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Furosemide Side Effects and How to Minimize Them

Furosemide Side Effects and How to Minimize Them

What is furosemide?

Furosemide is an oral prescription medicine, which is available under the brand name Lasix. This drug is also available in its generic form. The generic version of the drug mostly costs less than the branded ones. Furosemide is considered as a water pill or a loop diuretic that helps in preventing the body to absorb too much salt. The drug works by eliminating the salt from the body through the urine.

Furosemide is used for the treatment of edema or fluid retention problem in individuals who suffer from congestive heart failure, kidney damage, or liver problems. Furosemide is also used for the treatment of individuals suffering from high blood pressure or hypertension. Furosemide can be used as a combination medicine or therapy for high blood pressure treatment, wherein one would need to take other medications along with furosemide.

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Furosemide is a diuretic, which helps the body get rid of excess salt as well as water by increasing the amount of urine the body produces. Taking furosemide can help lower one’s blood pressure and reduce swelling. 

Don’ts

Avoid taking furosemide if you have the following conditions:

Before Usage

Before starting the treatment, inform the doctor about the following conditions:

  • If you are allergic to any of the contents present in furosemide.
  • If you are unable to pass urine.
  • If you have recently undergone a magnetic resonance imaging (MRI) or any other type of scans wherein a radioactive dye was used and injected into your veins. Furosemide and contrast dyes tend to harm the kidneys.
  • Let the doctor know if you are pregnant or planning a pregnancy.
  • Furosemide can pass into the breast milk and may harm the unborn baby. Hence, it is advisable to let the doctor know if you are nursing. Furosemide also has a tendency of slowing down the production of breast milk.
  • If you are suffering from other medical conditions such as high cholesterol levels or triglycerides, liver or kidney problems, gout, lupus, diabetes, sulfa allergy, an enlarged prostate, or other urination issues.

Usage

Furosemide should be taken exactly as prescribed by the doctor or you can follow the instructions mentioned on the medicine label. The doctor ca days, adjust the drug's dose for best results. Do not change the prescribed dose without the doctor’s permission. Higher doses of furosemide are known to cause irreversible hearing loss.

When taking the liquid solution of furosemide, the liquid medicine can be measured with the help of a dosing syringe, which comes along with the medicine. The use of furosemide can lead to frequent urination, which can easily lead to dehydration. In such cases, it is important to follow the doctor’s advice on using potassium supplements or consuming enough salt and water in the diet.

During the course of furosemide treatment, the individual would be required to carry out frequent blood tests. When you starting feeling fine, do not stop taking this medicine. It should be continued even when the symptoms tend to improve. High blood pressure usually does not come along with any symptoms, and hypertensive individuals may need to take blood pressure medicines for the rest of their lives.

Furosemide must be stored at room temperature and away from sunlight, heat, and moisture. When an oral solution of furosemide is left for over 90 days, the bottle must be discarded. 

Furosemide is usually taken once or twice a day. In case of a missed dose, take the missed dose as soon as you remember. However, if it is already time for the other dose, then skip taking the missed dose. Avoid taking an extra dose to prevent overdosing. In case of an overdose, seek medical attention right away. The symptoms related to an overdose include skin turning dry, thirstiness or feeling hot, fainting spells, feeling very weak, and excessive sweating.

Those who are taking sucralfate should be taking it two hours either before or after furosemide. While in the seated or lying down position, do not get up too fast or else it can lead to dizziness. Make sure to get up slowly and steadily to avoid any instances of falling. Since furosemide leads to frequent urination, it is best to always stay hydrated. Moreover, avoid drinking alcohol since it tends to worsen the side effects.

Side Effects

The oral tablet form of furosemide is known to cause the following side effects:

These side effects are mostly mild and tend to go away within a few days or weeks. However, if they tend to be persistent or become worse, then it is best to consult the doctor.

The serious side effects of furosemide are:

  • Severe electrolyte imbalance or loss of water leading to drowsiness, weakness, dry mouth, less urination, severe nausea and vomiting, feeling very thirsty, muscle pain or cramps, feeling restless, and fast heartbeat.
  • A dip in the level of thyroid hormones with symptoms such as weight gain, fatigue, unusual cold feeling, dry skin and hair, and signs of weakness.
  • Liver damage with signs of jaundice (skin and eyes turning yellow).
  • Inflammation of the pancreas with symptoms such as fever, pain while eating or drinking anything, and a severe case of nausea and vomiting.
  • Skin peeling or blistering.
  • Severe allergic reactions leading to sore throat, face and tongue swelling, fever with chills, burning eyes, changes in skin color, occurrence of skin rashes that tend to spread to other parts of the body, mostly on the face or upper part of the body.
  • Ringing sound in the ear or loss of hearing, which can either be temporary or permanent.
  • Severe kind of stomach pain that radiates to the back.
  • Easy bruising or bleeding.
  • Kidney problems along with less or no urination, painful urination, finding it difficult to urinate, shortness of breath, getting easily tired, and swollen feet and ankles. 

Drug Interactions

It is quite important to inform the doctor about any medications, vitamins, supplements, or herbs you have taken before starting the treatment of furosemide since there can be instances of drug interactions leading to severe side effects.

Drug interactions usually happen when any kind of substance does not allow the medicine to work the way it should be leading to some harmful effects. To avoid drug interactions, inform your doctor about the medications you are currently taking or have taken.

Below are some of the drugs that can lead to interactions with furosemide:

  • Antiseizure Drugs: Phenytoin can lead to a reduction of the effectiveness of furosemide.
  • Antibiotics: Gentamicin, amikacin, tobramycin, neomycin, and paromomycin can lead to an increased risk of hearing loss or damage if taken along with furosemide.
  • Immunosuppressants: Cyclosporine can lead to an increased risk of developing gouty arthritis if taken along with furosemide.
  • Certain Types of Cancer Drugs: Cisplatin can lead to an increased risk of kidney problems as well as hearing damage. Methotrexate is another cancer medication, which should not be taken along with furosemide since it can lead to a reduction in furosemide's effectiveness. Furosemide can also cause an increase in the amount of this drug to be present in the body, thereby increasing the chances of having certain side effects.
  • Muscle Relaxants: Succinylcholine, if taken along with furosemide, can increase its effects, leading to an increased chance of having side effects. Tubocurarine, another muscle relaxer, also tends to reduce its effectiveness when taken along with furosemide. 
  • Lithium: This drug is considered as a mood stabilizer. If lithium is taken along with furosemide, it can lead to increased lithium levels in the body, which also causes a rise in the lithium's side effects.
  • Thyroid Drugs: Taking high doses of levothyroxine along with furosemide can make this thyroid drug less effective. It would mean that it would not be effective enough to treat thyroid conditions. 
  • NSAIDs: Taking salsalate, aspirin, indomethacin, and diflunisal along with furosemide causes an increase in the levels of these NSAIDs in the body, thus leading to an increased risk of having dangerous side effects.
  • Other Diuretics: When ethacrynic acid is taken along with furosemide, there can be an increased risk of hearing loss or damage.

Minimizing the Side Effects

One of the best ways to minimize the side effects of furosemide is to take the drug exactly as prescribed by the doctor without altering the dosage strength and the duration of treatment. Even when the pain or symptoms have shown some improvements, do not change the dosage. Also, if the pain still persists, do not increase the dosage. It should be the doctor’s decision when it comes to dosage adjustments.

Drug interactions are one of the major causes of an increase in side effects, which is why it is quite important to minimize any kind of drug interactions. Inform the doctor if you are taking any prescription drugs, over-the-counter medicines, vitamins, herbs, or dietary supplements before taking furosemide.

Avoid alcohol during the treatment period since furosemide is known to increase the effect of alcohol and can cause drowsiness. 

If the doctor prescribes a certain type of diet such as a low-sodium diet, have plenty of potassium-rich food items like fresh fruits and vegetables. In some cases, the doctor can also recommend potassium supplements.

Any existing or past medical conditions can also act as a hurdle in the furosemide treatment leading to an increase in the side effects. Avoid taking furosemide for longer than the recommended duration or else it can cause irreversible hearing loss.

Taking furosemide can also lead to a sudden drop in the blood pressure level, especially when the individual stands up from a seated or lying down position. This side effect can be minimized by rising up slowly to avoid falling.

Do not take more than the required dose since overdosing can increase the risk of having dangerous side effects or cause another serious health condition.

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