International generic name
Drug form and composition
Solution for injection. One ampoule of 2 ml contains 20 mg Furosemide (10 mg
/ml). Tablets. One tablet contains 40 mg Furosemide.
Edema, due to cardiac, hepatal and renal diseases; preeclamsia and eclamsia edema;
chronic cardiovascular failure; swelling in burns; arterial hypertension (when saluretics
are contraindicated); in intoxications, in order to cause forced diuresis; in complex
treatment of the pulmonary and intracranial edema.
Dosage and administration
Tablets: The initial dose in adults is 40 mg (1 tablet) Furosemid; in case of
lack of diuretic effect 6-8 hours later additional 80-120 mg (2-3 tablets) may be
administered. Usual daily maintaining dose is 40-80 mg. Maximal dose should not
exceed 300 mg/24 h. In treatment of the arterial hypertension the preparation is
used in low doses - 10-20 mg daily. In children the preparation is used in daily
dose 1-2 mg per kg body weight. Solution for injection: Parenteral therapy in adults
is usually started with 20-40 mg Furosemid, intravenously or intramuscularly. In
patients with pulmonary edema the initial dose is 40 mg intravenously; the same
dose can be repeated with 20 minutes interval. In intoxication with barbiturates
40 mg Furosemid are injected, followed by 1-hour infusion of 500 ml saline. In intracranial
edema 20-40 mg Furosemid are injected 1-3 times daily. In children Furosemid is
applied intravenously or intramuscularly in dose 1-3 mg per kg body weight.
Severe liver failure (hepatal coma); acute intoxication with salicilate; renal
failure, accompanied by anuria or oliguria; severe hypokaliemia; hypovolemia with
or without hypotension.
Special warnings and precautions
Before the treatment with Furosemid existing hypokalemia, hyponatremia, hypovolemia
and hypotension should be corrected. During the treatment a potassium-rich diet
is advisable. Furosemid should be used with care in patients with auditory disorders,
allergy to sulphonamydes, and micturiton disorders. In pregnant women Furosemid
should be administered only after precise indications consideration. It should be
kept in mind that in nursing women the preparation passes in the mother milk and
depresses lactation. In such cases is advisable to stop the nursing. In drivers
and machinery operating persons Furosemid may disturb capabilities to normal professional
Furosemid reduces the therapeutic effect of vasopressor amines and anti-diabetic
medicines; potentiates the nephrotoxic effect of the cephalosporins, the ototoxic
effect of aminoglycosides, and cardio- and neurotoxic effects of the lithium; potentiates
effects of antihypertensive drugs and tubocurarine. In combined treatment with cardiac
glycosides the preparation increases sensitivity of the myocardium to digitalis.
In concomitant treatment with high dose salicylates salicylate intoxication is possibly
to develop. Indometacin reduces diuretic and antihypertensive effects of Furosemid.
In high dose hypokalemia, hyponatremia, hypocalcemia, hypovolemia, dehydration,
thrombosis and other violation of water-electrolyte balance may develop; in predisposed
patients allergy skin rash may be seen; blood count changes (leucopenia, agranulocytosis,
thrombocytopenia). In elderly patients with high dosesis is possibly to develop
a circulatory collapse.
Furosemide exerts a powerful diuretic effect, causing a high (20-30%) glomerular
excretion of sodium and water. It acts on the medullar portion of the ascending
limb of Henle loop, where are absorbed chloride and sodium ions, but not water,
blocking predominantly the active chloride transport. The sodium reabsorption inhibition
is a secondary effect. The preparation increases the selective elimination of the
sodium up to 35%, and, depending on the dose, stimulates renin - angiotensin - aldosterone
system. This leads to reducing of the cortical-papillary osmotic gradient and significant
decrease of the concentration capabilities of the kidney. Before the diuretic effect
become evident Furosemid reduces the heart preload by dilation of the capacitive
vessels, in case the renal function is normal and no significant edemas exist.
10 or 100 ampoules of 2 ml (10 mg). 20 or 2500 tablets of 40 mg.
Solution for injection - 3 years. Tablets - 5 years