DIURETICS, LOOP

Brand & Generic Names

Apo-Furosemide	Furoside
Bumex	Lasix
BUMETANIDE	Lasix Special
Edecrin	Myrosemide
ETHACRYNIC ACID	Novosemide
FUROSEMIDE	Uritol

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Diuretic (loop), antihypertensive

Uses

• Lowers high blood pressure.
• Decreases fluid retention.

Dosage & Usage Information

How to take:
Tablet or liquid: Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
1 dose a day: Take after breakfast.
More than 1 dose a day: Take last dose no later than 6 p.m. unless otherwise directed.

If you forget a dose:
1 dose a day: Take as soon as you remember up to 12 hours late. If more than 12 hours, wait for next scheduled dose (don't double this dose).
More than 1 dose a day: Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Increases elimination of sodium and water from body. Decreased body fluid reduces blood pressure.

Time lapse before drug works:
1 hour to increase water loss. Requires 2 to 3 weeks to lower blood pressure.

Don't take with:
Non-prescription drugs with aspirin.
Any other medicine without consulting your doctor.

Overdose

SYMPTOMS:
Weakness, lethargy, dizziness, confusion, nausea, vomiting, leg muscle cramps, thirst, stupor, deep sleep, weak and rapid pulse, cardiac arrest.

WHAT TO DO:

• Dial O (Operator) or 911 (emergency) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Dizziness.

Infrequent:

Mood change, fatigue, appetite loss, diarrhea, irregular heartbeat, muscle cramps, low blood pressure, abdominal pain, weakness.

Rare:

Rash or hives, yellow vision, ringing in ears, hearing loss, sore throat, fever, dry mouth, thirst, side or stomach pain, nausea, vomiting, unusual bleeding or bruising, joint pain, jaundice, numbness or tingling in hands or feet.

Warnings & Precautions

Don't take if:
You are allergic to loop diuretics.

Before you start, consult your doctor:

• If you are taking any other prescription or non-prescription medicine.
• If you are allergic to any sulfa drug.
• If you have liver or kidney disease.
• If you have gout, diabetes or impaired hearing.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug filters into milk. May harm child. Avoid.

Infants & children:
Use only under medical supervision.

Prolonged use:

• Impaired balance of water, salt and potassium in blood and body tissues.
• Possible diabetes.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
No problems expected.

Discontinuing:
Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:
Frequent laboratory studies to monitor potassium level in blood recommended. Eat foods rich in potassium or take potassium supplements. Consult doctor.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
-------------------------	-----------------------
ACE inhibitors*:	Possible excessive potassium
captopril, enalapril,	in blood.
Allopurinol	Decreased allopurinol effect.
Amiodarone	Increased risk of heartbeat irregularity
	due to low potassium.
Anticoagulants*	Abnormal clotting.
Antidepressants,	Excessive blood pressure drop.
Antidiabetics, oral*	Decreased antidiabetic effect.
Antihypertensives*	Increase antihypertensive effect.
	Dosages may require adjustment.
Barbiturates*	Low blood pressure.
Beta-adrenergic blockers*	Increased antihypertensive effect.
	Dosages may require adjustment.
Corticosteroids*	Decreased potassium.
Cortisone drugs*	Excessive potassium loss.
Digitalis preparations*	Excessive potassium loss could lead
	to serious heart rhythm disorders.
Diuretics, other*	Increased diuretic effect.
Hypokalemia-causing	Increased risk of excessive
medicines*	potassium loss.
Insulin	Decreased insulin effect.
Lithium	Increased lithium toxicity.
Narcotics*	Dangerous low blood pressure.
	Avoid.
Nephrotoxics*	Increased risk of toxicity.
Nimodipine	Dangerous blood pressure drop.
Nitrates*	Excessive blood pressure drop.
Non-steroidal	Decreased diuretic effect.
Phenytoin	Decreased diuretic effect.
Potassium supplements*	Decreased potassium effect.
Probenecid	Decreased probenecid effect.
Salicylates*	Dangerous salicylate retention.
Sedatives*	Increased diuretic effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Blood pressure drop.
	Avoid.
Beverages:	None expected.
Cocaine:	Dangerous blood pressure drop.
	Avoid.
Foods:	None expected.
Marijuana:	Increased thirst and urinary
	frequency, fainting.
Tobacco:	Decreased furosemide effect.