Furosemide (Furoxide) 10mg/ml (20mg/2ml) Solution for Injection (IM/IV) 2ml x 10 Ampoules

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Product Description:

Furosemide (Furoxide) is a potent loop diuretic used to treat conditions involving fluid retention (edema) and high blood pressure (hypertension). The Furoxide 10mg/ml (20mg/2ml) solution for injection is available in 2ml ampoules, typically packaged in a box containing 10 ampoules. This injectable form allows for rapid action, making it useful in emergency situations or when oral administration is not feasible.

Furosemide works by blocking sodium and chloride reabsorption in the loop of Henle in the kidneys, leading to increased urine production (diuresis). It is commonly used to treat conditions such as heart failure, kidney disease, and liver disease that result in fluid retention.

Indications:

Furosemide (Furoxide) is indicated for the following conditions:

• Edema (Fluid Retention): Associated with heart failure, liver disease (such as cirrhosis), and kidney disease (including nephrotic syndrome).

• Hypertension (High Blood Pressure): Used to lower blood pressure, particularly when other medications are not effective or in cases of severe hypertension.

• Acute Pulmonary Edema: Furosemide is often used in emergency settings to treat acute pulmonary edema, a condition in which fluid accumulates in the lungs, making breathing difficult.

• Chronic Kidney Disease (CKD) and Dialysis: For managing fluid overload in patients with kidney dysfunction.

• Hypercalcemia: Furosemide can be used as part of the treatment for high calcium levels (hypercalcemia), as it promotes calcium excretion.

Dosage:

The dosage of Furosemide (Furoxide) depends on the patient's condition, the severity of symptoms, and response to treatment. The typical dosing recommendations for adults are as follows:

• For Edema and Fluid Retention:

  • Initial Dose: The usual initial dose is 20 to 40mg (2 to 4ml) injected intravenously or intramuscularly, given as a single dose. If necessary, the dose may be increased based on the patient's response.

  • Titration: Doses may be increased by 20 to 40mg at 2-hour intervals until the desired diuretic effect is achieved. The total daily dose may reach 600mg in severe cases.

  • Maintenance Dose: Once the desired diuretic effect is achieved, the maintenance dose is generally between 20mg to 40mg once or twice a day.

• For Hypertension (Severe):

  • Furosemide is typically used as an adjunctive treatment for hypertension, often in combination with other antihypertensive medications. The initial dose is usually 20mg to 40mg intravenously, which may be adjusted based on the patient's blood pressure response.

• For Acute Pulmonary Edema:

  • Initial Dose: A bolus injection of 40mg (4ml) IV is often used. Further doses may be given every 1 to 2 hours if necessary.

• For Hypercalcemia:

  • The dose for hypercalcemia typically starts at 20 to 40mg intravenously, followed by incremental doses depending on the severity of hypercalcemia.

Important Note: The injection should be administered slowly, preferably over a period of 1 to 2 minutes when given intravenously, to reduce the risk of side effects like hypotension or ototoxicity. Always follow the prescribed dosing schedule from a healthcare provider.

Side Effects:

Common side effects of Furosemide (Furoxide) include:

• Electrolyte Imbalance: Such as hypokalemia (low potassium), hyponatremia (low sodium), and hypomagnesemia (low magnesium).

• Dehydration: Excessive fluid loss may lead to dehydration, causing dizziness, dry mouth, or hypotension.

• Hypotension (Low Blood Pressure): Particularly when administered too quickly, leading to dizziness or fainting.

• Ototoxicity (Hearing Loss): Especially if given in high doses or administered too rapidly.

• Headache and Dizziness: Common, particularly in the early stages of treatment.

• Rash or Itching: Some people may develop a rash or other allergic reactions.

• Nausea and Vomiting: Gastrointestinal discomfort may occur in some patients.

Less common but more serious side effects include:

• Severe Electrolyte Disturbances: Such as dangerously low levels of potassium, sodium, or magnesium, which can lead to serious complications like arrhythmias.

• Kidney Dysfunction or Acute Renal Failure: Rare, but furosemide may worsen kidney function in certain individuals, especially those with preexisting kidney disease.

• Pancreatitis: In rare cases, inflammation of the pancreas has been associated with furosemide use.

• Severe Allergic Reactions: Such as anaphylaxis, which requires immediate medical attention.

If you experience any of these serious side effects, contact your healthcare provider immediately.

Contraindications:

Furosemide (Furoxide) should not be used in the following conditions:

• Hypersensitivity to Furosemide or Sulfonamides: If you are allergic to furosemide or any component of the product, it should not be used.

• Anuria (Complete Lack of Urine Output): Furosemide should not be administered to patients who are unable to produce urine due to kidney failure.

• Severe Electrolyte Imbalance: Patients with severe hypokalemia (low potassium), hyponatremia (low sodium), or hypomagnesemia should not use furosemide until the electrolyte imbalances are corrected.

• Severe Dehydration: In cases of significant fluid loss or dehydration, furosemide should not be given until hydration is corrected.

• Hepatic Coma (Severe Liver Failure): In patients with end-stage liver disease or hepatic coma, furosemide is contraindicated due to the potential for worsening hepatic function.

Precautions:

• Renal Impairment: Use caution in patients with kidney disease, as furosemide can worsen kidney function, especially in those with preexisting kidney conditions. Regular monitoring of kidney function is recommended during treatment.

• Electrolyte Monitoring: Furosemide can cause significant electrolyte imbalances, so frequent monitoring of serum potassium, sodium, and magnesium levels is essential during treatment. Potassium supplementation may be needed if hypokalemia occurs.

• Elderly Patients: Older adults may be more susceptible to the adverse effects of furosemide, particularly hypotension and electrolyte imbalances. Dose adjustments and careful monitoring are required.

• Pregnancy and Breastfeeding: Furosemide should only be used during pregnancy if absolutely necessary, and under the guidance of a healthcare provider. It passes into breast milk, so caution should be exercised when administering it to breastfeeding mothers.

• Diabetic Patients: Furosemide can raise blood sugar levels, so careful monitoring of glucose levels is advised for diabetic patients.

• Hypotension: Furosemide can lower blood pressure, so use with caution in patients with low blood pressure or those who are dehydrated.

Drug Interactions:

• Other Diuretics: Using furosemide with other diuretics may increase the risk of electrolyte imbalances, dehydration, or hypotension.

• Antihypertensive Drugs: Furosemide may enhance the effects of blood pressure-lowering medications, increasing the risk of hypotension.

• Lithium: Furosemide can increase the risk of lithium toxicity due to changes in sodium and fluid balance.

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Concurrent use may reduce the diuretic effect of furosemide and increase the risk of kidney problems.

• Corticosteroids: When combined with corticosteroids, the risk of hypokalemia (low potassium) is increased.

• Aminoglycoside Antibiotics (e.g., Gentamicin): Concurrent use may increase the risk of ototoxicity (hearing damage).

Summary:

Furosemide (Furoxide) 10mg/ml Solution for Injection is a loop diuretic used to treat fluid retention (edema), hypertension, and acute pulmonary edema. It is available in 2ml ampoules, with each ampoule containing 20mg of furosemide. It is commonly used in emergency situations or when oral diuretics are not feasible.

The typical dose ranges from 20mg to 40mg initially, with the possibility of increasing the dose depending on the patient's response. Common side effects include electrolyte imbalances, hypotension, and dehydration, while serious side effects like ototoxicity or kidney dysfunction can occur.

Furosemide should not be used in patients with severe kidney failure, anuria, or severe electrolyte imbalances. It is essential to monitor electrolyte levels and kidney function regularly during treatment to avoid complications.

Always follow your healthcare provider’s dosing recommendations and consult them for any concerns or side effects.