20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function; increased doses may be required
<10           : Dose as in normal renal function; increased doses may be required
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Not dialysed. Dose as in GFR <10 mL/min
HD                     :Not dialysed. Dose as in GFR <10 mL/min
HDF/high flux   :Not dialysed. Dose as in GFR <10 mL/min
CAV/VVHD      :Not dialysed. Dose as in GFR=10–20 mL/min
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Analgesics: increased risk of nephrotoxicity with NSAIDs; antagonism of diuretic effect with NSAIDs
Anti-arrhythmics: risk of cardiac toxicity with anti-arrhythmics if hypokalaemia occurs; effects of lidocaine and mexiletine antagonised
Antibacterials: increased risk of ototoxicity with aminoglycosides, polymyxins and vancomycin; avoid concomitant use with lymecycline
Antidepressants: increased risk of hypokalaemia with reboxetine; enhanced hypotensive effect with MAOIs; increased risk of postural hypotension with tricyclics
Anti-epileptics: increased risk of hyponatraemia with carbamazepine
Antifungals: increased risk of hypokalaemia with amphotericinAntihypertensives: enhanced hypotensive effect; increased risk of first dose hypotensive effect with alpha-blockers; increased risk of ventricular arrhythmias with sotalol if hypokalaemia occurs
Antipsychotics: increased risk of ventricular arrhythmias with amisulpiride, sertindole or pimozide (avoid with pimozide) if hypokalaemia occurs; enhanced hypotensive effect with phenothiazines
Atomoxetine: hypokalaemia increases risk of ventricular arrhythmiasCardiac glycosides: increased toxicity if hypokalaemia occurs
Ciclosporin: variable reports of increased nephrotoxicity, ototoxicity and hepatotoxicity
Lithium: risk of toxicity
ADMINISTRATION
Reconstition
–
Route
IV peripherally or centrally, IM, oral
Rate of Administration
1 hour; not greater than 4 mg/minute
Comments
250 mg to 50 mL sodium chloride 0.9% or undiluted via CRIP Increased danger of ototoxicity and nephrotoxicity if infused at faster rate than approximately 4 mg/minute Protect from light Furosemide (frusemide).FUrosEMidE (FrUsEMidE) 339
OTHER INFORMATION
500 mg orally ≡ 250 mg IVExcreted by tubular secretion, therefore in severe renal impairment (GFR 5-10 mL/min) higher doses may be required due to a reduction in the number of functioning nephronsFurosemide acts within 1 hour of oral administration, (after IV peak effect within 30 minutes) diuresis complete within 6 hours.