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This medication is also used to treat high blood pressure hypertension. Like other loop diuretics, Lasix acts by inhibiting the Na-K-2Cl symporter in the thick ascending limb of the loop of Henle. The action on the distal tubules is independent of any inhibitory effect on carbonic anhydrase or aldosterone; it also abolishes the corticomedullary osmotic gradient and blocks negative as well as positive free water clearance. Due to the large NaCl absorptive capacity of the Loop of Henle, diuresis is not limited by development of acidosis, as it is with the carbonic anhydrase inhibitors. Safe usage and general guidance Take this medication exactly as it was prescribed for you.

Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Lasix will make you urinate more often and you may get dehydrated easily. Follow your doctor's instructions about using potassium supplements or getting enough salt and potassium in your diet. If you are being treated for high blood pressure, keep using Lasix even if you feel fine.

High blood pressure often has no symptoms. Store Lasix at room temperature away from heat, light, and moisture. Lasix liquid medicine should be used within 60 to 90 days after opening the bottle. Ask your pharmacist how many days your medicine is good for. Throw away any unused liquid after that time has passed. Precautions and risks Before you buy Lasix, tell your doctor if you have kidney disease, liver disease, gout, lupus, diabetes, or an allergy to sulfa drugs. Avoid becoming dehydrated. Follow your doctor's instructions about the type and amount of liquids you should drink while you are taking this medication. Serum and urine electrolyte determinations are particularly important when the patient is vomiting profusely or receiving parenteral fluids.

Abnormalities should be corrected or the drug temporarily withdrawn. Other medications may also influence serum electrolytes. Reversible elevations of BUN may occur and are associated with dehydration, which should be avoided, particularly in patients with renal insufficiency. Urine and blood glucose should be checked periodically in diabetics receiving Lasix, even in those suspected of latent diabetes. Lasix may lower serum levels of calcium rarely cases of tetany have been reported and magnesium. Accordingly, serum levels of these electrolytes should be determined periodically.

Pediatric Use. Drug Interactions Lasix may increase the ototoxic potential of aminoglycoside antibiotics, especially in the presence of impaired renal function. Except in life-threatening situations, avoid this combination. Lasix should not be used concomitantly with ethacrynic acid because of the possibility of ototoxicity. Patients receiving high doses of salicylates concomitantly with Lasix, as in rheumatic disease, may experience salicylate toxicity at lower doses because of competitive renal excretory sites. There is a risk of ototoxic effects if cisplatin and Lasix are given concomitantly. In addition, nephrotoxicity of nephrotoxic drugs such as cisplatin may be enhanced if Lasix is not given in lower doses and with positive fluid balance when used to achieve forced diuresis during cisplatin treatment.

Lasix has a tendency to antagonize the skeletal muscle-relaxing effect of tubocurarine and may potentiate the action of succinylcholine. Lasix combined with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers may lead to severe hypotension and deterioration in renal function, including renal failure. An interruption or reduction in the dosage of Lasix, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers may be necessary. Potentiation occurs with ganglionic or peripheral adrenergic blocking drugs.

Lasix may decrease arterial responsiveness to norepinephrine. However, norepinephrine may still be used effectively. Simultaneous administration of sucralfate and Lasix tablets may reduce the natriuretic and antihypertensive effects of Lasix. The intake of Lasix and sucralfate should be separated by at least two hours. In isolated cases, intravenous administration of Lasix within 24 hours of taking chloral hydrate may lead to flushing, sweating attacks, restlessness, nausea, increase in blood pressure, and tachycardia. Use of Lasix concomitantly with chloral hydrate is therefore not recommended.

Phenytoin interferes directly with renal action of Lasix. There is evidence that treatment with phenytoin leads to decreased intestinal absorption of Lasix, and consequently to lower peak serum furosemide concentrations. Methotrexate and other drugs that, like Lasix, undergo significant renal tubular secretion may reduce the effect of Lasix. Conversely, Lasix may decrease renal elimination of other drugs that undergo tubular secretion. Lasix can increase the risk of cephalosporin-induced nephrotoxicity even in the setting of minor or transient renal impairment. Concomitant use of cyclosporine and Lasix is associated with increased risk of gouty arthritis secondary to Lasix-induced hyperurecemia and cyclosporine impairment of renal urate excretion.

One study in six subjects demonstrated that the combination of furosemide and acetylsalicylic acid temporarily reduced creatinine clearance in patients with chronic renal insufficiency. There are case reports of patients who developed increased BUN, serum creatinine and serum potassium levels, and weight gain when furosemide was used in conjunction with NSAIDs. Literature reports indicate that coadministration of indomethacin may reduce the natriuretic and antihypertensive effects of Lasix furosemide in some patients by inhibiting prostaglandin synthesis. Indomethacin may also affect plasma renin levels, aldosterone excretion, and renin profile evaluation.

Carcinogenesis, Mutagenesis, Impairment of Fertility Furosemide was tested for carcinogenicity by oral administration in one strain of mice and one strain of rats. A small but significantly increased incidence of mammary gland carcinomas occurred in female mice at a dose 17. Furosemide was devoid of mutagenic activity in various strains of Salmonella typhimurium when tested in the presence or absence of an in vitro metabolic activation system, and questionably positive for gene mutation in mouse lymphoma cells in the presence of rat liver S9 at the highest dose tested.

Furosemide did not induce sister chromatid exchange in human cells in vitro, but other studies on chromosomal aberrations in human cells in vitro gave conflicting results. In Chinese hamster cells it induced chromosomal damage but was questionably positive for sister chromatid exchange. Studies on the induction by furosemide of chromosomal aberrations in mice were inconclusive. The urine of rats treated with this drug did not induce gene conversion in Saccharomyces cerevisiae. Pregnancy Furosemide has been shown to cause unexplained maternal deaths and abortions in rabbits at 2, 4 and 8 times the maximal recommended human dose. There are no adequate and well-controlled studies in pregnant women.

Lasix should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Treatment during pregnancy requires monitoring of fetal growth because of the potential for higher birth weights. The effects of furosemide on embryonic and fetal development and on pregnant dams were studied in mice, rats and rabbits. Data from the above studies indicate fetal lethality that can precede maternal deaths. The results of the mouse study and one of the three rabbit studies also showed an increased incidence and severity of hydronephrosis distention of the renal pelvis and, in some cases, of the ureters in fetuses derived from the treated dams as compared with the incidence in fetuses from the control group.

Nursing Mothers Because it appears in breast milk, caution should be exercised when Lasix is administered to a nursing mother. Lasix may inhibit lactation. Monitor renal function, and renal ultrasonography should be considered, in pediatric patients receiving Lasix. If Lasix is administered to premature infants during the first weeks of life, it may increase the risk of persistence of patent ductus arteriosus. Geriatric Use Controlled clinical studies of Lasix did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.

In general, dose selection for the elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

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High blood pressure often has no symptoms. Store Lasix at room temperature away from heat, light, and moisture. Lasix liquid medicine should be used within 60 to 90 days after opening the bottle. Ask your pharmacist how many days your medicine is good for. Throw away any unused liquid after that time has passed. Precautions and risks Before you buy Lasix, tell your doctor if you have kidney disease, liver disease, gout, lupus, diabetes, or an allergy to sulfa drugs. Avoid becoming dehydrated. Follow your doctor's instructions about the type and amount of liquids you should drink while you are taking this medication.

Avoid exposure to sunlight or artificial UV rays sunlamps or tanning beds. Lasix can make your skin more sensitive to sunlight and sunburn may result. Get emergency medical help if you have any of these signs of an allergic reaction:

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