Other Names

Lasix, Uritol

Classification

  Loop Diuretic

Action

•A non K+ sparing potent loop diuretic that inhibits sodium and chloride re-absorption at the proximal and distal tubules and ascending Loop of Henle

Indications

•Adjunct in treatment of acute pulmonary edema

•Treatment of edema associated with congestive heart failure, nephritic syndrome and hepatic cirrhosis when oral or IM therapy is not feasible

•For edema refractory to other agents

Contraindications

•Hypersensitivity to the medication

•Patients with anuria

Precautions

•Administer with caution in patients receiving corticosteroids

•May precipitate gout; hyperglycemia in diabetics; vascular thrombosis in elderly or debilitated

Adverse Reactions

•Anticoagulants (potentiating effects)

•Electrolyte imbalance (particularly hypokalemia) volume depletion

• Postural hypotension; nausea and vomiting

•Deafness or tinnitus with large parenteral doses

•Dermatitis, pruritus, blurred vision, dizziness, bladder spasms, pancreatitis, thrombocytopenia, agranulocytosis

•Very rarely cardiac arrest has occurred after IV or IM administration (may occur especially in digitalized patients with hypokalemia)

Interactions/Compatibility/Stability

•Anticoagulants (potentiating effects)

•Exposure to light may cause discoloration of drug but this does not affect potency

•Many incompatibilities; do not mix with any other injectable drugs (compatible for at least 4 hours with solutions containing heparin or potassium chloride)

•Stable 24 hours at room temperature in D5W, NS or Ringer’s Lactate

Special Considerations

•Oral therapy provides comparable diuresis

•With catecholamines (i.e. dopamine, dobutamine, epinephrine) precipitation is likely to occur (avoid simultaneous infusion/injection via same IV line)

•Monitor BP and pulse rate routinely

• Monitor blood glucose in diabetic patients

•Watch for signs of hypokalemia

Dosages

•Preparation: 40 mg/4 ml (10 mg/ml)

•Adult: Usual diuretic dose: 20 - 40 mg as a single injection. May repeat q 1 - 2 hours

•For acute pulmonary edema: 40 mg. May repeat q 1 - 2 hours if necessary

•For oliguria or acute renal failure where conventional doses produce inadequate diuresis: 250 mg

•Pediatric: 0.5 - 1 mg/kg and repeated up to a maximum of 6 mg/kg

Kinetics

Onset:        IV 5 minutes

Peak:          30 minutes

Duration:    2 hours

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