Wednesday, March 14, 2012

Frusemide (Furosemide)

Frusemide Pamphlet
Frusemide 40 mg
Ampoules for I.M. or IV. injection
Composition:
Each ampoule of 4 ml contains 40 mg frusemide (as frusemide sodium).
Indications: —
Frusemide 40 mg injection solution is indicated in conditions where adequate
diuresis is not obtained with oral administration or with lower intravenous doses of —
frusemide, particularly in cases of: —
* Dedema due to cardiac and hepatic disease (ascites). —
* Oedema due to renal disease (in the nephrotic syndrome, therapy of the —
underlying disease hasrecedence).
:
* Acute cardiac insufficiency, especially in pulmonary oedema (administration in conjunction with other therapeutic measures).
* Supportive measures in brain oedema.
* Oedema due to burns.
* Hypertensive crisis (in addition to other antihypertensive measures).
* To support forced diuresis in poisoning.
* Hypercalcaemia.
Contraindications:
* Anuria.
* Hepatic coma.
* Severe hypokalaemia.
* Hyponatraemia and/or hypovolaemia with or without hypotension.
* Hypersensitivity to sulfonamides.
Side Effects:
Cardiovascular: volume depletion and dehydration, orthostatichypotension.
Dermatological: dermatitis, photosensitivity.
ENT: transient deafness with too rapid I.V. injection.
GIT: abdominal discomfort and pain.
Hematological: agranulocytosis, transient leucopenia, thrombocytopenia.
Metabolic: hypochioremic alkalosis, asymptomatic hyperuricaemia, fluid and electrolyte imbalances (including hypocalcaemia, hypokalaemia, hypomagnesaemia, and hyponatraemia), hyperglycaemia, and impairment of glucose tolerance.
Note: Drug should be discontinued if dehydration or hypotension occurs or if BUN and creatinine levels rise.
Drug Interactions:
Frusemide may increase the ototoxic and nephrotoxic potential of aminoglycoside antibiotics, especially in the presence of impaired renal function.
Frusemide should not be used concomitantly with ethacrynic acid because of the possibility of enhanced ototoxicity.
Patients receiving high doses of salicylates concomitantly with Frusemide may experience salicylate toxicity at lower dose.
Frusemide has a tendency to antagonize the skeletal muscle relaxing effect of tubocurarine and may prolong the action of succinyicholine.
Frusemide may reduce renal clearance at lithium and increase lithium levels; lithium dosage may require adjustment.
Frusemide potentiates the therapeutic effect of most other antihypertensive drugs and of other diuretics.
Indomethacin and probenecid may reduce frusemide’s diuretic effect; their combined use is not recommended. However, if there is no therapeutic alternative,
an increased frusemide dosage may be required. 

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