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Frusemide (Furosemide) (rest of pamphlet)

Frusemide Pamphlet
Effects on Diagnostic Tests:
Frusemide therapy alters electrolyte balance and liver and renal function tests.
Pregnancy:
Frusemidé should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Nursing mothers:
Because it appears in breast milk, caution should be exercised when frusemide is
administered to a nursing mother
.
Paediatric Use:
Use Frusemide with caution in neonates. The usual paediatric dose can be used, but dosing intervals should be extended. In neonates with respiratory distress syndrome, diuretic treatment with frusemide in the first few weeks of life may _____
increase the risk of persistent patent ductus arteriosus (PDA).
Hearing loss in neonates has been associated with the use of frusemide injection.
Warnings:
Sudden alterations of fluid and electrolyte balance in patients with liver cirrhosis may precipitate hepatic coma; therefore strict observation is necessary during the period of diuresis.
Supplementing potassium chloride and, if required, aldosterone antagonists, is helpful in preventing hypokalaemia and metabolic alkalosis.
Digitalis therapy may exacerbate metabolic effects of hypokalaemia, especially myocardial effects.
Dosage:
Usual dose:
Unless otherwise prescribed by the physician, the initial dose for adults and adolescents over 15 years is 20 to 40 mg frusemide (1/2 - I ampoule) intravenously or intramuscularly. May be repeated in 1 to 2 hours. If necessary, increase dosage by 20 mg increments (under close medical supervision and not sooner than 2 hours after previous dose) until desired diuresis is obtained. IV bolus doses should not exceed I gm/day. After the initial diuresis the minimum effective dose may be given once or twice daily for maintenance.
Acute pulmonary oedema:
Adults: An initial dose of 40 mg (1 ampoule) is slowly administered intravenously;
then a further l.V. dose of 20 - 40 mg (1/2 - I ampoule) is injected within 20 - 30 minutes if needed.
Infants and children: 1 mg/kg intramuscularly or intravenously every 2hours until response is achieved, with a maximum dose of 6 mg/kg/day.
Forced diuresis:
A dose of 20-40 mg frusemide (1/2 - I ampoule) is added to l.V. infusion of dextrose 5% in water, normal saline solution or lactated Ringer’s solution.
Hypercalcaemia: 80 to 100 mg at I to 2-hour intervals, given concomitantly with
normal saline. Total IV dose required has ranged from 160 mg to 3.2 gm.
Mode and
duration of treatment
The duration of treatment is at the physician’s decision.
Each 40 mg or fraction thereof should be given over I to 2 minutes. high-dose
therapy in an infusion should not exceed a rate of 4 mg/mm.
Frusemide should not be mixed with other drugs in the same syringe.
Produced by
Medical Union Pharmaceuticals,
Abu-Sultan, Ismailia, Egypt. 

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