G-Furosemide 250 mg (Tablet)

Indications

• Fluid retention associated with chronic congestive cardiac failure
• Fluid retention associated with acute congestive cardiac failure
• Fluid retention associated with chronic renal failure
• Maintenance of fluid excretion in acute renal failure
• Fluid retention associated with nephrotic syndrome
• Fluid retention associated with liver disease
• Hypertension
• Hypertensive crisis
• Support of forced diuresis

Pharmacology

• Monosulphonyl diuretic
• Effective diuretic in low glomerular filtration rate (GFR)
• Distinctive action on renal tubular function
• Inhibition of sodium and chloride transport in the ascending limb of the loop of Henle
• Prompt onset of action
• Independence of action from acid-base balance changes
• Readily absorbed from the gastrointestinal tract
• Considerable proportions are bound to plasma proteins
• Rapid excretion in the urine
• Effects evident in about 5 minutes, lasting for about 2 hours after intravenous injection

Dosage & Administration

• Initial adult dose is 40 mg daily
• Reduced to 20 mg daily or 40mg on alternate days for some patients
• Daily doses of 80mg or higher may be required for some patients
• Dose titration may be up to 600 mg/day for clinically severe edematous states
• Dosage adjustment for children based on age and weight
• Dosage adjustment for hypertension based on response
• Different dosages and administration for specific tablet strengths and formulations
• Elderly patients may require slower elimination of furosemide

Interaction

• Marked fall in blood pressure when ACE inhibitors are added to therapy
• Increased serum lithium levels when given concomitantly with furosemide
• Increased toxic effects of nephrotoxic antibiotics with concomitant administration of furosemide

Contraindications

• Anuria
• Electrolyte deficiency
• Pre-comatose states associated with liver cirrhosis
• Hypersensitivity to furosemide or sulphonamides

Side Effects

• Disturbed electrolytes and water balance
• Alkalosis
• Uric acid retention
• Rarely produce acute gout
• Provoke hyperglycemia and glycosuria

Pregnancy & Lactation

• Pregnancy category C
• Cautious use in cardiogenic shock complicated by pulmonary oedema
• Monitoring blood pressure and pulse during rapid diuresis
• Caution in patients liable to electrolyte deficiency
• Inhibits lactation or may pass into breast milk

Precautions & Warnings

• Increased risk of acute retention in patients with prostatic hypertrophy
• Special caution when driving or performing hazardous tasks
• Additional risks when ACE inhibitors are added to therapy
• Increased toxic effects of nephrotoxic antibiotics with concomitant administration

Overdose Effects

• Clinical picture depends on electrolyte and fluid loss
• Symptoms may include hypovolaemia, dehydration, haemoconcentration, cardiac arrhythmias
• No specific antidote known
• Management may include measures like gastric lavage or activated charcoal

Therapeutic Class

• Loop diuretics

Storage Conditions

• Protect from light
• Do not use after the date of expiry
• Keep out of the reach of children

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