- Prescribed for: Congestive heart failure, cirrhosis of the liver, fluid accumulation in the lungs, kidney dysfunction, high blood pressure, and other conditions where it may be desirable to rid the body of excess fluid. Bumetanide can be used to treat people who urinate frequently at night. It does not work in prostatic hypertrophy.
Loop diuretics are strong medicines that work similarly to the less potent and more widely used thiazide diuretics. Not only do they affect the same part of the kidney as the thiazide-type diuretics, they also affect the portion of the kidney known as the loop of Henle. This double action is what makes the loop diuretics such potent drugs. All 4 loop diuretics can be used for the same purposes, but their doses are quite different.
Cautions and Warnings of Generic Lasix
Do not take these medicines if you are sensitive or allergic to them. People allergic to sulfa drugs may also be allergic to Furosemide, Torsemide, or Bumetanide.
Loop diuretics are potent medicines and can cause depletion of water and electrolytes. They should not be taken without constant medical supervision. You should not take these drugs if your urine production has been decreased abnormally by some type of kidney disease.
Excessive use of loop diuretics will result in dehydration or reduction in blood volume, and may cause circulatory collapse or other related problems, particularly in older adults.
Ringing or buzzing in the ears, hearing loss, deafness, fainting, and fullness in the ears can occur with these drugs. Hearing usually returns within 24 hours but some loss may be permanent.
These drugs, may worsen systemic lupus erythematosus. Diarrhea may occur with Ethacrynic Acid or Furosemide solution (because of the sorbitol content). Rarely, people taking Bumetanide have developed thrombocytopenia (bleeding caused by very low platelet counts).
Because of the potent effect that these drugs, have on blood electrolytes – potassium, sodium, carbon dioxide, and others – frequent laboratory evaluations of these electrolytes should be performed during the few months of therapy and periodically thereafter.
People taking a loop diuretic may develop increased levels of total cholesterol, LDL cholesterol, and triglycerides.
Possible Side Effects
- Common: changes may develop in potassium and other electrolyte concentrations in your body. In the case of hypokalemia (low blood potassium), you may observe dryness of the mouth, excessive thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular tiredness, low blood pressure, decreased frequency of urination and decreased amount of urine produced, abnormal heart rate, and stomach upset (including nausea and vomiting). To make up for this potassium loss, potassium supplements (tablets, liquids, or powders) and/or potassium-rich foods (bananas, citrus fruits, melons, and tomatoes) are recommended.
- Loop diuretics may change sugar metabolism in your body: If you have diabetes mellitus, you may develop high blood sugar or sugar in the urine. To treat this problem, the dosage of your antidiabetes drugs will have to be increased.
- Less common: abdominal discomfort, nausea, vomiting, diarrhea, rash, dizziness, light-headedness, headache, blurred vision, fatigue, weakness, jaundice (yellowing of the eyes or skin), acute gout attacks, dermatitis and other skin reactions, tingling in the extremities, dizziness upon rising quickly from a sitting or lying position, and anemias.
- Rare: a sweet taste in the mouth, a burning feeling In the stomach and/or mouth, excessive thirst, increased perspiration; and frequent urination.
- Loop diuretics increase the action of other blood-pressure-lowering drugs. This is beneficial and is frequently used to help lower blood pressure in patients with hypertension.
- The possibility of developing electrolyte imbalances in body fluids is increased if you take medications such as Digitalis or adrenal corticosteroids while you are taking a loop diuretic. Be aware that the potassium loss caused by loop diuretics will significantly affect the toxicity of Digitalis.
- Loop diuretics may increase the action of oral anticoagulants (blood-thinners); dosage adjustment may be needed if you are taking an anticoagulant.
- If you are taking an oral antidiabetes drug (except Metformin) and begin taking a loop diuretic, the antidiabetes dosage may need to be altered.
- The action of Theophylline may be altered by any loop diuretic. Your doctor should check your Theophylline levels after you have started on a loop diuretic.
- If you are taking Lithium Carbonate, you should probably not take a diuretic, which; by impairing the elimination of Lithium from the blood, adds a high risk of Lithium toxicity.
- People taking Chloral Hydrate (as a nighttime sedative) rarely experience hot flashes, high blood pressure, sweating, abnormal heart rhythms, weakness, and nausea when they also take a loop diuretic.
- Periodic hearing loss or ringing or buzzing in the ears may occur if a loop diuretic is taken with Cisplatin (anticancer drug) or an aminoglycoside antibiotic. Make sure your doctor knows you are taking a loop diuretic before giving you an injection of either of these.
- Clofibrate and thiazide diuretics increase the action of loop diuretics.
- Charcoal tablets, Phenytoin, Probenecid, Aspirin and other salicylate drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs) may decrease the effectiveness of loop diuretics.
- If you are taking a loop diuretic for high blood pressure or congestive heart failure, avoid over-the-counter cough, cold, and allergy products, which often contain stimulant drugs; check with your pharmacist before taking any over-the-counter drug if you’re taking a loop diuretic.
Loop diuretics rob your body of potassium. To counteract this effect, be sure to eat high-potassium foods (including bananas, citrus fruits, melons, and tomatoes).
Furosemide should be taken on an empty stomach, at least 1 hour before or 2 hours after meals. The other loop diuretics (Bumetanide, Torsemide, and Ethacrynic Acid) may be taken without regard to food or meals, and may be taken with food or meals if they upset your stomach.
Usual Dose of Generic Lasix
0.5 to 2 mg per day. It may also be taken every other day for 3 or 4 consecutive days followed by 1 or 2 medicine-free days.
- Adult: 50 to 200 mg, taken every day or every other day.
- Child: starting dose, 25 mg; increase slowly.
- Adult: 20 to 80 mg per day, depending on your response. Doses of 600 mg (or more) per day have been prescribed.
- Infant and Child: 0.9 mg per pound of body weight daily in a single dose. If therapy is not successful, the dose may be increased in small steps, but not more than 2.7 mg per pound per day.
- Adult: 5 to 20 mg once per day; however, doses up to 200 mg may be prescribed.
- Child: not recommended.
Maintenance doses for all of the loop diuretics are adjusted to the minimum effective level to meet the individual’s needs.
Generic Lasix Overdosage
Symptoms include dehydration, reduced blood volume, passing of tremendous amounts of urine, weakness, dizziness, confusion, loss of appetite, tiredness, vomiting, and cramps. Overdose victims should be taken to an emergency room for treatment. ALWAYS bring the medicine bottle with you.
If while taking a loop diuretic the amount of urine you produce each day is dropping or if you suffer from cramps, significant loss of appetite, muscle weakness, tiredness, or nausea, contact your doctor immediately.
Loop diuretics are usually taken once a day after breakfast. If a second dose is needed, it should be taken no later than 2 p.m. to avoid waking up during the night to urinate.
To avoid the dizziness associated with these drugs, rise slowly and carefully when you are getting up from a sitting or lying position.
Loop diuretics can increase blood sugar. Diabetics may have to have their medicine adjusted.
Loop diuretics can make some people very sensitive to the sun or sunlamps. Avoid excess exposure, use sunscreens, and wear protective clothing.
If you forget to take a loop diuretic dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
- Loop diuretics have been used to treat specific conditions in pregnancy, but they should be used only when absolutely necessary.
- Loop diuretics may pass into breast milk. Bottle-feed your baby if you must take one of these medicines.
Seniors are more sensitive to the effects of these drugs. Follow your doctor’s directions and report any side effects at once.
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