Furosemide 40 mg tablets 50

Belarus

Furosemide

40 mg

One tablet contains: active ingredient: furosemide - 40 mg;

Excipients: lactose monohydrate, potato starch, starch 1500 (corn starch partially pregelatinized), magnesium stearate.

Highly active diuretics. Sulfonamides.

Edema of cardiac or renal origin.

Edema of hepatic origin is usually in combination with potassium-sparing diuretics. Arterial hypertension in patients with chronic renal failure who are contraindicated in the appointment of thiazide diuretics (especially with creatinine clearance below 30 ml / min).

• hypersensitivity to furosemide or to any of the auxiliary substances;
• acute renal failure;
• hepatic encephalopathy;
• urinary tract obstruction;
• hypovolemia or dehydration;
• decompensated hypokalemia;
• decompensated hyponatremia;
• pregnancy, breastfeeding;
• combinations with lithium;
• galactosemia, glucose-galactose malabsorption syndrome, lactase deficiency;
• hepatitis and hepatocellular insufficiency in patients on hemodialysis in severe renal failure (creatinine clearance < 30 ml / min), due to the risk of accumulation of furosemide, the excretion of which is carried out mainly with bile.

Use in pregnancy and lactation

During pregnancy, use furosemide is possible only for a short time and only when the intended benefit of the therapy to the mother outweighs the potential risk to the fetus.

Since furosemide can be excreted in breast milk, as well as suppress lactation, if necessary, breastfeeding should be discontinued during lactation.

Use in case of impaired liver function

Contraindicated in severe liver failure, hepatic coma and precoma.

Use in renal dysfunction

Contraindicated in acute glomerulonephritis, acute renal failure with anuria.

Use in elderly patients

With caution it is used in elderly patients with severe atherosclerosis.

Special instructions

With caution it is used for prostatic hyperplasia, SLE, hypoproteinemia (risk of ototoxicity), diabetes mellitus (decreased glucose tolerance), with stenosing atherosclerosis of the cerebral arteries, against the background of prolonged therapy with cardiac glycosides, in elderly patients with severe atherosclerosis, pregnancy (especially the first half), lactation.

Before starting treatment, electrolyte disorders should be compensated. During the period of treatment with furosemide, it is necessary to monitor blood pressure, the level of electrolytes and glucose in the blood serum, liver and kidney function.

For the prevention of hypokalemia, it is advisable to combine furosemide with potassium-sparing diuretics. With the simultaneous use of furosemide and hypoglycemic drugs, it may be necessary to adjust the dose of the latter.

It is not recommended to mix a solution of furosemide in one syringe with any other drugs.

Influence on the ability to drive vehicles and control mechanisms

When using furosemide, it is impossible to exclude the possibility of a decrease in the ability to concentrate, which is important. for persons driving vehicles and working with mechanisms.

Drug Interactions

With simultaneous use with antibiotics of the aminoglycoside group (including gentamicin, tobramycin), it is possible to enhance the nephro- and ototoxic effect.

Furosemide reduces the clearance of gentamicin and increases the concentration in the blood plasma of gentamicin, as well as tobramycin.

With simultaneous use with antibiotics of the cephalosporin group, which can cause impaired renal function, there is a risk of increased nephrotoxicity.

With simultaneous use with beta-adrenomimetics (including fenoterol, terbutaline, salbutamol) and with corticosteroids, hypokalemia may increase.

With simultaneous use with hypoglycemic agents, insulin, it is possible to reduce the effectiveness of hypoglycemic agents and insulin, because furosemide has the ability to increase the glucose content in the blood plasma.

With simultaneous use with ACE inhibitors, the antihypertensive effect is enhanced. Pronounced arterial hypotension is possible, especially after taking the first dose of furosemide, apparently due to hypovolemia, which leads to a transient increase in the hypotensive effect of ACE inhibitors. The risk of impaired renal function increases and the development of hypokalemia is not excluded.

With simultaneous use with furosemide, the effects of non-depolarizing muscle relaxants are enhanced.

With simultaneous use with indomethacin, other NSAIDs, it is possible to reduce the diuretic effect, apparently due to inhibition of the synthesis of prostaglandins in the kidneys and sodium retention in the body under the influence of indomethacin, which is a nonspecific COX inhibitor; reduction of antihypertensive effect.

Furosemide is believed to interact with other NSAIDs in a similar way.

When used simultaneously with NSAIDs that are selective inhibitors of COX-2, this interaction is expressed to a much lesser extent or is practically absent.

With simultaneous use with astemizole, the risk of developing arrhythmia increases.

With simultaneous use with vancomycin, it is possible to increase oto- and nephrotoxicity.

With simultaneous use with digoxin, digitoxin, it is possible to increase the toxicity of cardiac glycosides, associated with the risk of hypokalemia while taking furosemide.

There are reports of the development of hyponatremia with simultaneous use with carbamazepine.

With simultaneous use with colestyramine, colestipol, the absorption and diuretic effect of furosemide decreases.

With simultaneous use with lithium carbonate, it is possible to enhance the effects of lithium due to an increase in its concentration in the blood plasma.

With simultaneous use with probenecid, renal clearance decreases furosemide.

With simultaneous use with sotalol, hypokalemia and the development of ventricular arrhythmia of the "pirouette" type are possible.

With simultaneous use with theophylline, a change in the concentration of theophylline in the blood plasma is possible.

With simultaneous use with phenytoin, the diuretic effect of furosemide is significantly reduced.

After intravenous administration of furosemide against the background of chloral hydrate therapy, an increase in sweating, a feeling of heat, instability of blood pressure, tachycardia are possible.

With simultaneous use with cisapride, hypokalemia may increase.

It is assumed that furosemide can reduce the nephrotoxic effect of cyclosporine.

With simultaneous use with cisplatin, it is possible to enhance the ototoxic effect.

Taken orally. The dose depends on the course and severity of the disease.

Adults.

With edema of cardiac, renal or hepatic origin:

• moderate condition: 1/2-1 tablet per day,
• severe condition: 2-3 tablets per day in 1 or 2 doses, or 3-4 tablets per day in 2 doses.

With high blood pressure in patients with chronic renal failure: in combination with other antihypertensive drugs (antagonists of the renin-angiotensin system), the usual doses of 20-120 mg per day in one or two doses are recommended.

Children

For the treatment of edema, the daily dose is 1-2 mg / kg body weight in 1-2 doses.

Use in elderly patients

Dose selection and regulation in elderly patients should be exercised with caution, usually starting at a lower level of the therapeutic dose range.

From the cardiovascular system : decrease in blood pressure, orthostatic hypotension, collapse, tachycardia, arrhythmias, decreased BCC.

From the side of the central nervous system and the peripheral nervous system: dizziness, headache, myasthenia gravis, cramps of the calf muscles (tetany), paresthesia, apathy, adynamia, weakness, lethargy, drowsiness, confusion.

From the senses: visual and hearing impairment.

From the digestive system: decreased appetite, dry mouth, thirst, nausea, vomiting, constipation or diarrhea, cholestatic jaundice, pancreatitis (exacerbation).

From the genitourinary system: oliguria, acute urinary retention (in patients with prostatic hypertrophy), interstitial nephritis, hematuria, decreased potency.

On the part of the hematopoietic system: leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia.

On the part of water-electrolyte metabolism: hypovolemia, dehydration (risk of thrombosis and thromboembolism), hypokalemia, hyponatremia, hypochloremia, hypocalcemia, hypomagnesemia, metabolic alkalosis.

From the side of metabolism: hypovolemia, hypokalemia, hyponatremia, hypochloremia, hypokalemic metabolic alkalosis (as a consequence of these disorders - arterial hypotension, dizziness, dry mouth, thirst, arrhythmia, muscle weakness, convulsions), hyperuricemia (with possible exacerbation of gout), hyperglycemia.

Allergic reactions: purpura, urticaria, exfoliative dermatitis, erythema multiforme exudative, vasculitis, necrotizing angiitis, skin itching, chills, fever, photosensitivity, anaphylactic shock.

Other: with intravenous administration (additionally) - thrombophlebitis, calcification of the kidneys in premature infants.

Store at a temperature of 15 to 25 degrees.