LASIX ® Furosemide

LASIX® is a furosemide-based drug

THERAPEUTIC GROUP: Diuretics / loop diuretics

Indications LASIX ® furosemide

LASIX ® is indicated in all forms of edema of cardiac genesis, insufficient control of edema (of renal or non-renal origin), refractory edema to corticosteroids, light and medium degree of hypertension.
LASIX ® in solution for infusion and in 500mg tablets, is indicated only in case of acute or chronic renal insufficiency, and in case of nephrotic syndrome (chronic glomerulonephritis, lupus erythematosus) with impaired renal function.

Mechanism of action LASIX ® furosemide

LASIX ® is absorbed very quickly from the gastrointestinal tract, maintaining a "high bioavailability, which is between 50% and 70%. In the bloodstream, furosemide (active ingredient of LASIX ® is strongly bound to albumin and other plasma proteins, and subsequently excreted mainly through the urine. The rapid diuretic action of LASIX ® is due to the biological effect of furosemide, a molecule capable of acting on the ascending tract of the loop of Henle and the distal tubule (portions of the nephron - functional unit of the kidney responsible for the phenomenon of filtration / reabsorption) by inhibiting the reabsorption, mainly of chlorine and sodium, and further reducing the reabsorption of water at the level of the proximal renal tubule.

The particular effectiveness of the active principle allows LASIX ® to act within 30-60 minutes of oral intake and even when the normal filtering capacity of the kidney is seriously compromised.

Studies carried out and clinical efficacy

1. FUROSEMIDE AND DIURETICS OF THE "ANSA IN" PRIMARY HYPERTENSION

Cochrane Database Syst Rev. 2009 Oct 7;: CD003825.

Blood pressure lowering efficacy of loop diuretics for primary hypertension.

Musini VM, Wright JM, Bassett K, Jauca CD.

Primary hypertension is a very common pathological condition in the western population, characterized by blood pressure values ​​above 140 / 90mmHg. This study seeks to understand and examine the state of the art regarding the use of loop diuretics, among such as furosemide, in the treatment of this pathology. More precisely, it is shown how the effect induced by these drugs and in particular by furosemide (20/40 mg / day) in is very modest, resulting in a reduction in blood pressure of only 4/8 mmHg. The same authors, therefore, , suggest re-evaluating the use of these drugs in the treatment of primary hypertension, taking into account the cost (also in terms of health) / benefits ratio.

2. THE DIURETIC EFFECTS OF FUROSEMIDE
Ann Pharmacother. 2004 Apr; 38: 544-9. Epub 2004 Feb 24.

Diuretic effects of subcutaneous furosemide in human volunteers: a randomized pilot study.

Verma AK, da Silva JH, Kuhl DR.

To investigate the diuretic effects of furosemide, 20 mg of furosemide was administered subcutaneously in 12 healthy volunteers. The study showed that this type of intake can have significant diuretic effects with clinically unimportant side effects, such as redness and burning at the injection site.

3. FUROSEMIDE AND HOSPITALIZATION

Am Heart J. 2010 Aug; 160: 264-271.e1.

Diuretic dose and long-term outcomes in elderly patients with heart failure after hospitalization. Abdel-Qadir HM, Tu JV, Yun L, Austin PC, Newton GE, Lee DS.

This study, conducted on 4400 patients, shows how high doses of furosemide can increase the incidence of episodes of renal dysfunction, arrhythmias and cardiovascular accidents of various kinds. This study therefore suggests avoiding the use of furosemide if not really necessary. thus distinguishing therapeutic use from indiscriminate abuse.

Method of use and dosage

LASIX ® 25mg tablets of furosemide: we recommend taking 1-3 tablets in a single intake, choosing the time according to when you want to get the diuretic effect.
The same dosage can be used in the treatment of hypertension.
In case of failure or insufficient effect, it is possible to repeat the dosage at least 4 hours after the first intake.
As for LASIX ® vials and LASIX ® tablets of 500mg, the dose must be adjusted according to the needs and requirements of the patient.

LASIX ® furosemide warnings

Before taking the drug LASIX ® during therapy, it is necessary to make sure of the patency of the urinary tract, of the levels of potassium, sodium, creatininemia, glycaemia, glycosuria, acid-base balance. More careful monitoring, strictly supervised by medical personnel , are required in the treatment of patients with hypotension, diabetes mellitus, gout, hepatoneural syndrome, liver disease, nephrotic syndrome etc.
Although LASIX ® therapy has been associated with hypokalaemia only in very rare cases, before and during treatment it would be necessary to add potassium-rich foods to one's diet, such as potatoes, bananas, oranges, tomatoes and spinach ...
The potential and unpredictable hypotensive action of LASIX ® could compromise the patient's perceptive and reactive abilities, and negatively affect the ability to use vehicles and machinery.

PREGNANCY AND BREASTFEEDING

LASIX ® should not be administered during the entire pregnancy period.
The active ingredient of LASIX ® can easily pass into breast milk and inhibit lactation, as well as create damage to the newborn; therefore breastfeeding should be discontinued during furosemide therapy.

Interactions

The gastric filling state and the concomitant administration of food can reduce the absorption profile of LASIX ® by altering its normal functionality; therefore it is recommended to take this drug on an empty stomach.
LASIX ® can also interact with different drugs:

• Sucralfate, with consequent reduction in the absorption of furosemide (it is therefore recommended to administer it after at least 2 hours).
• Salts of lithium, reducing the elimination of this compound, with a consequent enhancement of the toxic effects.
• ACE inhibitors, with possible severe hypotension and severe renal impairment.
• Non-steroidal anti-inflammatory drugs, with reduction of the biological efficacy of furosemide.
• Corticosteroids, high-dose licorice, carbenoxolone resulting in hypokalemia.
• Antihypertensives of various kinds, with possible pressure drop
• Chloral hydrate, with skin redness, sweating, agitation, nausea and Tachycardia.
• Antidiabetic agents, increasing their elimination in the kidney and reducing their therapeutic power.

Contraindications LASIX ® furosemide

LASIX ® should not be used in case of:

• Hypersensitivity to one of its components;
• Allergy to sulfonamides due to possible cross-reactivity with furosemide;
• Severe hypotension;
• Hypokalemia, hyponatremia;
• Hepatic encephalopathy;
• Coma or precoma;
• Pregnancy, even presumed, and breastfeeding.

Undesirable Effects - Side Effects

Undesirable effects associated with the administration of LASIX ® can also occur at therapeutic doses and include:

1. Increased urinary excretion of electrolytes, resulting in increased thirst, headache, confusion, muscle cramps, tetany, myasthenia, heart rhythm disturbances and gastrointestinal disturbances. These conditions are also closely associated with the concomitant presence of various kinds of pathologies and unbalanced nutrition.
2. Dehydration, more frequent in elderly patients, with possible thrombosis linked to haemoconcentration and consequent increase in serum levels of creatinine, uric acid, triglycerides and cholesterol.
3. Impaired glucose tolerance, with potential worsening of glycemic control in patients with diabetes mellitus.
4. Hypotension resulting in confusion, headache, dizziness, sleepiness, visual disturbances, weakness, dry mouth and difficulty in standing upright.
5. Skin reactions, rash, erythema, dermatitis and shock (very rare), in case of hypersensitivity to the drug or to one of its components.

In the event of an overdose, the onset of the aforementioned side effects is more likely and much faster.

Note

LASIX ® is sold only under medical prescription.
The use of LASIX ® should always take place after consulting your doctor.
The indiscriminate use of LASIX, among athletes and non-athletes, to search for the loss of a few kilos, exposes the body to serious side effects. Furthermore, it is always advisable to reiterate that weight loss is dictated by the elimination of liquids and salts and not by a real slimming effect, intended as a loss of fat mass.

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