📋 Indications & Clinical Dosage
*Oedema:*
ORAL: Adult: Initially 40 mg daily in the morning, then maintenance 20-40 mg daily
BY IM INJ, or BY SLOW IV INJ, or BY IV INF: Adult: Initially 20-50 mg, increased in steps of 20 mg every 2 hours ifrequired, doses greater than 50mg given by IV INF only; max. 1.5 g per day.
*Resistant oedema:*
ORAL: Adult: 80-120 mg daily
BY IM INJ, or BY SLOW IV INJ, or BY IV INF: Adult: Initially 20-50 mg, increased in steps of 20 mg every 2 hours ifrequired, doses greater than 50mg given by IV INF only; max. 1.5 g per day
*Resistant hypertension:*
Adult: 40-80 mg daily
BY IM INJ, or BY SLOW IV INJ, or BY IV INF: Adult: Initially 20-50 mg, increased in steps of 20 mg every 2 hours ifrequired, doses greater than 50mg given by IV INF only; max. 1.5 g per day.
*Heart Failure:*
BY IM INJ, or BY SLOW IV INJ: Adults: 20-40 mg. May repeat or increase by 20 mg after 2 hr.
Children: 1 mg/kg single dose. May increase by 1 mg/kg after 2 hr. Max: 6 mg/kg.
💊 Mode of Administration
IV injections should be given slowly over 1-2 min; maximum rate of administration for IVPB or infusion: 4 mg/min; replace parenteral therapy with oral therapy as soon as possible. In CHF and chronic renal failure: It has been suggested that doses as high as 2 to 2.5 gm/day or more are well tolerated and effective in these patients. For IV bolus injection, the maximum dose should not exceed 1 gm/day given over 30 min. IV Infusion solution mixed in NS or D5W solution is stable for 24 hours at room temperature.
⛔ Contraindications
Renal failure with anuria, hepatic coma, hypokalaemia, hyponatraemia, hypotension, hypersensitivity to sulphonamides, in pregnancy for short time and if strictly indicated.
⚠️ Precautions & Warnings
Furosemide may pass into breast milk and inhibit lactation, stop breast feeding, hepatorenal syndrome, hypoproteinaemia may reduce diuretic effect and increase risk of side effects
🔄 Drug Interactions
Digitalis, lithium, aminoglycosides, cephalosporins, antihypertensives, NSAIDs.
⚠️ Adverse Reactions / Side Effects
Disorders of electrolyte balance, dehydration, allergic reactions, gout, intrahepatic cholestasis
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Caution advised
Lactation / Breastfeeding:
Caution advised
🧪 Compatibility & Storage Stability
Compatibility: Stable in D5LR, D5NS, DEW, D1OW, D2OW, mannitol 20%, LR, NS.
Stability & Storage: Exposure to light may cause slight discoloration. Do not dispense discolored tablet or use discolored injection. Store injection at room temperature (15C- 30C)
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.