment of oedema, when oral therapy cannot be given, 20 mg to 50 mg of Furosemide may be administered by intramuscular or slow intravenous injection; if necessary further doses may be given, increasing by 20 mg increments and not given more often than every 2 hours. If doses greater than 50 mg are required, they should be given by slow intravenous infusion. For pulmonary oedema, if an initial slow intravenous injection of 40 mg doses not produce a satisfactory response within one hour, the dose may be increased to 80 mg given slowly intravenously.
For children, doses by injection are 0.5 to 1.5 mg per kg daily up to a maximum of 20 mg daily.
High dose therapy, in the management of oliguria in acute or chronic renal failure where the glomerular filtration rate is less than 20 mL per minute Furosemide 250 mg diluted to 250 mL in a suitable diluents is infused over one hour. If urine output is insufficient within the next hour, this dose may be followed by 500 mg added to an appropriate infusion fluid, the total volume of which must be governed by the patient's state of hydration and infused over approximately 2 hours. If a satisfactory urine output has still not been achieved within one hour of the end of the second infusion then a third dose of 1 g may be infused over approximately 4 hours. The rate of infusion should never exceed 4 mg per minute. In oliguric patients with significant fluid overload, the injection may be given without dilution directly into the vein, using a constant rate infusion pump with a micrometer screw-gauge adjustment; the rate of administration should still never exceed 4 mg per minute. Patients who do not respond to a dose of 1 g probably required dialysis.
During treatment with these high-doses forms of Furosemide therapy, careful laboratory control is essential, Fluid balance and electrolytes should be carefully controlled and, in particular, in patient with shock, measures should be taken to correct the blood pressure and circulating blood volume, before commencing this type of treatment.
Or as prescribed by a physician.

High dose of Furosemide therapy is contraindicated in renal failure caused by nephrotoxic or hepatotoxic drugs and in renal failure associated with hepatic coma.

Furosemide should not be given in precomatoses states associated with hepatic cirrhosis. It should be used with care in patients with prostatic hyperplasia or impairment of micturition since it can precipitate acute urinary retention.

The most common side effects associated with Furosemide therapy is fluid and electrolyte imbalance including hyponatremia, hypokalemia, and hypochloraemic alkalosis, particularly after large doses or prolonged administration. Because of their shorter duration of action, the risk of hypokalemia maybe less with loop diuretics such as Furosemide than with thiazide diuretics, Furosemide increases the urinary excretion of calcium. Nephrocalcinosis has been reported when Furosemide has been used to treat preterm infants.

Store at temperatures not exceeding 30°C. Protect from light.

Diuretics

C03CA01 - furosemide ; Belongs to the class of high-ceiling sulfonamide diuretics.

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