Alsix

Indications

Frusemide (also spelled furosemide) is a strong water tablet (diuretic). It is used to remove extra fluid that causes swelling (oedema) in heart failure, liver disease and kidney disease such as nephrotic syndrome, and to treat fluid on the lungs. It is sometimes used for high blood pressure. The injection is used in emergencies and in hospital.

How It Works

It acts on the kidneys so that they pass more salt and water into the urine. This reduces the amount of fluid in the body, easing swelling and breathlessness. Its effect starts within about an hour of a tablet and lasts about 6 hours.

Dosage and Administration

• Adults, swelling: usually 20 to 40 mg once a day in the morning to start; the doctor adjusts the dose to the response.
• Adults, high blood pressure: usually 20 to 40 mg a day, as prescribed.
• Higher doses (for example in severe kidney failure), children and injections (given by a doctor or nurse): as prescribed.

Take it in the morning, or a second dose by mid-afternoon, so that you are not up at night passing urine. Do not stop it or change the dose without asking the doctor.

Interactions

Gentamicin and similar antibiotics can increase the risk of hearing and kidney damage. It raises the level of Lithium. Low potassium caused by frusemide can make Digoxin more toxic. NSAID painkillers (such as Ibuprofen and Diclofenac) can reduce its effect and harm the kidneys. Taking it with other blood pressure medicines, such as Enalapril or Losartan, can cause low blood pressure. Steroids and some asthma medicines can add to potassium loss. It can raise blood sugar, so diabetes medicines may need adjusting. Sucralfate reduces its absorption; take them at least 2 hours apart.

Contraindications

• Allergy to frusemide, sulphonamides or any ingredient of the product.
• Not passing any urine (anuria), or severe dehydration.
• Very low blood sodium or potassium.
• Liver failure with confusion or reduced consciousness (hepatic coma or precoma).
• Untreated Addison's disease.

Side Effects

Common: passing urine more often, thirst, dizziness when standing up, tiredness, muscle cramps and low blood potassium, sodium or magnesium. It can also raise uric acid (causing gout), raise blood sugar and make the skin more sensitive to sunlight.

Get urgent medical help if you have: severe thirst, very dry mouth, confusion or fainting; a fast or irregular heartbeat; severe muscle weakness or cramps; ringing in the ears or loss of hearing; passing very little urine; severe stomach pain; yellowing of the skin or eyes; unusual bruising or bleeding; or a severe rash, blistering, or swelling of the face, lips or throat.

Pregnancy and Lactation

Avoid in pregnancy unless the doctor decides it is necessary, as it can reduce blood flow to the baby. It passes into breast milk and may reduce milk supply; use only if the doctor advises.

Precautions and Warnings

Regular blood tests for kidney function and salts are needed. Tell the doctor if you have diabetes, gout, liver or kidney disease, an enlarged prostate or difficulty passing urine, or low blood pressure. Older people are more likely to become dehydrated or dizzy. Weigh yourself regularly if the doctor asks, and report sudden weight changes. Avoid strong sunlight.

Overdose

Overdose can cause dehydration, very low blood pressure, dizziness, fainting, confusion and dangerous changes in blood salts that can affect the heart. Seek emergency medical help at once.

Therapeutic Class

Loop diuretic.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.