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The active ingredient Furosemide belongs to the group of loop diuretics. It is used as a diuretic for hypertension, ascites and fluid retention (edema) in order to remove excess fluid from the body. Although Furosemide in 1962 came on the market, it is still the most powerful diuretic that is available. Here you can read everything you need to Furosemide, side effects and use.
How Furosemide acts
In the kidney, the blood is filtered. Here waste products, pollutants and some drugs are extracted and ultimately excreted in the urine. The smallest functional unit of the kidney is in the nephron, which consists of the glomeruli and renal tubules one. Many of these nephrons are connected in parallel and filter small molecules from the blood (blood proteins and blood cells remain in the blood). The resulting primary urine is still unfocused and is concentrated in the renal tubules by the resumption of the water contained. In this case, other substances which are essential for the body, but have been filtered out (for example, glucose, sodium, potassium and chloride ions), again absorbed into the blood.
The renal tubule is divided into different sections, Furosemide in so-called ascending limb of Henle’s loop (hence the name loop diuretic) effect: It inhibits here the resumption of sodium, potassium and chloride ions – they leave the body with the urine. Along with these charged particles and large quantities of water are excreted, which is actually intended Furosemide effect. At high doses of Furosemide urine amounts of up to 50 liters a day. Increased excretion of water lowers the blood pressure.
degradation and excretion of Furosemide
After taking the drug is taken up about two-thirds from the intestine into the blood. The effect occurs after about half an hour. Only a small portion of the drug is metabolized in the liver (about ten percent), the rest is excreted unchanged – about one-third with the chair, the remaining amount in the urine. After about one hour, the active ingredient is excreted in half.
When is Furosemide used?
The active ingredient Furosemide is used for:
- water retention in the body (edema) caused by diseases of the heart, kidneys or liver
- threatening kidney failure
Depending on the underlying disease can be prescribed short term or long-term therapy the drug.
How Furosemide is used
Furosemide is usually applied in the form of tablets or capsules with sustained release. Doses are sober in the morning with a glass of water. Higher dosages can also be distributed over multiple doses over the day. Most are 40 to 120 milligrams doses Furosemide of a day sufficient in some cases and depending on the underlying disease and doses of up to 500 milligrams a day may be prescribed.
In the hypertension therapy Furosemide is often combined with other anti-hypertensives to reduce the rate of side effects and increase the effectiveness.
What are the side effects of Furosemide?
With more than one in ten patients Furosemide side effects show as electrolyte imbalance (especially changes in sodium and potassium), dehydration, low blood volume and, elevated blood lipids and increased creatinine in the blood.
In addition, with every tenth to hundredth patient to elevated cholesterol and uric acid levels in the blood, gout attacks and discomfort as a result of electrolyte imbalance (leg cramps, weakness, drowsiness, confusion, heart rhythm disturbances, etc.).
What should be considered when taking Furosemide?
If during treatment with Furosemide, further ingredients such as glucocorticoids (“cortisone”) or laxatives, this may lead to low blood potassium levels. The same applies if larger quantities are consumed licorice.
Non-steroidal anti-inflammatory drugs (such as aspirin), for example, are often used as a headache remedy, can attenuate the Furosemide effect. The same effect can occur when the combined use of Phenytoin (at) or substances that are also excreted by the renal tubules such as probenecid (for gout) and Methotrexate (for cancer and autoimmune diseases).
Caution is advised when concomitant use of drugs that act on the heart or as side effects trigger a certain heart rhythm disorder (called QT prolongation). Because Furosemide affects the electrolyte concentrations, can turn out the effect of these drugs on the heart weaker or stronger. This is particularly true for cardiac glycosides such as Digoxin and digitoxin.
The concomitant use with active substances which the kidneys or hearing damage (nephrotoxic or ototoxic effect) should be avoided. Examples of such drugs are antibiotics such as gentamicin, tobramycin, kanamycin, and anticancer drugs such as cisplatin.
The concomitant use of mood stabilizer lithium should only be monitored closely because lithium is transported in the body such as sodium. Thus, its distribution in the body can significantly change.
In pregnancy Furosemide can be applied in the short term under strict medical supervision. It crosses the placenta and passes into breast milk, so nursing mothers should stop breast-feeding if necessary.
The drug is also suitable for the treatment of children, but in a correspondingly reduced dosage. Since children under six often have problems swallowing tablets should be avoided to the oral solution here.
How to obtain drugs with Furosemide
The drug Furosemide is only available on prescription in each dose and can be purchased at the pharmacy with a valid prescription.
Since when Furosemide is known?
From 1919 toxic mercury compounds have been used as a diuretic. The German company Hoechst finally developed in 1959 the mercury-free drug Furosemide and told him in 1962 for a patent. Then he was soon put into practice.