Generic Name: Brand Name: Lasix Classification: Loop Diuretics

Generic Name: furosemide
Brand Name: Lasix
Classification: Loop diuretics
Mode of Action:
Furosemide promotes diuresis by blocking tubular reabsorption of sodium and

chloride in the proximal and distal tubules, as well as in the thick ascending loop
of Henle. This diuretic effect is achieved through the competitive inhibition of
sodium-potassium-chloride cotransporters (NKCC2) expressed along these
tubules in the nephron, preventing the transport of sodium ions from the lumenal
side into the basolateral side for reabsorption. This inhibition results in increased
excretion of water along with sodium, chloride, magnesium, calcium, hydrogen,
and potassium ions. As with other loop diuretics, furosemide decreases the
excretion of uric acid.
Dosage:
Pediatric
Infants and Children
o 1-2 mg/kg IV/IM/PO once initially

o increased by 1-2 mg/kg q6-8hr (PO) or 1 mg/kg q2hr (IV/IM)
 individual dose not to exceed 6 mg/kg
 Neonates
o (<28 days): 0.5-1 mg/kg IV/IM q8-24hr
 *individual dose not to exceed 2 mg/kg
 Adult
 For edema
o 20-80 mg PO once daily; may be increased by 20-40 mg q6-8hr
 *not to exceed 600 mg/day
 For Acute Pulmonary Edema/Hypertensive Crisis/Increased Intracranial
Pressure
o 0.5-1 mg/kg (or 40 mg) IV over 1-2 minutes; may be increased to 80
mg if there is no adequate response within 1 hour
 *not to exceed 160-200 mg/dose
Indication:
o Edema
o Congestive heart failure
o Cirrhosis of the liver
o Renal disease
o Hypertension
Contraindication:
o Hypersensitivity to furosemide and sulfonamides.

o Anuria
o Lactation
Side Effects:
o oral and gastric irritation

o cramping
o diarrhea
o constipation
o nausea
o vomiting
o vertigo
o dizziness
o headache
o paresthesias
o muscle spasm
o Weakness
o restlessness
o fever
o Orthostatic hypotension
Adverse Effects:
o hepatic encephalopathy in patients with hepatocellular insufficiency

o pancreatitis
o jaundice (intrahepatic cholestatic jaundice)
o increased liver enzymes
o anorexia
o Severe anaphylactic or anaphylactoid reactions (e.g. with shock)
o systemic vasculitis
o interstitial nephritis
o necrotizing angiitis
o tinnitus and hearing loss
o blurred vision
o xanthopsia
o hyperglycemia
o glycosuria
o hyperuricemia
o urinary bladder spasm
o thrombophlebitis
o exfoliative dermatitis
o bullous pemphigoid
o purpura
o photosensitivity
o rash
o pruritis
Drug Interaction
o ↑ risk of hypotension with antihypertensives, nitrates, or acute
ingestion of alcohol.
o ↑ risk of hypokalemia with other diuretics, amphotericin B, stimulant
laxatives, and corticosteroids.
o Hypokalemia may ↑ risk of digoxin toxicity and ↑ risk of arrhythmia
in patients taking drugs that prolong the QT interval.
o ↓ lithium excretion, may cause lithium toxicity.
o ↑ risk of ototoxicity with aminoglycosides or cisplatin.
o ↑ risk of nephrotoxicity with cisplatin.
o NSAIDS ↓ effects of furosemide.
o May ↑ risk of methotrexate toxicity.
o ↓ effects when given at same time as sucralfate, cholestyramine, or
colestipol.
o ↑ risk of salicylate toxicity (with use of high-dose salicylate therapy).
o Concurrent use with cyclosporine may ↑ risk of gouty arthritis.
Nursing Responsibilities:
1. Remember the 5 rights of medication administration: patient, drug, dose,

route, and time
2. Advise watcher of the patient to contact health care professional if weight
gain of the patient is more than 3 lbs in 1 day.
3. Instruct watcher of the patient to notify health care professional of all Rx or
OTC medications, vitamins, or herbal products being taken by the patient
and to consult health care professional before taking any OTC medications
concurrently with this therapy.
4. Instruct watcher of the patient to notify health care professional of
medication regimen before treatment or surgery.
5. Caution watcher of the patient to use sunscreen and protective clothing to
the patient to prevent photosensitivity reactions.
6. Advise watcher of the patient to contact health care professional
immediately if rash, muscle weakness, cramps, nausea, dizziness,
numbness, or tingling of extremities occurs to the patient.
7. Instruct watcher of the patient to give furosemide as directed. Give missed
doses as soon as possible; do not double doses.
8. Caution patient to change positions slowly to minimize orthostatic
hypotension. Caution patient that exercise during hot weather, or standing
for long periods during therapy may enhance orthostatic hypotension.
9. Advise watcher of the patient, if the patient is diabetic, to monitor blood
glucose closely; may cause increased blood glucose levels.
10. Emphasize the importance of routine follow-up examinations.

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Generic Name: furosemide

Brand Name: Lasix

Classification: Loop diuretics

Furosemide promotes diuresis by blocking tubular reabsorption of sodium and

Infants and Children

o 1-2 mg/kg IV/IM/PO once initially

o Hypersensitivity to furosemide and sulfonamides.

o oral and gastric irritation

o hepatic encephalopathy in patients with hepatocellular insufficiency

1. Remember the 5 rights of medication administration: patient, drug, dose,

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