It has been demonstrated that LASIX inhibits primarily the absorption of sodium and chloride not only in the proximal and distal tubu but also in the loop of Henle. The high degree of efficacy is largely due to the unique site of action.  The action on the distal tubule is independent of any inhibitory effect on carbonic anhydrase and aldosterone.

LASIX is indicated in adults and pediatric patients for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome.  LASIX is particularly useful when an agent with greater diuretic potential is desired.

Oral LASIX may be used in adults for the treatment of hypertension alone or in combination with other antihypertensive agents.  Hypertensive patients who cannot be adequately controlled with thiazides will probably also not be adequately controlled with LASIX alone.

The usual initial dose of LASIX is 20 mg to 80mg given as a single dose. Ordinarily a prompt diuresis ensues.  If needed, the same dose can be administered 6 to 8 hours later or the dose may be increased.  The dose may be raised by 20 mg or 40mg and given not sooner than 6 to 8 hours after the previous dose until the desired diuretic effect has been obtained.  The individually determined single dose should then be given once or twice daily (e.g., at 8 am and 2 pm).  The dose of LASIX may be carefully titrated up to 600 mg/day in patients with clinically severe edematous states.

Some adverse reactions are:

cramping

pancreatitis

diarrhea

systemic vasculitis

headache

tinnitus and hearing loss

LASIX is contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide.

In patients with hepatic cirrhosis and ascites, LASIX therapy is best initiated in the hospital.  In hepatic coma and in states of electrolyte depletion, therapy should not be instituted until the basic condition is improved.  Sudden alterations of fluid and electrolyte balance in patients with cirrhosis may precipitate hepatic coma; therefore, strict observation is necessary during the period of diuresis.  Supplemental potassium chloride and, if required, an aldosterone antagonist are helpful in preventing hypokalemia and metabolic alkalosis.