Powerful diuretic Lasix: instructions for use of tablets and solution for intravenous administration. Lasix tablets - official * instructions for use

Name:

Lasix (Lasix)

Pharmachologic effect:

The active substance of Lasix - furosemide - has a diuretic effect due to the blockade of the reabsorption of sodium and chlorine ions in the ascending part of the loop of Henle. To a small extent, Lasix also acts on the convoluted tubules, this mechanism is not associated with antialdosterone activity or inhibition of carbonic anhydrase. Lasix promotes the excretion of potassium, magnesium, calcium.

When administered intravenously, Lasix is able to quickly reduce blood pressure, pulmonary artery pressure, preload and pressure in the left ventricle. The diuretic effect is observed already after 5 minutes, reaching a maximum within half an hour, the duration of the diuretic period is about 2 hours.

When taken orally, the diuretic effect of Lasix begins within the first hour, reaching a maximum after 1.5-2 hours, the duration of the effective period is about 7 hours.

In the body, Lasix is metabolized and excreted, mainly in the urine, as a compound with glucuronic acid.

Indications for use:

1.Edematous syndrome developed due to:

heart disease,

kidney disease,

liver disease,

Acute left ventricular failure

burn disease,

Pre-eclampsia of pregnant women (the use of Lasix is possible only after the restoration of the BCC).

2. Forced diuresis.

3. Complex therapy of arterial hypertension.

Application method:

The method of application and dosing regimen should be set individually, depending on the degree of violation of the water and electrolyte balance, the magnitude of glomerular filtration. In the future, dose adjustment is necessary, depending on the severity of the patient's condition, the magnitude of diuresis. Usually the drug is prescribed in the form of tablets, but if this is not possible, or it is an urgent condition, the drug is administered intravenously by stream, the time of administration of Lasix should not be less than 1.5-2 minutes.

With moderate severity of edematous syndrome, the initial dose of Lasix is 20-80 mg orally or 20-40 mg intramuscularly or intravenously, with insufficient effect, the dose can be increased by 40 mg in case of oral administration and by 20 mg if Lasix is administered as an injection . An increase in dose is possible no earlier than 6-8 hours after taking the initial oral dose and no earlier than 2 hours after parenteral administration. Dose adjustment occurs until adequate diuresis occurs. The single dose selected in this way can be administered once or twice a day. The maximum effect of Lasix is observed if the drug is administered 2-4 times a week.

For children, the dose is calculated depending on the body weight of the child and the method of administration of Lasix. The initial dose for oral administration is 2 mg / kg, with the injection method of administration - 1 mg / kg. Then it is possible to increase the dose by 2 mg / kg when taken orally and by 1 mg / kg when taken parenterally. An increase in dose is possible no earlier than 6-8 hours after taking the initial oral dose and no earlier than 2 hours after parenteral administration.

In the complex treatment of arterial hypertension, the dose of Lasix, as a rule, is 80 mg / day, it is desirable to divide the daily dose into two doses. A further increase in the dose is impractical; if the effect is insufficient, other antihypertensive agents should be added.

In case of pulmonary edema, 40 mg is injected intravenously, with insufficient effect, another 20-40 mg can be administered after 20 minutes.

When carrying out forced diuresis, 20-40 mg of Lasix is added to the solution for intravenous infusion. In the future, the dose of Lasix may be adjusted, depending on the fluid and electrolyte balance and the patient's condition.

Undesirable phenomena:

When using Lasix in large doses, a decrease in BCC (volume of circulating blood) occurs, as a result of which thickening of the blood develops and thrombosis is possible. A frequent side effect is the development of water and electrolyte disorders: alkalosis (including increased metabolic alkalosis in diabetes mellitus), deficiency of sodium, chlorine, calcium, potassium, violation of the biochemical properties of blood: increased levels of creatinine, cholesterol, triglycerides, uric acid (with exacerbation of gout), glucose (especially in diabetes mellitus).

Allergic reactions are possible, ranging from skin manifestations (purpura, dermatitis, itching, erythema) and up to anaphylactic shock.

Rarely, blood disorders occur: leukopenia, eosinophilia, hemolytic changes, agranulocytosis, thrombocytopenia.

In low birth weight or premature infants, the use of Lasix in the first weeks of life may lead to non-closure of the ductus arteriosus.

Contraindications:

Contraindications are severe electrolyte imbalance, intolerance to furosemide or any other component of the Lasix drug, anuria, dehydration, BCC deficiency, hepatic coma of any stage, pregnancy up to 12 weeks and lactation.

During pregnancy:

In the period up to 12 weeks, the use of Lasix is absolutely contraindicated; in later periods, the use of Lasix is possible only under strict indications, since the drug is able to penetrate the placental barrier.

Interaction with other drugs:

The development of hypokalemia when taking Lasix can lead to an increase in the action of cardiac glycosides.

With the combined appointment of Lasix with glucocorticosteroids, laxatives, more careful monitoring of the electrolyte composition of the blood is necessary, since taking a combination of these drugs increases the risk of developing hypokalemia.

When Lasix is combined with cephalosporin antibiotics or aminoglycosides, it is possible to increase their blood levels and, accordingly, increase side effects.

Probenecid, phenytoin, and NSAIDs may reduce the diuretic effect of Lasix.

With the simultaneous appointment of IACF and Lasix, an increase in the hypotensive effect is possible, up to the development of collapse or a decrease in kidney function and acute renal failure.

The combination of Lasix with antidiabetic agents requires dose adjustment of the latter.

Lasix is able to enhance the toxic effects of theophylline, lithium preparations and curariform drugs.

Overdose:

In case of an overdose of Lasix, arterial hypotension, electrolyte imbalance, dizziness, dry mouth, visual impairment are most often observed. Treatment is aimed at restoring the water and electrolyte balance and normalizing the BCC.

Release form of the drug:

Tablets 40 mg No. 45.

Tablets 40 mg No. 50.

Solution for injection 10 mg per 1 ml, 2 ml ampoule, 10 ampoules per pack.

Storage conditions:

Store in a place protected from direct sunlight at room temperature (17-26 °C).

Compound:

Tablets:

Active substance: furosemide 40 mg

Additional substances: corn starch, pregelatinized corn starch, lactose, anhydrous colloidal silicon, talc, Mg stearate.

Ampoules for injection:

Active substance: furosemide 10 mg per 1 ml

Additional substances: Na hydroxide, Na chloride, treated water for injection.

Additionally:

Receiving Lasix can lead to a decrease in the speed of reactions and concentration, especially after taking the first doses of the drug or while drinking alcohol, this should be taken into account by persons working with complex mechanisms or driving vehicles.

Do not use Lasix during lactation, as the drug can not only penetrate into breast milk, but also suppress the process of milk production.

It is advisable to prescribe Lasix in combination with potassium preparations to prevent the development of hypokalemia and with constant monitoring of the electrolyte composition of the blood.

Similar drugs:

Spironolactone Mannit Triampur Compositum Triampur compositum Frusemen

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One of the most powerful diuretics is the diuretic Lasix. This medication is highly effective and has a minimum number of serious side effects. An important advantage of "Lasix" is the availability of various dosage forms and due to this it can be used in all sorts of situations, both planned and critical. It is necessary to use this pharmaceutical preparation only as prescribed by a specialized specialist and only in the doses indicated by him.

"Lasix" is one of the strongest diuretics, with minimal cases of side effects.

Pharmacological group

The drug "Lasix" refers to the "loop" diuretic drugs. ATS code C03C A01. Furosemide acts as an active substance, which affects the kidneys, namely, it stimulates the export of excess water, salt and sodium with urine, but does not retain calcium, magnesium and potassium, which in most cases is dangerous with negative consequences. Furosemide increases urine production and therefore Lasix is considered a diuretic drug. The drug acts on the loop of Henle and, based on this, it is referred to as a "loop" diuretic.

Release form and composition of the product

The described pharmacological agent is produced in two forms: tablets and injections. The tablet form of the drug contains the following components:

furosemide;
corn starch;
milk sugar;
talc;
food emulsifier E572;
colloidal anhydrous silicon.

Lasix is available in solid form and in ampoules.

The drug in ampoules includes furosemide as an active substance, and such additional elements:

sodium chloride;
caustic soda;
distilled water.

Diuretic tablets "Lasix" are packed in 10 pieces in foil strips. Each carton pack contains 5 strips. You can buy medicine in pharmacies, packaged in 15 tablets in a plate, then there will be 3 pcs in a pack. The solution for i / m and / in the introduction is a clear liquid, poured into glass ampoules. The ampoules are placed in blister packs made of plastic, one piece per pack.

Indications for the use of the drug

Lasix is prescribed for patients who have the following pathologies:

edema resulting from diseases of the liver, kidneys and heart ailments;
edema due to burn disease or acute failure of the left ventricle of the heart.
forced diuresis;
hypertonic disease.

Contraindications

"Lasix" is not treated during pregnancy, feeding, with gout, renal failure.

lack of potassium and sodium in the body;
kidney dysfunction, accompanied by a lack of urine flow to the bladder;
decrease in the volume of blood circulation;
acute glomerulonephritis;
arterial hypotension;
hypersensitivity to the components of the drug;
gout;
failure of the outflow of urine;
pregnancy;
inflammation of the pancreas;
lactation period.

Method of application and dosage

They give injections and put droppers to patients if oral administration of the drug is not possible, or with a pronounced edematous phenomenon. The dosage is selected by the attending physician individually for each patient. Start taking with the smallest doses, which are sufficient to manifest the desired effect. With pathologies of the heart, edema is removed by drinking 20-80 mg of Lasix per day. If edematous syndrome occurs with hypertension, then a diuretic medication is recommended to be taken at 80 mg per day, dividing the dose into 2 doses: in the morning and in the afternoon. In case of pulmonary edema, a diuretic is administered intravenously at first 40 mg, and if necessary, after half an hour, another 20-40 mg.

The information is valid as of 2011 and is provided for reference purposes only. Please contact your doctor to choose a treatment regimen and be sure to read the instructions for the drug first.

Latin name: LASIX

Marketing authorization holder: AVENTIS PHARMA Ltd.

Instructions for use of the drug LASIX (LASIX)

LASIX - release form, composition and packaging

Tablets white or almost white, round, engraved with "DLI" above and below the marks on one side.

Sodium chloride, sodium hydroxide, water for injections.

2 ml - dark glass ampoules with a break point (10) - cellular contour plastic packaging (1) - cardboard packs.

pharmachologic effect

Lasix is a strong and fast-acting sulfonamide diuretic. Lasix blocks the transport system of Na +, K +, Cl - ions in the thick segment of the ascending knee of the loop of Henle, and therefore, its diuretic effect depends on the drug entering the lumen of the renal tubules (due to the anion transport mechanism). The diuretic effect of Lasix is associated with inhibition of sodium chloride reabsorption in this section of the loop of Henle. Secondary effects in relation to increased sodium excretion are: an increase in the amount of urine excreted (due to osmotically bound water) and an increase in potassium secretion in the distal renal tubule. At the same time, the excretion of calcium and magnesium ions increases. With a decrease in tubular secretion of furosemide or when the drug binds to albumin located in the lumen of the tubules (for example, with nephrotic syndrome), the effect of furosemide is reduced.

With a course of taking Lasix, its diuretic activity does not decrease, since the drug interrupts the tubular-glomerular feedback in Macula densa (tubular structure closely associated with the juxtaglomerular complex). Lasix causes dose-dependent stimulation of the renin-angiotensin-aldosterone system.

In heart failure, Lasix rapidly reduces preload (due to venous dilatation), reduces pulmonary artery pressure and left ventricular filling pressure. This rapidly developing effect seems to be mediated through the effects of prostaglandins and therefore the condition for its development is the absence of disturbances in the synthesis of prostaglandins, in addition to which a sufficient preservation of kidney function is also required for this effect to be realized.

The drug has a hypotensive effect, which is due to an increase in sodium excretion, a decrease in circulating blood volume and a decrease in the response of vascular smooth muscles to vasoconstrictor stimuli (due to the natriuretic effect, furosemide reduces the vascular response to catecholamines, the concentration of which in patients with arterial hypertension is increased).

After ingestion of 40 mg of Lasix, the diuretic effect begins within 60 minutes and lasts about 3-6 hours.

In healthy volunteers treated with 10 to 100 mg of Lasix, dose-dependent diuresis and natriuresis were observed.

Pharmacokinetics

Furosemide is rapidly absorbed from the gastrointestinal tract. Its T max (time to reach C max in the blood) is from 1 to 1.5 hours. The bioavailability of furosemide in healthy volunteers is approximately 50-70%. In patients, the bioavailability of Lasix can be reduced by up to 30%, as it can be influenced by various factors, including the underlying disease. V d furosemide is 0.1-0.2 l / kg of body weight. Furosemide binds very strongly to plasma proteins (more than 98%), mainly to albumins.

Furosemide is excreted mainly unchanged and mainly by secretion in the proximal tubules. Glucuronated metabolites of furosemide account for 10-20% of the drug excreted by the kidneys. The rest of the dose is excreted through the intestines, apparently by biliary secretion. The final T 1/2 of furosemide is approximately 1-1.5 hours.

Furosemide crosses the placental barrier and is excreted in breast milk. Its concentrations in the fetus and newborn are the same as in the mother.

Features of pharmacokinetics in certain groups of patients

With renal failure, the excretion of furosemide slows down, and the half-life increases; with severe renal failure, the final T 1/2 may increase up to 24 hours.

In nephrotic syndrome, a decrease in plasma protein concentrations leads to an increase in the concentrations of unbound furosemide (its free fraction), and therefore, the risk of developing an ototoxic effect increases. On the other hand, the diuretic effect of furosemide in these patients may be reduced due to binding of furosemide to tubular albumin and reduced tubular secretion of furosemide.

With hemodialysis and peritoneal dialysis and permanent outpatient peritoneal dialysis, furosemide is excreted insignificantly.

With liver failure T 1/2 furosemide increases by 30-90% mainly due to an increase in V d . Pharmacokinetic parameters in this category of patients can vary greatly.

In heart failure, severe arterial hypertension and in the elderly, the excretion of furosemide slows down due to a decrease in renal function.

Dosage of LASIX

Tablets should be taken on an empty stomach, without chewing and drinking plenty of liquid. When prescribing Lasix, it is recommended to use its smallest doses, sufficient to achieve the desired effect. The recommended maximum daily dose for adults is 1500 mg. At children The recommended oral dose is 2 mg/kg body weight (but not more than 40 mg/day). The duration of treatment is determined by the doctor individually, depending on the indications.

Edema syndrome in chronic heart failure

Edema syndrome in chronic renal failure

The natriuretic response to furosemide depends on several factors, including the severity of renal failure and sodium levels in the blood, so the effect of the dose cannot be accurately predicted. In patients with chronic renal failure, careful dose selection is required, by gradually increasing it so that fluid loss occurs gradually (fluid loss of up to approximately 2 kg of body weight / day is possible at the beginning of treatment).

The recommended starting dose is 40-80 mg/day. The required dose is selected depending on the diuretic response. The entire daily dose should be taken once or divided into two doses. In patients on hemodialysis, the usual maintenance dose is 250-1500 mg / day.

Acute kidney failure (to maintain fluid excretion)

Before starting treatment with furosemide, hypovolemia, arterial hypotension and significant electrolyte and acid-base disturbances should be eliminated. It is recommended to transfer the patient from intravenous administration of Lasix to Lasix tablets as soon as possible (the dose of Lasix tablets depends on the selected intravenous dose).

Edema in nephrotic syndrome

Edema syndrome in liver diseases

Lasix is prescribed in addition to treatment with aldosterone antagonists in case of their insufficient effectiveness. To prevent the development of complications, such as impaired orthostatic regulation of blood circulation or electrolyte or acid-base disorders, careful dose selection is required so that fluid loss occurs gradually (fluid loss of up to approximately 0.5 kg of body weight / day is possible at the beginning of treatment). The recommended starting dose is 20-80 mg/day.

Arterial hypertension

Lasix may be used alone or in combination with other antihypertensive agents. The usual maintenance dose is 20-40 mg/day. In arterial hypertension in combination with chronic renal failure, higher doses of Lasix may be required.

drug interaction

Cardiac glycosides, drugs that cause QT interval prolongation - in case of development of electrolyte disturbances (hypokalemia or hypomagnesemia) while taking furosemide, the toxic effect of cardiac glycosides and drugs that cause QT interval prolongation increases (the risk of developing rhythm disturbances increases).

Glucocorticosteroids, carbenoxolone, licorice in large quantities and prolonged use of laxatives when combined with furosemide increase the risk of hypokalemia.

Aminoglycosides - slowing down the excretion of aminoglycosides by the kidneys when they are used simultaneously with furosemide and an increase in the risk of developing ototoxic and nephrotoxic effects of aminoglycosides. For this reason, the use of this combination of drugs should be avoided, except when necessary for health reasons, in which case a correction (reduction) of maintenance doses of aminoglycosides is required.

Drugs with a nephrotoxic effect - when combined with furosemide, the risk of developing their nephrotoxic effect increases.

High doses of certain cephalosporins (especially those with a predominantly renal route of excretion) - in combination with furosemide, the risk of nephrotoxicity increases.

Cisplatin - when used simultaneously with furosemide, there is a risk of developing an ototoxic effect. In addition, in the case of co-administration of cisplatin and furosemide in doses above 40 mg (with normal renal function), the risk of cisplatin nephrotoxicity increases.

Non-steroidal anti-inflammatory drugs (NSAIDs) - NSAIDs, including acetylsalicylic acid, may reduce the diuretic effect of furosemide. In patients with hypovolemia and dehydration (including while taking furosemide), NSAIDs can cause the development of acute renal failure. Furosemide may enhance the toxic effect of salicylates.

Phenytoin - a decrease in the diuretic effect of furosemide.

Antihypertensives, diuretics or other drugs that can reduce blood pressure - when combined with furosemide, a more pronounced hypotensive effect is expected.

Angiotensin-converting enzyme (ACE) inhibitors - the appointment of an ACE inhibitor in patients previously treated with furosemide can lead to an excessive decrease in blood pressure with deterioration in kidney function, and in some cases - to the development of acute renal failure, therefore, three days before the start of treatment with inhibitors ACE or increasing their dose, it is recommended to cancel furosemide, or reduce its dose.

Probenicid, methotrexate, or other drugs that, like furosemide, are secreted in the renal tubules can reduce the effects of furosemide (same renal secretion pathway), on the other hand, furosemide can lead to a decrease in renal excretion of these drugs.

Hypoglycemic agents, pressor amines (epinephrine, norepinephrine) - weakening of the effects when combined with furosemide.

Theophylline, diazoxide, curare-like muscle relaxants - increased effects when combined with furosemide.

Lithium salts - under the influence of furosemide, lithium excretion decreases, due to which the serum concentration of lithium increases and the risk of developing the toxic effects of lithium, including its damaging effects on the heart and nervous system, increases. Therefore, when using this combination, monitoring of serum lithium concentrations is required.

Sucralfate - reducing the absorption of furosemide and weakening its effect (furosemide and sucralfate should be taken at least two hours apart).

Cyclosporine A - when combined with furosemide, the risk of developing gouty arthritis due to hyperuricemia caused by furosemide and impaired renal excretion of urate by cyclosporine increases.

Radiopaque agents - Patients at high risk of radiopaque nephropathy treated with furosemide had a higher incidence of renal impairment compared to patients at high risk of radiopaque nephropathy who received only intravenous hydration prior to radiopaque administration.

The use of LASIX during pregnancy

Furosemide crosses the placental barrier, so it should not be given during pregnancy. If, for health reasons, Lasix is prescribed to pregnant women, then careful monitoring of the condition of the fetus is necessary.

Furosemide is contraindicated during lactation. Furosemide suppresses lactation.

Application in childhood

Contraindication: children under 3 years of age (solid dosage form).

LASIX - side effects

From the water-electrolyte and acid-base state

Hyponatremia, hypochloremia, hypokalemia, hypomagnesemia, hypocalcemia, metabolic alkalosis, which can develop as either a gradual increase in electrolyte deficiency or a massive loss of electrolytes over a very short time, for example, in the case of high doses of furosemide in patients with normal renal function. Symptoms indicating the development of electrolyte and acid-base disturbances may include headache, confusion, convulsions, tetany, muscle weakness, cardiac arrhythmias and dyspeptic disorders. Factors contributing to the development of electrolyte disturbances are underlying diseases (eg, cirrhosis of the liver or heart failure), concomitant therapy, and malnutrition. In particular, vomiting and diarrhea may increase the risk of hypokalemia. Hypovolemia (decrease in circulating blood volume) and dehydration (more often in elderly patients), which can lead to hemoconcentration with a tendency to develop thrombosis.

From the side of the cardiovascular system

Excessive decrease in blood pressure, which, especially in elderly patients, can be manifested by the following symptoms: impaired concentration and psychomotor reactions, headache, dizziness, drowsiness, weakness, visual disturbances, dry mouth, impaired orthostatic regulation of blood circulation; collapse.

From the side of metabolism

Elevated serum levels of cholesterol and triglycerides, transient increases in blood creatinine and urea, elevated serum uric acid concentrations, which may cause or exacerbate the manifestations of gout. Decreased glucose tolerance (possible manifestation of latent diabetes mellitus).

From the urinary system

The appearance or intensification of symptoms due to the existing obstruction of the outflow of urine up to acute urinary retention with subsequent complications (for example, with prostatic hypertrophy, narrowing of the urethra, hydronephrosis); hematuria, decreased potency.

From the gastrointestinal tract

Rarely - nausea, vomiting, diarrhea, constipation; isolated cases of intrahepatic cholestasis, increased levels of hepatic transaminases, acute pancreatitis.

From the side of the central nervous system, the organ of hearing

In rare cases - hearing loss, usually reversible, and / or tinnitus, especially in patients with renal insufficiency or hypoproteinemia (nephrotic syndrome), rarely - paresthesia.

From the skin, allergic reactions

Rarely - allergic reactions: pruritus, urticaria, other types of rash or bullous skin lesions, erythema multiforme, exfoliative dermatitis, purpura, fever, vasculitis, interstitial nephritis, eosinophilia, photosensitivity. Extremely rare - severe anaphylactic or anaphylactoid reactions up to shock, which have so far been described only after intravenous administration.

From the peripheral blood

Rarely - thrombocytopenia. In rare cases, leukopenia. In some cases, agranulocytosis, aplastic anemia or hemolytic anemia. Since some adverse reactions (such as a change in the blood picture, severe anaphylactic or anaphylactoid reactions, severe allergic skin reactions) under certain conditions can threaten the life of patients, any side effects should be reported to the doctor immediately.

Special instructions for taking LASIX

Before starting treatment with Lasix, the presence of pronounced urinary outflow disorders, including unilateral ones, should be excluded.

Patients with partial obstruction of the outflow of urine need careful monitoring, especially at the beginning of treatment with Lasix.

During treatment with Lasix, regular monitoring of serum sodium, potassium and creatinine concentrations is usually required, especially careful monitoring should be carried out in patients at high risk of developing fluid and electrolyte imbalance in cases of additional loss of fluid and electrolytes (for example, due to vomiting, diarrhea or intense sweating).

Before and during treatment with Lasix, hypovolemia or dehydration, as well as clinically significant disturbances in the water-electrolyte and / or acid-base state, should be monitored and, if any, eliminated, which may require a short-term cessation of treatment with Lasix.

Registration numbers:

Edema syndrome, which appeared due to cardiac, hepatic, renal and intoxication diseases.
Edema of lungs and brain.
Edema resulting from a burn disease.
Forced diuresis.
Renal failure.
Preeclampsia in pregnancy.

Mode of application

Dosage and method of administration are prescribed by the attending physician for each patient individually.. The dose during the course should be adjusted depending on the amount of diuresis and the severity of the disease.

The medicine may be prescribed in the form of tablets or intravenously with a minimum dose. Before starting the course, you need to check the pressure, electrolyte balance and acid-base indicators.

During the course, electrolyte losses should be monitored and constantly replenished. The substance is excreted in the urine.

Most often, tablets are prescribed by a doctor, however, if a person's condition is regarded as life-threatening, intravenous administration is prescribed.

The solution should be injected slowly, at least one and a half to two minutes. However, with the improvement and stabilization of the condition, it is necessary to switch to tablets as soon as possible: with intravenous administration, side effects are more often observed.

Tablets are taken orally, before meals, without chewing and washing down with any liquid: water, tea, compote, fruit drink.

When injected already after 5 minutes, you can observe an excellent diuretic result, the maximum of which can be recorded in half an hour, and the duration of the effective period is up to two hours.

With the oral route reception, the result will appear within one hour, and the maximum will reach in an hour and a half. In this case, the scoring period will last about seven hours.

With mild edema, the dose is 20 to 80 mg in tablets or 20 to 40 mg IV or intramuscularly. If the result is not observed, then the amount of the drug should be increased by 40 mg when taken in tablets and by 20 mg when the drug is administered by injection.

You can increase the dose only 6-8 hours after the first dose with the oral route and only 2 hours after the injection. You can adjust the amount of medication before diuresis begins.

This adjusted dose can be taken 1 time or 2 times a day. The best result is observed when the drug is prescribed to be taken up to 4 times a week.

The dose for children is calculated based on weight. When taken orally, it can start at 2 mg per kilogram, and when administered by injection, 1 mg per kilogram of body weight.

You can gradually increase the dose by 2 mg per kilogram when taken in tablets and by 1 mg per kilogram when administered by injection. You can increase the dose for a child at the same interval as for an adult.

For the treatment of arterial hypertension, the amount of the drug should be 80 mg per day and divided into 2 doses. With an unexpressed effect, you should start taking other antihypertensive drugs.

To relieve pulmonary edema, 40 mg is administered intravenously, and if the effect is not observed, then after 20 minutes another 40 mg is administered.

When forced treatment is carried out, up to 40 mg of the solution is added directly to the dropper, to the intravenous infusion solution. Then the amount of medicine will be adjusted.

Release form, composition

The drug is available in the form:

white tablets of 40 mg;
a clear colorless solution for injections of 10 mg per 1 ml, with dark glass ampoules of 2 ml. The package contains 10 ampoules;
for children, granules are produced for the preparation of a suspension, which is taken orally.

The active substance of the drug Means - furosemide is a loop diuretic, a diuretic with a pronounced, rapidly advancing, short-term, strong effect and a moderate decrease in pressure.

The composition of the tablets includes 40 mg of furosemide and other dry ingredients. The composition of the solution includes furosemide in the amount of 10 mg per 1 milliliter, sodium hydroxide and chloride, medical water.

Interaction with other drugs

When prescribing a drug along with glucocorticosteroids and laxatives, the electrolyte composition of the blood should be monitored, because the likelihood of developing hypokalemia increases.

When treated together with cephalosporin antibiotics, their blood levels may increase and then you can be afraid of side effects.

The diuretic effect may decrease when taken with probenecid, phenytoin and NSAIDs.

Complex administration with IACF can lead to an increase in the hypotensive effect and deterioration of kidney function.

Also, a diuretic can enhance the toxic effect of theophylline and lithium preparations.

If the drug is taken in large quantities, a decrease in the volume of circulating blood is gradually observed, as a result, its thickening may develop and thrombosis may begin.

Water-electrolyte fluctuations may appear: changes in biochemistry may occur: the amount of creatinine, cholesterol, glucose, etc.

On the part of the cardiovascular system, there may be a rapid decrease in blood pressure, which will be manifested by common characteristic symptoms.

allergic reactions may manifest skin pathologies: purpura, urticaria, dermatitis, itching, etc. Very rarely, but blood pathologies may occur: eosinophilia, leukopinia, etc.

In case of an overdose, a decrease in pressure and a violation of electrolytic balance can be recorded.

Contraindications

You can not use the drug for violations of electrolytic balance, with intolerance to furosemide or another component, with anuria, dehydration, with hepatic coma, hypokalemia and hyponatremia.

It should be taken with caution in conditions where a decrease in blood pressure can be dangerous and there is difficulty in urine output.

During pregnancy

During pregnancy up to 12 weeks, you should not take a diuretic in any case. At a later date, it is used only on strict indications. The active components of the diuretic can pass through the placental barrier.

Do not use a diuretic during lactation, because it can penetrate into breast milk or suppress its production. If there is a need for admission, then breastfeeding should be suspended and resumed no earlier than 2 days after the drug is discontinued.

Terms and conditions of storage

The drug should be stored in a place that is protected from sunlight, with a room temperature not exceeding 26 degrees.

Shelf life - 3 years of solution and 4 years of tablets.

Price

The cost of the drug in Russia the average is 50 rubles for tablets and 85-90 rubles for a solution.

In Ukraine the cost varies depending on the form of release and the country of manufacture. Tablets can cost from 35 to 48 hryvnia, medicine in ampoules from 60 to 75 hryvnia.

Analogues

Analogues for the active substance include drugs: furon, furosemide, fursemide.

Lasix is a fast-acting diuretic, chemically a sulfamide derivative. So that the reader immediately understands what is at stake - this is the original furosemide preparation from the global pharmaceutical corporation Sanofi Aventis. The mechanism of the diuretic action of lasix is to inhibit the reabsorption (reabsorption) of sodium and chlorine ions in the renal tubules. Thus, the body is more willing to part with sodium (with chlorine too, but the first is of much greater clinical importance), as a result of which a whole cascade of secondary effects is potentiated: an increase in the volume of urine excreted, an increase in the excretion of potassium, calcium and magnesium ions. It is characteristic that with repeated administration of Lasix, its diuretic activity does not weaken. In patients with chronic heart failure, the drug reduces preload in the shortest possible time (this occurs due to the expansion of the vessels of the venous bed), “bleeds steam” (read: reduces pressure) in the pulmonary artery system and the left ventricular chamber. The rapidity of its pharmacological effect, according to experts, lasix is due to prostaglandins, so the necessary condition for the drug to unfold "to its fullest" is the normal functioning of the prostaglandin system, as well as adequate kidney function. Lasix has an antihypertensive effect based on increased excretion of sodium from the body, increased diuresis and the associated decrease in circulating blood volume, and a decrease in the sensitivity of smooth muscle walls of blood vessels to vasoconstrictive effects. In the latter case, we are talking, first of all, about catecholamines: due to increased sodium excretion, lasix softens the increased (which is typical for hypertensive patients) vascular response to these powerful vasoconstrictors. As shown by clinical studies involving healthy volunteers, the diuretic and saluretic effect of lasix is observed when taking the drug in the range from 10 to 100 mg.

After parenteral administration of 20 mg of the drug, the diuretic effect began to appear after 15 minutes and lasted about 3 hours.

The manufacturer has mastered the production of two dosage forms of lasix: tablets and solution for intravenous and intramuscular administration. Treatment with lasix is recommended using the lowest effective dose of the drug. It should be noted the dose-dependence of the therapeutic effect of the drug, and also mention that lasix has a very high pharmacological "ceiling" (its activity increases in a wide range of doses). Despite the declared two ways of parenteral administration (intravenous and intramuscular), the second of them is used only in exceptional cases, when it is not possible to inject a solution into a vein or take a tablet. The intravenous and oral route of administration is exactly the same: the injection is made only in situations where, for some reason, it is impossible to take the drug orally, there are disturbances in the absorption of furosemide in the small intestine, or an extremely rapid therapeutic effect is necessary. When using the injectable form of Lasix, it is recommended to transfer the patient to the tablet form as soon as possible. Before starting pharmacotherapy, it is necessary to exclude the presence of pronounced disorders of urodynamics (urine outflow). During treatment, it is desirable to control the concentrations of sodium, potassium, and creatinine ions in the blood. Particularly careful monitoring should be carried out for patients prone to violations of water and electrolyte balance (which may be caused by diarrhea, vomiting or intense hyperhidrosis). During the medication course, it is recommended to enrich your diet with potassium, for which foods such as lean meat, tomatoes, cauliflower, spinach, potatoes, bananas, dried fruits, etc. are introduced into the menu. Sometimes, depending on the situation, you may need to take potassium supplements.

Pharmacology

After ingestion of 40 mg of Lasix, the diuretic effect begins within 60 minutes and lasts about 3-6 hours.

In healthy volunteers treated with 10 to 100 mg of Lasix, dose-dependent diuresis and natriuresis were observed.

Pharmacokinetics

Furosemide crosses the placental barrier and is excreted in breast milk. Its concentrations in the fetus and newborn are the same as in the mother.

Features of pharmacokinetics in certain groups of patients

With renal failure, the excretion of furosemide slows down, and the half-life increases; with severe renal failure, the final T 1/2 may increase up to 24 hours.

With hemodialysis and peritoneal dialysis and permanent outpatient peritoneal dialysis, furosemide is excreted insignificantly.

In liver failure, T 1/2 of furosemide increases by 30-90%, mainly due to an increase in V d . Pharmacokinetic parameters in this category of patients can vary greatly.

In heart failure, severe arterial hypertension and in the elderly, the excretion of furosemide slows down due to a decrease in renal function.

Release form

Tablets white or almost white, round, engraved with "DLI" above and below the lines on one side.

	1 tab.
furosemide	40 mg

Excipients: lactose, starch, pregelatinized starch, talc, colloidal silicon dioxide, magnesium stearate.

10 pieces. - strips of aluminum foil (5) - packs of cardboard.
15 pcs. - strips of aluminum foil (3) - packs of cardboard.

Dosage

Tablets should be taken on an empty stomach, without chewing and drinking plenty of liquid. When prescribing Lasix, it is recommended to use its smallest doses, sufficient to achieve the desired effect. The recommended maximum daily dose for adults is 1500 mg. In children, the recommended oral dose is 2 mg/kg body weight (but not more than 40 mg/day). The duration of treatment is determined by the doctor individually, depending on the indications.

Edema syndrome in chronic heart failure

Edema syndrome in chronic renal failure

Acute kidney failure (to maintain fluid excretion)

Edema syndrome in liver diseases

Arterial hypertension

Overdose

If you suspect an overdose, you must always consult a doctor, as in case of an overdose, certain therapeutic measures may be required.

The clinical picture of acute or chronic overdose of the drug depends mainly on the degree and consequences of fluid and electrolyte loss; overdose can be manifested by hypovolemia, dehydration, hemoconcentration, cardiac arrhythmia and conduction disturbances (including atrioventricular blockade and ventricular fibrillation). Symptoms of these disorders are arterial hypotension (up to the development of shock), acute renal failure, thrombosis, delirium, flaccid paralysis, apathy and confusion.

There is no specific antidote. If a little time has passed after ingestion, then to reduce the absorption of furosemide from the gastrointestinal tract, you should try to induce vomiting or perform a gastric lavage, and then take activated charcoal orally. Treatment is aimed at correcting clinically significant disorders of the water-electrolyte and acid-base status under the control of serum electrolyte concentrations, indicators of the acid-base status, hematocrit, as well as at preventing or treating possible serious complications developing against the background of these disorders.

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