Lasix, also known as its generic name Furosemide, is a medication used to treat edema, a symptom associated with cardiovascular disease, liver and kidney problems, and hypertension. It can be taken alone or in combination with other hypotensive drugs and should be taken orally, preferably in the morning, with a potassium-rich diet to compensate for any potential deficiencies. It is important to avoid consuming alcohol during treatment.

The active ingredient in Lasix is furosemide and its inactive ingredients include talc USP, lactose monohydrate NF, magnesium stearate NF, starch NF, and colloidal silicon dioxide NF. The chemical formula of the drug is 4-chloro-N-furfuryl-5-sulfamoylanthranilic acid. The medication is available as white tablets in doses of 20, 40, and 80 mg.

In addition to the oral tablet form, Lasix can also be found in oral solution and injection solution forms. The substance is a white, odorless crystalline powder that is practically insoluble in water and dilute acids, partially soluble in alcohol, and completely soluble in dilute alkali solutions.

Mechanism of Action

The purpose of Lasix is to eliminate excessive fluid from the human body. Normally, the kidneys filter out sodium, chloride, water, and other substances from the blood, which then becomes urine. However, most of the water, sodium, and chloride is reabsorbed back into the bloodstream before it is excreted as urine. Lasix works by preventing the reabsorption of chloride and sodium, causing the kidneys to filter out more water, leading to an increased production of urine. After oral consumption, the drug takes effect within an hour and lasts for six to eight hours. An injection of Lasix starts producing a diuretic effect within five minutes, with a duration of two hours. However, the diuretic effect of the medication can cause depletion of body fluids, chloride, sodium, and other minerals, and therefore, patients must be monitored by a doctor during the course of treatment.

Uses of Lasix

The drug functions by enhancing urination, which aids the body in eliminating surplus salt and water. In certain instances, Lasix is also employed to lower elevated levels of calcium in the bloodstream. This medication can relieve symptoms like swelling in the legs or arms and difficulty breathing, and it is additionally used to manage high blood pressure and avert heart attacks, strokes, and kidney issues.

In addition to the conditions mentioned earlier, Lasix can also be used to treat:

  • Chronic heart failure causing fluid accumulation
  • Chronic heart failure leading to fluid in the lungs
  • Cirrhosis of the liver causing excess fluid buildup
  • Edema due to impaired kidney function
  • Significant water retention

How to Take

Lasix should be taken orally as directed by a healthcare professional, with or without food, typically once or twice a day. It is recommended to not take the medication less than 4 hours before bedtime to avoid frequent trips to the bathroom. To achieve the best results, it is important to take the drug regularly, even if you feel well. For example, patients with high blood pressure may not experience any symptoms.

If you are also taking cholestyramine, Sucralfate, or colestipol, it is recommended to wait at least 2 hours between taking Lasix and these substances, as they can interfere with the absorption of furosemide.

As Lasix causes increased urination, it is important to stay hydrated and follow your healthcare provider’s instructions regarding potassium and salt intake, or the use of potassium supplements. Regular blood tests may be required during the course of treatment, and it is important to notify your doctor immediately if your condition worsens.

Dosage: 20mg, 40mg, 100mg

The dosage of Lasix is tailored to the individual, taking into account factors such as age, medical condition, and response to treatment. In children, the dose is also determined by weight. To minimize the risk of side effects, older adults are typically advised to start with a low dose of Lasix 20 mg. As a general guideline, the starting dose is 20 to 80 mg, taken as a single dose. If necessary, the same dose can be repeated every 6 to 8 hours to achieve the desired effect. In cases of severe edema, the Lasix dosage may be increased to a maximum of 600 mg per day. When taking a daily dose that exceeds 80 mg for extended periods of time, it is important to be under close medical supervision.

Important Information About Taking Lasix

You should not exceed the recommended dose of Lasix. An overdose of furosemide may lead to irreversible hearing loss and other undesired reactions.

Before you start Lasix treatment, inform your healthcare professional if you have the following problems or conditions:

  • Kidney disease
  • Inability to urinate
  • Bladder obstruction, enlarged prostate, or other urination problems
  • An electrolyte imbalance, for example, low levels of magnesium or potassium in your blood
  • Liver diseases including Cirrhosis
  • High cholesterol or triglycerides
  • Diabetes
  • Gout
  • Lupus
  • Sulfa drug allergy

Your medical advisor should also know if you have recently had a magnetic resonance imaging or other kinds of scan that imply injections of a radioactive dye into your veins because a combination of contrast dyes and furosemide can cause harm to your kidneys.

Metolazone and Lasix

Before starting treatment with Lasix, inform your healthcare professional if you are also taking metolazone. To ensure the safe use of both medications together, you may require additional testing or adjustments to your dose. The combination of these drugs can result in low levels of magnesium, sodium, and potassium in the body.

If you experience muscle cramps, dizziness, fast heart rate, thirst, decreased urination, or feelings of fatigue, contact your doctor immediately. It is also important to monitor your blood pressure and kidney function regularly. Be sure to inform your healthcare provider about all medications you are taking, including vitamins and supplements, and do not discontinue use without first consulting with your doctor.

Missing a Dose

There are situations when Lasix is used only once, so in this case, you will not be on a dosing schedule. However, if you are using the pharmaceutical regularly, you should take the missed dose soonest. If it is almost time to take your next dose, skip the missed one. Do not take an additional pill to make up the missed dose.

Overdosing

The symptoms of an overdose may include heavy sweating, irritability, feeling thirsty or hot, mood changes, dry or wrinkled skin, sunken eyes, muscle cramps, seizures, weak pulse, fainting, or extreme weakness.

If you are suspecting an overdose, you should seek emergency medical attention.

Precautions while taking Lasix

  • You should not take sucralfate within less than two hours before or after you take furosemide.
  • As furosemide can make you dizzy, you should avoid getting up rapidly if you are sitting or lying.
  • Keep yourself properly hydrated. Adhere to the recommendations of your health advisor about the kind and amount of drinks you should consume when taking Lasix.
  • Combining alcohol with Lasix intake may cause side effects.

Side Effects

Together with its needed effects, furosemide may also lead to some unwanted reactions. Be aware that if any of these adverse effects occur, you may need medical attention. Talk to your medical advisor immediately, if you experience any of the conditions described below.

The following adverse effects are grouped by an organ system and ranked according to decreasing severity.

Gastrointestinal System Reactions

  • Hepatic encephalopathy in patients having hepatocellular insufficiency
  • Jaundice
  • Pancreatitis
  • Oral and gastric irritation
  • Diarrhea
  • Nausea
  • Increased liver enzymes
  • Vomiting
  • Anorexia
  • Cramping
  • Constipation

Systemic Hypersensitivity Reactions

  • Systemic vasculitis
  • Harsh anaphylactic or anaphylactoid reactions
  • Necrotizing angiitis
  • Interstitial nephritis

Central Nervous System Reactions

  • Paresthesias
  • Tinnitus and hearing loss
  • Dizziness
  • Vertigo
  • Xanthopsia
  • Headache
  • Blurred vision

Hematologic Reactions

  • Thrombocytopenia
  • Aplastic anemia
  • Agranulocytosis
  • Leukopenia
  • Hemolytic anemia
  • Anemia
  • Eosinophilia

Dermatologic-Hypersensitivity Reactions

  • Erythema multiforme
  • Stevens-Johnson Syndrome
  • Toxic epidermal necrolysis
  • Acute generalized exanthematous pustulosis
  • Drug rash with eosinophilia and systemic symptoms
  • Bullous pemphigoid
  • Pruritis
  • Urticaria
  • Exfoliative dermatitis
  • Photosensitivity
  • Purpura
  • Rash

Cardiovascular Reactions

  • Increase in triglyceride serum and cholesterol levels
  • Orthostatic hypotension may be escalated by alcohol, narcotics, or barbiturates

Other Reactions

  • Glycosuria
  • Hyperglycemia
  • Muscle spasm
  • Hyperuricemia
  • Urinary bladder spasm
  • Restlessness
  • Fever
  • Thrombophlebitis

Some of the Lasix side effects may not require medical attention because they usually disappear as your body adjusts to the drug. Healthcare provider may recommend you how to reduce or prevent these side effects. However, if they persist, you should talk to your healthcare professional.

Lasix For Dogs

Lasix is also commonly used in veterinary medicine. The drug contains the active ingredient furosemide, which works by blocking the reabsorption of electrolytes in the kidneys, leading to increased urination and the release of potassium. Vets frequently prescribe Lasix or generic furosemide for the treatment of uremia, hyperkalemia, pulmonary edema, and various other conditions. When the medication is taken for extended periods of time, it is important to regularly monitor hydration and electrolyte levels, especially in dogs that are also experiencing vomiting or diarrhea.

Nursing implications

Nursing implications indicate that a patient will need to urinate more frequently once the medication takes effect, provided their kidney function is unimpaired. If a patient has limited mobility or experiences urinary incontinence, the nursing diagnosis may involve the risk of falls or skin breakdown, respectively. In cases where a patient has a urinary catheter handling increased urine output, the risk of infection may also rise. Additionally, the presence of a catheter, particularly indwelling types, can contribute to the nursing diagnosis of an altered body image.

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