Lasix

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Lasix tablets are white or almost white, round. Its pharmacological action – diuretic. It blocks reabsorption of sodium and chlorine ions in the ascending limb of Henle’s loop. It also increases the excretion of potassium, calcium, magnesium.

Clinical pharmacology

The beginning of the diuretic effect, when taken orally, is already observed within 1 hour. The maximum effect is achieved after 1–2 hours. The overall effect duration is 6–8 hours. With the intravenous administration, the beginning of the action is 5 minutes, the maximum effect is 30 minutes, the overall effect duration is about 2 hours. With intravenous administration, it causes venous expansion, quickly reduces preload, reduces pressure in the left ventricle and the pulmonary artery system. It also reduces systemic pressure.

Indications

Lasix is prescribed in the following diagnosis:

  • edema syndrome of various origins (cardiac, hepatic, renal after the second month of pregnancy, intoxication);
  • pulmonary and brain edema;
  • arterial hypertension;
  • forced diuresis;
  • renal failure.

Dosage and administration

It is applied orally. It is taken on an empty stomach.

A mild edematous syndrome: the initial dose for adults is 20–80 mg when taken orally.

Persistent edema: the same or increasing by 20–40 mg. the dose can be readministered no earlier than 6–8 hours (2 hours for parenteral administration) until a diuretic effect is obtained.

Such an individually selected dosage can be applied 1 or 2 times a day. The greatest efficiency is achieved when taking the drug for 2–4 days a week. For children, the initial dosage is 2 mg/kg body weight (with parenteral administration – 1 mg/kg), it can be increased by 1-2 mg/kg with an unsatisfactory effect, but not earlier than after 6-8 hours (for parenteral administration, this period is at least 2 hours).

Arterial hypertension: the initial dosage for adults is 80 mg per day in 2 divided doses.

Pulmonary edema: Lasix is administered intravenously in a dose of 40 mg, if necessary, after 20 minutes, the drug can be administered in a dose of 20 to 40 mg.

Contraindications

  • Acute glomerulonephritis;
  • Stenosis of the urethra;
  • Acute renal failure with anuria;
  • Hypokalemia;
  • Alkalosis;
  • Precomatous conditions;
  • Severe hepatic failure;
  • Hepatic coma and precoma;
  • Diabetic coma;
  • Aortic stenosis;
  • Hypertrophic obstructive cardiomyopathy;
  • Increased central venous pressure;
  • Arterial hypotension;
  • Myocardial infarction;
  • Pancreatitis;
  • Disorder of water-electrolyte metabolism (hypovolemia, hyponatremia, hypokalemia, hypochloremia, hypocalcemia, hypomagnesemia);
  • Digitalis intoxication;
  • Hypersensitivity to furosemide.

Side effects

  • Cardiovascular system: decreased blood pressure, orthostatic hypotension, collapse, tachycardia, arrhythmias, decreased BCC.
  • Central nervous system and peripheral nervous system: dizziness, headache, myasthenia gravis, cramps of the calf muscles (tetany), paresthesia, apathy, adynamia, weakness, lethargy, drowsiness, confusion.
  • Organs of senses: impaired vision and hearing.
  • Digestive system: loss of appetite, dry mouth, thirst, nausea, vomiting, constipation or diarrhea, cholestatic jaundice, pancreatitis (exacerbation).
  • Genitourinary system: oliguria, acute urinary retention (in patients with prostatic hypertrophy), interstitial nephritis, hematuria, decreased potency.
  • Hemopoietic system: leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia.
  • Water-electrolyte metabolism: hypovolemia, dehydration (risk of thrombosis and thromboembolism), hypokalemia, hyponatremia, hypochloremia, hypocalcemia, hypomagnesemia, metabolic alkalosis.
  • Side of metabolism: hypovolemia, hypokalemia, hyponatremia, hypochloremia, hypokalemic metabolic alkalosis (as a result of these disorders – arterial hypotension, dizziness, dry mouth, thirst, arrhythmia, muscle weakness, cramps), hyperuricemia (with possible exacerbation), hyperemia, hyperemia.
  • Allergic reactions: purpura, urticaria, exfoliative dermatitis, erythema multiforme exudative, vasculitis, necrotizing angiitis, pruritus, chills, fever, photosensitivity, anaphylactic shock.
  • Other: thrombophlebitis, calcification of the kidneys in premature infants.

Pregnancy and lactation

During pregnancy, it should be used according to strict indications and only as a short therapy. During treatment, breastfeeding should be arrested for therapy duration.

Interactions

  • It increases the risk of intoxication with cardiac glycosides (against the background of glucocorticoids, the likelihood of hypokalemia), nephrotoxic and ototoxic effects of aminoglycosides, cephalosporins, cisplatin.
  • It enhances the effect of curariform agents;
  • It increases the reabsorption of lithium in the renal tubules.
  • NSAIDs reduce the diuretic effect.

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