Active Ingredient: Furosemide
The treatment of oedema associated with congestive heart failure, cirrhosis of the liver, renal disease including nephrotic syndrome.
The treatment of peripheral oedema due to mechanical obstruction, venous insufficiency, mild to moderate hypertension.
For this indication, competent medicine agencies globally authorize below treatments:
Oral
20 - 80 mg
From 10 To 40 mg 2 time(s) per day every day
Initially 40mg daily in the morning; ordinarily a prompt diuresis ensues and the starting dose can then be maintained or even reduced. Diuresis lasts for approximately four hours following administration and hence the time of administration can be adjusted to suit the patient’s requirements. Maintenance dose is 20mg daily or 40mg on alternate days, increased in resistant oedema to 80mg daily.
Intravenous
20 - 1,000 mg
From 10 To 500 mg 2 time(s) per day every day
Initially, doses of 20-50mg may be administered by the intramuscular route, or by slow intravenous injection at a rate not exceeding 4mg/minute. The diuretic effect of furosemide is proportional to the dosage and, if larger doses are required, they should be given as a controlled infusion at a rate not exceeding 4mg/minute and titrated according to the response.
Elimination of furosemide is generally slower in the elderly. Dosage should be titrated until the required effect is achieved.
Furosemide Injection 250mg/25ml is for slow intravenous injection at a rate not exceeding 4mg/minute.
An initial dose of 250mg (one 25ml ampoule) may be added to about 225ml Sodium Chloride Injection B.P. or Ringer’s Solution for Injection, and infused over one hour at a drip rate of 80 drops/minute (4mg/minute).
If urine output within the next hour is insufficient, a dose of 500mg (two 25ml ampoules) in an appropriate infusion fluid, the total volume of which must be governed by the patient’s state of hydration, may be infused at a rate not exceeding 4mg/minute. If a satisfactory urine output has still not been achieved within one hour following the end of the second infusion, a third dose consisting of 1,000mg (four 25ml ampoules) in an appropriate infusion fluid may be given. The rate of infusion should never exceed 4mg/minute.
If the third infusion (1,000mg over 4 hours) is not effective, dialysis will probably be required.
In oliguric or anuric patients with significant fluid overload, it may not be practicable to use the aforementioned method of administration. In such cases, the use of a constant-rate infusion pump with a micrometer screw-gauge adjustment may be considered for direct administration of the injection into the vein. The rate of infusion should still never exceed 4mg/min.
If the response to either method of administration is satisfactory (urine output 40-50ml/hour), the effective dose (of up to 1,000mg) may be repeated every 24 hours. Alternatively, treatment may be maintained by oral administration, using 500mg by mouth for each 250mg required by injection. Appropriate adjustments to dosage may then be made according to the patient’s response.
Elimination of furosemide is generally slower in the elderly. Dosage should be titrated until the required effect is achieved.
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