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furosemide 40 mg
Excipients: lactose, starch, pregelatinized starch, talc, colloidal silicon dioxide, magnesium stearate.
Loop «diuretics quick action, a sulfonamide derivative. The mechanism of action related to the blockade of reabsorption of ions of chlorine and sodium in an upward knee loop of Henle. The drug acts on the convoluted tubules, and this effect is not associated with the inhibition of carbonic anhydrase or antialdosterone activity. Lasix has a strong diuretic, natriuretic , hlorureticheskoe action. Increases excretion of potassium, calcium, magnesium.
When receiving the drug inside the top of diuretic effect is observed within the first hour, and the maximum effect is achieved within 1-2 hours after ingestion; duration of diuretic effect is 6-8 hours.
The on / in the introduction of the beginning and the maximum diuretic effect observed respectively after 5 min and 30 min after injection, and its duration is about 2 hours.
The on / in the introduction of Lasix causes varicose veins, quickly reducing preload, reducing the filling pressures of the left ventricle and pulmonary artery pressure. It reduces systemic blood pressure.
When receiving the tablets inside Lasix bioavailability is 64%. The value of maximum blood plasma concentration of the drug increases with increasing dose, but the time does not achieve a maximum dose-dependent and varies widely depending on the condition of the patient. The half-life is approximately 2 hours. After the on / in the introduction of Lasix is excreted in urine was significantly greater than after oral administration. The blood plasma drug is mainly due to the protein, mostly to albumin: in the concentration range from 1 to 400 ng / ml protein in contact with healthy individuals is 91-99%. Free fraction of 2.5-4.1% therapeutic concentrations. During drug biotransformation in the body it is converted mainly glucuronide
From the water-electrolyte and acid-base status
Hyponatremia, hyposalemia, hypokalemia, hypomagnesemia, hypocalcemia, metabolic alkalosis, which may develop in the form of a gradual rise or electrolyte deficits or massive loss of electrolytes in a very short time, for example, in the case of high-dose furosemide patients with normal renal function. Symptoms indicating the development of disorders of electrolyte and acid-base balance, can be a headache, confusion, cramps, tetany, muscle weakness, heart rhythm disorders and dyspepsia. Factors contributing to the development of electrolyte abnormalities are the main diseases (eg, cirrhosis of the liver, or heart failure), concomitant therapy, and poor diet. In particular the risk of hypokalemia may increase in vomiting and diarrhea. Hypovolemia (blood volume reduction) and dehydration (often in elderly patients), which may cause hemoconcentration with a tendency to develop thrombosis.
Excessive decrease in blood pressure, which, especially in elderly patients may show the following symptoms: impaired concentration and psychomotor reactions, headache, dizziness, drowsiness, weakness, visual disturbances, dry mouth, violation of orthostatic circulatory regulation; collapse.
Caution must be exercised with concomitant administration of Lasix and hypoglycemic drugs, as it may require dose correction last.
If necessary, the simultaneous use of Lasix and pressor amines is necessary to bear in mind the increased risk of side effects and reducing the effectiveness of both drugs.
Effects on ability to drive vehicles and management mechanisms
Using the drug can not exclude the possibility of reducing the ability to concentrate, it’s important for people to drive and use machines.
— Edema syndrome in patients with chronic heart failure;
— Edema syndrome in patients with chronic renal failure;
— Acute renal failure, including that burns during pregnancy and (to maintain fluid excretion);
— Edema syndrome with nephrotic syndrome (nephrotic syndrome in the foreground is the treatment of the underlying disease);
— Edema syndrome in liver disease (if necessary
addition to the treatment of aldosterone antagonists);
— arterial hypertension.
— Kidney failure with anuria (in the absence of reaction to furosemide);
— Hepatic coma and precoma;
— Severe hypokalemia;
— Severe hyponatremia;
— Hypovolemia (hypotension with or without), or dehydration;
— Pronounced violations of the outflow of urine from any cause (including unilateral urinary tract disease);
— Digitalis intoxication;
— Acute glomerulonephritis;
— Decompensated aortic and mitral stenosis, hypertrophic obstructive cardiomyopathy;
— Increase of central venous pressure (more than 10 mm Hg..);
— Children under 3 years of age (the solid dosage form);
— Hypersensitivity to the active substance or to any component of the drug; in patients with allergies to sulfonamides (sulfanilamide antimicrobials or sulfonylureas) may be allergic to cross furosemide.
With simultaneous use of Lasix with cardiac glycosides increases the risk of glycoside intoxication, and when combined with the use of corticosteroids — the risk of hypokalemia.
With simultaneous use of Lasix potentiates the effect of muscle relaxants.
When applied simultaneously with Lasix cephalosporins and aminoglycosides or cisplatin may increase its plasma concentration, which can lead to the development of nephropathy and ototoxic effects.
Concomitant use of Lasix with lithium therapy may lead to increased reabsorption of lithium ions in the renal tubules and the appearance of toxic effects.
With simultaneous use of NSAIDs may reduce the diuretic effect of Lasix.
With simultaneous use of Lasix and antihypertensive drugs (including ACE inhibitors), anti-hypertensive effect is potentiated.
While the use of Lasix action hypoglycemic drugs and pressor amines may be weakened.
General recommendations: The tablets should be taken on an empty stomach, without chewing and drinking plenty of fluids. In the appointment of Lasix recommended to use the lowest dose sufficient to achieve the desired effect. The maximum recommended daily dose for adults is 1500 mg. In children, the recommended dose for oral administration is 2 mg / kg body weight (no more than 40 mg /). Duration of treatment is determined by the physician individually depending on indications. Special recommendations for dosage regimen in adults: edema syndrome in patients with chronic heart failure The recommended starting dose is 20-80 mg / dose required is selected depending on the diuretic response. It is recommended that the daily dose is divided into 2-3 doses. Edema syndrome in patients with chronic renal failure, natriuretic response to furosemide depends on several factors, including the severity of renal failure and the sodium content in the blood, so the effect of the dose can not be accurately predicted. In patients with chronic renal insufficiency careful titration is required, by its gradual increase so that fluid loss occurs gradually (in the early treatment possible loss of fluid to about 2 kg of body weight /). The recommended starting dose is 40-80 mg / dose required is selected depending on the diuretic response. All the daily dose should be taken once or divided into two doses. In patients on hemodialysis, usually maintenance dose is 250-1500 mg / Acute renal failure (to maintain fluid excretion) Before treatment, furosemide should be eliminated hypovolemia, hypotension, and significant violations of electrolyte and acid-base status. Recommended as the patient can be transferred faster than with on / in the introduction of Lasix Lasix tablets at the reception (at a dose of Lasix tablets depends on the selected I / dose). Edema in nephrotic syndrome The recommended starting dose is 40-80 mg / dose required is selected depending on the diuretic response. The daily dose may be taken at one time or divided into several doses. Edematous syndrome in diseases of the liver Lasix administered in addition to the treatment of aldosterone antagonists in case of their lack of effectiveness. To prevent the development of complications such as orthostatic circulatory regulation violation or breach of electrolyte or acid-base balance of the careful selection of the dose is required in order to fluid loss occurs gradually (in the early treatment possible loss of fluid to about 0.5 kg of body weight /). The recommended starting dose is 20-80 mg /. Hypertension Lasix can be used alone or in combination with other antihypertensive agents. The usual maintenance dose is 20-40 mg /