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Furosemide: Drug information

Furosemide: Drug information
(For additional information see "Furosemide: Patient drug information" and see "Furosemide: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Fluid/electrolyte loss:

Furosemide is a potent diuretic that, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dose and dose schedule must be adjusted to the individual patient's needs.

Brand Names: US
  • Furoscix;
  • Lasix
Brand Names: Canada
  • APO-Furosemide;
  • BIO-Furosemide [DSC];
  • Furosemide Special;
  • Lasix Oral;
  • Lasix Special;
  • MINT-Furosemide;
  • PMS-Furosemide [DSC];
  • PRO-Furosemide;
  • TEVA-Furosemide
Pharmacologic Category
  • Antihypertensive;
  • Diuretic, Loop
Dosing: Adult

Note: Loop diuretic approximate oral dose equivalency for patients with normal kidney function: Furosemide 40 mg = bumetanide 1 mg = torsemide 10 to 20 mg (Ref).

Ascites due to cirrhosis

Ascites due to cirrhosis:

Note: Generally used in combination with spironolactone but may be used as monotherapy for patients with hyperkalemia. For combination therapy, a dosing ratio of spironolactone 100 mg to furosemide 40 mg should generally be maintained but can be adjusted for electrolyte abnormalities (Ref).

Oral: Initial: 40 mg once daily; titrate every 3 to 5 days based on response and tolerability; once-daily dosing is preferred; maximum dose: 160 mg once daily (Ref). For small-volume ascites in patients who weigh <50 kg, some experts recommend a starting dose of 20 mg once daily (Ref).

Edema or volume overload

Edema or volume overload:

Naive to loop diuretics:

Oral, IV: Initial: 20 to 40 mg once then titrate as needed to an effective dose (see "Titration to effect" below) (Ref).

Note: Oral bioavailability varies widely but on average is 50% of the IV dose (Ref).

Refractory edema or acute decompensation in patients taking oral loop diuretics:

IV: Bolus/intermittent dosing: Initial: Administer 1 to 2.5 times the total daily oral maintenance dose once (eg, a patient taking oral furosemide 40 mg twice daily at home [80 mg/day] can be given 80 mg to 200 mg IV as an initial bolus) then titrate as needed to an effective dose (see "Titration to effect" below) (Ref).

Continuous infusion: Note: Reserve for patients who have responded to bolus therapy.

eGFR ≥30 mL/minute/1.73 m2: IV: Initial: 5 mg/hour; if diuretic response is not adequate, repeat IV bolus dose and increase continuous infusion to 10 mg/hour; continue to bolus and titrate infusion as needed up to 40 mg/hour (Ref).

eGFR <30 mL/minute/1.73 m2: IV: Initial: 20 mg/hour; if diuretic response is not adequate, repeat IV bolus dose and increase continuous infusion to 40 mg/hour (Ref).

Note: Higher continuous infusion rates have been described but are not recommended due to potential for side effects; consider alternative strategies for fluid removal (Ref).

Titration to effect: If the initial dose does not result in diuresis, double the individual dose (rather than administer the same dose more frequently) until diuresis occurs. Titration of an IV dose can occur at ≥2-hour intervals as needed in hospitalized patients. Once an effective dose is identified, it is typically administered once or twice daily but may be given more frequently if needed. The maximum effective dose varies by population; higher-than-usual doses may be required for patients with nephrotic syndrome or kidney failure. The maximum recommended total daily dose is 600 mg/day to avoid toxicity (Ref).

Transitioning from IV to oral: There is substantial variability in oral bioavailability; typically administer 1 to 2 times the IV dose orally (eg, total daily IV dose of 80 mg/day should be converted to an oral dose of 80 to 160 mg/day in 1 to 2 divided doses); monitor urine output and adjust oral dose as needed (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function: IV, Oral:

eGFR >30 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR ≤30 mL/minute/1.73 m2: Higher doses may be required to achieve desired diuretic response due to decreased secretion into the tubular fluid. However, single doses >160 to 200 mg IV (or oral equivalent) are unlikely to result in additional diuretic effect (Ref).

Hemodialysis, intermittent (thrice weekly): Not dialyzable (Ref).

IV, Oral:

Anuric patients: There is no expected clinical benefit; use not recommended (Ref).

Patients with residual kidney function: Dose as per eGFR ≤30 mL/minute/1.73 m2.

Peritoneal dialysis: Not dialyzable (Ref).

IV, Oral:

Anuric patients: There is no expected clinical benefit; use not recommended (Ref).

Patients with residual kidney function: Dose as per eGFR ≤30 mL/minute/1.73 m2. Note: If necessary, limited (single dose) data suggest that an oral dose of 500 mg may be more effective than 250 mg in increasing urine output (Ref).

CRRT:

Note: Drug clearance is dependent on the effluent flow rate, filter type, and method of renal replacement. Recommendations are based on high-flux dialyzers and effluent flow rates of 20 to 25 mL/kg/hour (or ~1,500 to 3,000 mL/hour) unless otherwise noted.

IV, Oral: In general, use not recommended; fluid management can be more effectively managed using CRRT ultrafiltration (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration):

Note: Drug clearance is dependent on the effluent flow rate, filter type, and method of renal replacement. Close monitoring of response and adverse reactions (eg, ototoxicity) due to drug accumulation is important.

IV, Oral:

Anuric patients: There is no expected clinical benefit; use not recommended (Ref).

Patients with residual kidney function: Dose as per eGFR ≤30 mL/minute/1.73 m2 (Ref).

Dosing: Hepatic Impairment: Adult

Diminished natriuretic effect with increased sensitivity to hypokalemia and volume depletion in cirrhosis. Monitor effects, particularly with high doses.

Dosing: Pediatric

(For additional information see "Furosemide: Pediatric drug information")

Note: Oral and parenteral (IV, IM) doses may not be interchangeable; due to differences in bioavailability, oral doses are typically higher than IV. Oral solution is available in multiple concentrations (8 mg/mL and 10 mg/mL); extra precautions should be taken to verify and avoid confusion between the different concentrations; dose should be clearly presented as mg (not mL). Oral dose equivalency for adult patients with normal renal function (approximate): Furosemide 40 mg = bumetanide 1 mg = torsemide 20 mg = ethacrynic acid 50 mg (Ref).

Edema

Edema (diuresis):

Oral: Infants, Children, and Adolescents:

Intermittent dosing (acute): Initial: 2 mg/kg as a single dose; if ineffective, may increase in 6 to 8 hours in increments of 1 to 2 mg/kg/dose; maximum dose: 6 mg/kg/dose.

Maintenance dosing (chronic): Limited data available: Initial: 0.5 to 2 mg/kg/dose every 6 to 24 hours; usual initial adult dose: 20 to 80 mg/dose; if initial dose ineffective, may increase dose in increments of 1 to 2 mg/kg/dose; maximum daily dose: 6 mg/kg/day not to exceed maximum adult daily dose: 600 mg/day; adjust dose to minimal effective dose for maintenance (Ref). Note: Smaller doses on a mg/kg basis may be needed in larger children, especially in those who are diuretic naive.

IM, intermittent IV: Infants, Children, and Adolescents: Limited data available: Initial: 0.5 to 2 mg/kg/dose every 6 to 12 hours; usual initial adult dose: 20 to 40 mg/dose; if initial dose ineffective after 2 hours, may increase dose by 1 mg/kg/dose; maximum dose: 6 mg/kg/dose not to exceed maximum adult dose: 200 mg/dose; adjust to minimal effective dose for maintenance (Ref). Note: Smaller doses on a mg/kg basis may be needed in larger children, especially in those who are diuretic naive. Dosing in adolescents based on experience in adult and pediatric patients.

Continuous IV infusion:

Infants and Children: Limited data available: Initial: IV bolus dose of 0.1 mg/kg followed by continuous IV infusion of 0.05 to 0.4 mg/kg/hour; titrate dosage to clinical effect (Ref).

Adolescents: Very limited data available; dosing in adolescents based on reported experience in adult and pediatric patients (Ref): IV bolus dose of 0.1 mg/kg; usual adult bolus dose: 40 to 100 mg over 1 to 2 minutes; followed by continuous IV infusion of 0.1 to 0.4 mg/kg/hour; usual adult dosing range: 10 to 40 mg/hour.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no pediatric specific recommendations; in adults with acute renal failure, very high doses may be necessary to initiate diuretic effect; avoid use in oliguric states.

Dialysis: Not removed by hemo- or peritoneal dialysis; supplemental dose is not necessary.

Dosing: Hepatic Impairment: Pediatric

Diminished natriuretic effect with increased sensitivity to hypokalemia and volume depletion in cirrhosis; monitor effects, particularly with high doses

Dosing: Older Adult

Oral, IV: Initial: 20 mg/day; increase slowly to desired response.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Cartridge Kit, Subcutaneous:

Furoscix: 80 mg/10 mL (1 ea)

Solution, Injection:

Generic: 10 mg/mL (2 mL, 4 mL, 10 mL)

Solution, Injection [preservative free]:

Generic: 10 mg/mL (2 mL, 4 mL, 10 mL)

Solution, Oral:

Generic: 8 mg/mL (500 mL); 10 mg/mL (60 mL, 120 mL)

Tablet, Oral:

Lasix: 20 mg

Lasix: 40 mg, 80 mg [scored]

Generic: 20 mg, 40 mg, 80 mg

Generic Equivalent Available: US

May be product dependent

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Injection:

Generic: 10 mg/mL (2 mL, 4 mL, 30 mL)

Solution, Intravenous:

Generic: 10 mg/mL (25 mL)

Solution, Oral:

Lasix Oral: 10 mg/mL (120 mL) [contains alcohol, usp, methylparaben, polysorbate 80]

Tablet, Oral:

Lasix Special: 500 mg [contains fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]

Generic: 20 mg, 40 mg, 80 mg

Product Availability

Furoscix 80 mg/10 mL single-dose prefilled cartridge: FDA approved October 2022; availability anticipated in the first quarter of 2023. Information pertaining to this product within the monograph is pending revision. Furoscix is indicated for the treatment of congestion due to fluid overload in adult patients with New York Heart Association (NYHA) Class II and Class III chronic heart failure. Furoscix is administered as a subcutaneous infusion using an on-body infusor. Consult the prescribing information for additional information.

Administration: Adult

Parenteral: Undiluted direct IV injections may be administered at a rate of 20 to 40 mg per minute; for high doses (eg, ≥160 mg), consider a short-term infusion at a maximum rate of administration of 4 mg/minute; rapid administration increases the risk of ototoxicity due to the high concentrations achieved in a short period of time (Ref).

Oral: May administer with or without food.

Note: When IV or oral administration is not possible, the sublingual route may be used. Place 1 tablet under tongue for at least 5 minutes to allow for maximal absorption. Patients should be advised not to swallow during disintegration time (Ref).

Administration: Pediatric

Oral: May administer with food or milk to decrease GI distress.

Parenteral:

IM: Administer undiluted; in general, not preferred if IV access is available.

IV: May be administered undiluted direct IV at a maximum rate of 0.5 mg/kg/minute (not to exceed 4 mg/minute); may also be diluted and infused over 10 to 15 minutes (following maximum rate as above); in adults, 20 to 40 mg undiluted solution may be administered over 1 to 2 minutes.

Usual Infusion Concentrations: Adult

IV infusion: 1 mg/mL or 2 mg/mL or undiluted as 10 mg/mL

Usual Infusion Concentrations: Pediatric

IV infusion: 1 mg/mL or 2 mg/mL or undiluted as 10 mg/mL

Use: Labeled Indications

Edema or volume overload: Management of edema associated with heart failure, cirrhosis of the liver (ie, ascites), or kidney disease (including nephrotic syndrome); acute pulmonary edema.

Medication Safety Issues
Sound-alike/look-alike issues:

Furosemide may be confused with famotidine, finasteride, fluconazole, FLUoxetine, fosinopril, loperamide, torsemide

Lasix may be confused with Lanoxin, Lidex, Lomotil, Lovenox, Luvox, Luxiq, Wakix

Older Adult: High-Risk Medication:

Beers Criteria: Diuretics are identified in the Beers Criteria as potentially inappropriate medications to be used with caution in patients 65 years and older due to the potential to cause or exacerbate syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatremia; monitor sodium concentration closely when initiating or adjusting the dose in older adults (Beers Criteria [AGS 2019]).

International issues:

Lasix [US, Canada, and multiple international markets] may be confused with Esidrex brand name for hydrochlorothiazide [multiple international markets]; Esidrix brand name for hydrochlorothiazide [Germany]; Losec brand name for omeprazole [multiple international markets]

Urex [Australia, Hong Kong, Turkey] may be confused with Eurax brand name for crotamiton [US, Canada, and multiple international markets]

Adverse Reactions (Significant): Considerations
Acute kidney injury

Loop diuretics, including furosemide, may lead to acute kidney injury due to fluid loss (Ref).

Mechanism: Dose-related; related to the pharmacologic action (ie, volume depletion) (Ref).

Risk factors:

• Excessive doses (Ref)

• Concurrent administration of nephrotoxic agents (Ref)

• Older adults (Ref)

• Preexisting volume depletion (Ref)

• Reduced blood flow to the kidney or depletion of effective blood volume (eg, bilateral renal artery stenosis, cirrhosis, nephrotic syndrome, heart failure) (Ref)

• Critically ill (Ref)

Fluid/electrolyte loss

Loop diuretics, including furosemide, may lead to profound diuresis (especially if given in excessive amounts), resulting in hypovolemia and electrolyte loss. Electrolyte disturbances (eg, hypocalcemia, hypokalemia, hypomagnesemia) may predispose a patient to serious cardiac arrhythmias.

Mechanism: Dose-related; related to the pharmacologic action (Ref).

Risk factors:

• Excessive doses with initiation or dose adjustment (Ref)

• Reduced dietary fluid and/or electrolyte intake (Ref)

• Concurrent illness leading to excessive fluid loss (eg, diarrhea, vomiting) (Ref)

• Concomitant administration of an additional diuretic (Ref)

• Very high or very restricted dietary sodium (Ref)

Hypersensitivity reactions (immediate and delayed)

Immediate hypersensitivity reactions, including angioedema, urticaria, and anaphylaxis have been reported with furosemide (Ref). Delayed hypersensitivity reactions (Ref) range from maculopapular skin rash to rare severe cutaneous adverse reactions (SCARs), including acute generalized exanthematous pustulosis (Ref), drug reaction with eosinophilia and systemic symptoms (Ref), Stevens-Johnson syndrome (Ref) and toxic epidermal necrolysis.

Mechanism: Non-dose-related; immunologic. Immediate hypersensitivity reactions: IgE-mediated, with specific antibodies formed against a drug allergen following initial exposure (Ref). SCARs: Delayed type IV hypersensitivity reactions involving a T-cell mediated drug-specific immune response (Ref).

Onset: Immediate hypersensitivity reactions: Rapid; generally occurs within 1 hour of administration but may occur up to 6 hours after exposure (Ref). Delayed hypersensitivity reactions: Varied; typically occur days to 12 weeks after drug exposure (Ref) but may occur more rapidly (usually within 1 to 4 days) upon reexposure (Ref).

Risk factors:

• Cross-reactivity: Cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides (such as furosemide) may not occur, or at the very least this potential is extremely low (Ref). Cross-reactivity due to antibody production (anaphylaxis) is unlikely to occur with antibiotic sulfonamides and nonantibiotic sulfonamides (Ref). There is limited published information regarding cross-reactivity between furosemide and other sulfonamides (Ref) and among other sulfonamide loop diuretics (Ref).

Ototoxicity

Loop diuretics, including furosemide, have been associated with hearing loss (deafness) and tinnitus, which is generally reversible (lasting from 30 minutes to 24 hours after administration (Ref)). Cases of permanent hearing loss have also been reported (Ref).

Mechanism: Dose-related; related to the pharmacologic action (ie, inhibition of a secretory isoform of the Na-K-2Cl co-transporter in the inner ear and impacts on ionic composition of cochlear fluids) (Ref).

Risk factors:

• Concurrent kidney disease (Ref)

• Excessive doses

• IV administration (Ref); bolus (higher risk) versus continuous infusion (Ref)

• Concurrent use of other ototoxic agents (eg, aminoglycosides) can lead to ototoxicity at lower doses (Ref)

• Premature very low birth weight (VLBW) neonates due to immature kidney function (ie, PMA <31 weeks with doses given more frequently than every 24 hours; PMA ≥31 weeks with dose given more frequently than every 12 hours) (Ref).

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not defined:

Cardiovascular: Necrotizing angiitis (Hendricks 1977), orthostatic hypotension, thrombophlebitis

Dermatologic: Acute generalized exanthematous pustulosis (Noce 2000), bulla (hemorrhagic) (Sladden 2016), bullous pemphigoid (Lee 2006), erythema multiforme (Zugerman 1980), exfoliative dermatitis, lichenoid eruption (Arias-Santiago 2010), pruritus, skin photosensitivity (Moore 2002), skin rash, Stevens-Johnson syndrome (Wright 2010), toxic epidermal necrolysis, urticaria (Dominguez-Ortega 2003)

Endocrine & metabolic: Glycosuria, hyperglycemia, hyperuricemia, hypocalcemia, hypochloremic alkalosis, hypokalemia, hypomagnesemia, hypovolemia, increased serum cholesterol, increased serum triglycerides

Gastrointestinal: Abdominal cramps, anorexia, constipation, diarrhea, gastric irritation, nausea, oral irritation, pancreatitis, vomiting

Genitourinary: Bladder spasm

Hematologic & oncologic: Agranulocytosis, anemia, aplastic anemia, hemolytic anemia (Maddox 1992), leukopenia (Ma 2017), purpuric disease, thrombocytopenia (Ochoa 2013)

Hepatic: Hepatic encephalopathy, increased liver enzymes, intrahepatic cholestatic jaundice

Hypersensitivity: Anaphylactic shock, anaphylaxis (Dominguez-Ortega 2003), angioedema (Dominguez-Ortega 2003), nonimmune anaphylaxis

Immunologic: Drug reaction with eosinophilia and systemic symptoms (James 2018)

Nervous system: Dizziness, headache, paresthesia, restlessness, vertigo

Neuromuscular & skeletal: Asthenia, muscle spasm

Ophthalmic: Blurred vision, xanthopsia

Otic: Deafness (Rifkin 1978), tinnitus (Skeith 2013)

Renal: Acute kidney injury, calcium nephrolithiasis (pediatric patients), interstitial nephritis (allergic) (Jennings 1986), nephrolithiasis (pediatric patients)

Miscellaneous: Fever (Edrup 2010)

Postmarketing:

Endocrine & metabolic: Exacerbation of diabetes mellitus, hyponatremia (in combination with spironolactone in patients with heart failure) (Velat 2020)

Neuromuscular & skeletal: Tetany

Contraindications

Hypersensitivity to furosemide or any component of the formulation; anuria.

Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to sulfonamide-derived drugs; complete kidney shutdown; hepatic coma and precoma; uncorrected states of electrolyte depletion, hypovolemia, dehydration, or hypotension; jaundiced newborn infants or infants with disease(s) capable of causing hyperbilirubinemia and possibly kernicterus; breastfeeding. Note: Manufacturer labeling for Lasix Special and Furosemide Special Injection also includes: GFR <5 mL/minute or GFR >20 mL/minute; hepatic cirrhosis; kidney failure accompanied by hepatic coma and precoma; kidney failure due to poisoning with nephrotoxic or hepatotoxic substances; pediatric patients ≤15 years of age.

Note: Although the FDA-approved product labeling states this medication is contraindicated in patients with hypersensitivity to sulfonamide-containing drugs, the scientific basis of this cross-sensitivity has been challenged. See "Warnings/Precautions" for more detail.

Warnings/Precautions

Concerns related to adverse effects:

• Hyperuricemia: Asymptomatic hyperuricemia has been reported with use; rarely, may precipitate gout.

• Sulfonamide (“sulfa”) allergy: The approved product labeling for many medications containing a sulfonamide chemical group includes a broad contraindication in patients with a prior allergic reaction to sulfonamides. There is a potential for cross-reactivity between members of a specific class (eg, two antibiotic sulfonamides). However, concerns for cross-reactivity have previously extended to all compounds containing the sulfonamide structure (SO2NH2). An expanded understanding of allergic mechanisms indicates cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or at the very least this potential is extremely low (Brackett 2004; Johnson 2005; Slatore 2004; Tornero 2004). In particular, mechanisms of cross-reaction due to antibody production (anaphylaxis) are unlikely to occur with nonantibiotic sulfonamides. T-cell-mediated (type IV) reactions (eg, maculopapular rash) are not well understood and it is not possible to completely exclude this potential based on current insights. In cases where prior reactions were severe (Stevens-Johnson syndrome/toxic epidermal necrolysis), some clinicians choose to avoid exposure to these classes.

• Thyroid effects: Doses >80 mg may result in transient increase in free thyroid hormones, followed by an overall decrease in total thyroid hormone levels.

Disease-related concerns:

• Adrenal insufficiency: Avoid use of diuretics for treatment of elevated blood pressure in patients with primary adrenal insufficiency (Addison disease). Adjustment of glucocorticoid/mineralocorticoid therapy and/or use of other antihypertensive agents is preferred to treat hypertension (Bornstein 2016; Inder 2015).

• Bariatric surgery: Dehydration: Avoid diuretics in the immediate postoperative period after bariatric surgery; electrolyte disturbances and dehydration may occur. Diuretics may be resumed, if indicated, once oral fluid intake goals are met (Ziegler 2009).

• Cirrhosis: In cirrhosis, avoid electrolyte and acid/base imbalances that might lead to hepatic encephalopathy; correct electrolyte and acid/base imbalances prior to initiation when hepatic coma is present. Supplemental potassium or an aldosterone antagonist, when appropriate, may reduce risk of hypokalemia and metabolic alkalosis. Close monitoring warranted, especially with initiation of therapy.

• Diabetes: Use with caution in patients with prediabetes or diabetes mellitus; may see a change in glucose control.

• Prostatic hyperplasia/urinary stricture: May cause urinary retention due to increased urine production, especially upon initiation of therapy.

• Systemic lupus erythematosus: May cause systemic lupus erythematosus exacerbation or activation.

Special populations:

• Pediatric: May lead to nephrocalcinosis or nephrolithiasis in premature infants and in infants and children <4 years of age with chronic use. May prevent closure of patent ductus arteriosus in premature infants.

• Surgical patients: If given the morning of surgery, furosemide may render the patient volume depleted and blood pressure may be labile during general anesthesia.

Dosage form specific issues:

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Zar 2007).

Other warnings and precautions:

• Diuretic resistance: For some patients, despite high doses of loop diuretic, an adequate diuretic response cannot be attained. Diuretic resistance may be overcome by IV rather than oral administration or the use of two diuretics together (eg, a loop diuretic in combination with a thiazide diuretic). When multiple diuretics are used, serum electrolytes need to be monitored even more closely (ACC [Hollenberg 2019]).

Warnings: Additional Pediatric Considerations

Furosemide stimulates prostaglandin E2 (PGE2) which may prevent closure of patent ductus arteriosus (PDA) in premature infants. However, one large, retrospective cohort study involving 43,576 VLBW infants (median birth weight and GA: 1,120 g and 29 weeks) evaluated the association between the exposure to furosemide and the occurrence of PDA. Exposure to furosemide was not associated with an increased odds of PDA treatment (Thompson 2018). Another smaller placebo-controlled study (n=68, GA: <34 weeks, birth weight: <2,000 g) found no difference in PDA closure rate between patients treated with furosemide or placebo in combination with indomethacin (Lee 2010).

Metabolism/Transport Effects

Substrate of OAT1/3; Inhibits MRP2

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Acebrophylline: May enhance the therapeutic effect of Furosemide. Risk C: Monitor therapy

Ajmaline: Sulfonamides may enhance the adverse/toxic effect of Ajmaline. Specifically, the risk for cholestasis may be increased. Risk C: Monitor therapy

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Aliskiren: May decrease the serum concentration of Furosemide. Risk C: Monitor therapy

Allopurinol: Loop Diuretics may enhance the adverse/toxic effect of Allopurinol. Loop Diuretics may increase the serum concentration of Allopurinol. Specifically, Loop Diuretics may increase the concentration of Oxypurinol, an active metabolite of Allopurinol. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Amikacin Liposome (Oral Inhalation): Loop Diuretics may enhance the nephrotoxic effect of Amikacin Liposome (Oral Inhalation). Loop Diuretics may enhance the ototoxic effect of Amikacin Liposome (Oral Inhalation). Risk C: Monitor therapy

Aminoglycosides: Loop Diuretics may enhance the adverse/toxic effect of Aminoglycosides. Specifically, nephrotoxicity and ototoxicity. Risk C: Monitor therapy

Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Risk X: Avoid combination

Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Risk C: Monitor therapy

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Angiotensin II Receptor Blockers: Loop Diuretics may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Loop Diuretics may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Angiotensin-Converting Enzyme Inhibitors: Loop Diuretics may enhance the hypotensive effect of Angiotensin-Converting Enzyme Inhibitors. Loop Diuretics may enhance the nephrotoxic effect of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor therapy

Antidiabetic Agents: Hyperglycemia-Associated Agents may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Antihypertensive Agents: Loop Diuretics may enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arsenic Trioxide: Loop Diuretics may enhance the hypotensive effect of Arsenic Trioxide. Loop Diuretics may enhance the QTc-prolonging effect of Arsenic Trioxide. Management: When possible, avoid concurrent use of arsenic trioxide with drugs that can cause electrolyte abnormalities, such as the loop diuretics. Risk D: Consider therapy modification

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Beta2-Agonists: May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

Bilastine: Loop Diuretics may enhance the QTc-prolonging effect of Bilastine. Risk C: Monitor therapy

Bile Acid Sequestrants: May decrease the absorption of Loop Diuretics. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Cabozantinib: MRP2 Inhibitors may increase the serum concentration of Cabozantinib. Risk C: Monitor therapy

Canagliflozin: May enhance the hypotensive effect of Loop Diuretics. Risk C: Monitor therapy

Cardiac Glycosides: Loop Diuretics may enhance the adverse/toxic effect of Cardiac Glycosides. Specifically, cardiac glycoside toxicity may be enhanced by the hypokalemic and hypomagnesemic effect of loop diuretics. Risk C: Monitor therapy

Cefazedone: May enhance the nephrotoxic effect of Loop Diuretics. Risk C: Monitor therapy

Cefotiam: Loop Diuretics may enhance the nephrotoxic effect of Cefotiam. Risk C: Monitor therapy

Cefpirome: Loop Diuretics may enhance the nephrotoxic effect of Cefpirome. Risk C: Monitor therapy

Ceftizoxime: Loop Diuretics may enhance the nephrotoxic effect of Ceftizoxime. Risk C: Monitor therapy

Cephalosporins: Furosemide may enhance the nephrotoxic effect of Cephalosporins. Risk C: Monitor therapy

Cephalothin: Loop Diuretics may enhance the nephrotoxic effect of Cephalothin. Risk C: Monitor therapy

Cephradine: May enhance the nephrotoxic effect of Loop Diuretics. Risk C: Monitor therapy

Chloral Betaine: Furosemide may enhance the adverse/toxic effect of Chloral Betaine. Management: Consider alternatives to this combination when possible; if combined use cannot be avoided, monitor closely for evidence of toxicity. Risk D: Consider therapy modification

Chloral Hydrate: Furosemide may enhance the adverse/toxic effect of Chloral Hydrate. Risk X: Avoid combination

CISplatin: Loop Diuretics may enhance the nephrotoxic effect of CISplatin. Loop Diuretics may enhance the ototoxic effect of CISplatin. Risk C: Monitor therapy

Corticosteroids (Systemic): May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

CycloSPORINE (Systemic): May enhance the adverse/toxic effect of Loop Diuretics. Risk C: Monitor therapy

Desmopressin: May enhance the hyponatremic effect of Loop Diuretics. Risk X: Avoid combination

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diacerein: May enhance the therapeutic effect of Diuretics. Specifically, the risk for dehydration or hypokalemia may be increased. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Dichlorphenamide: Loop Diuretics may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Dofetilide: Loop Diuretics may enhance the QTc-prolonging effect of Dofetilide. Management: Monitor serum potassium and magnesium more closely when dofetilide is combined with loop diuretics. Electrolyte replacements will likely be required to maintain potassium and magnesium serum concentrations. Risk D: Consider therapy modification

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Empagliflozin: May enhance the hypotensive effect of Loop Diuretics. Risk C: Monitor therapy

Ethacrynic Acid: Furosemide may enhance the ototoxic effect of Ethacrynic Acid. Risk X: Avoid combination

Fexinidazole: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Management: Avoid use of fexinidazole with OAT1/3 substrates when possible. If combined, monitor for increased OAT1/3 substrate toxicities. Risk D: Consider therapy modification

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Foscarnet: Loop Diuretics may increase the serum concentration of Foscarnet. Management: When diuretics are indicated during foscarnet treatment, thiazides are recommended over loop diuretics. If patients receive loop diuretics during foscarnet treatment, monitor closely for evidence of foscarnet toxicity. Risk D: Consider therapy modification

Fosphenytoin-Phenytoin: May diminish the diuretic effect of Furosemide. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Iodinated Contrast Agents: Loop Diuretics may enhance the nephrotoxic effect of Iodinated Contrast Agents. Risk C: Monitor therapy

Ipragliflozin: May enhance the adverse/toxic effect of Loop Diuretics. Specifically, the risk for intravascular volume depletion may be increased. Risk C: Monitor therapy

Ivabradine: Loop Diuretics may enhance the arrhythmogenic effect of Ivabradine. Risk C: Monitor therapy

Leflunomide: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Levodopa-Containing Products: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Containing Products. Risk C: Monitor therapy

Levosulpiride: Loop Diuretics may enhance the adverse/toxic effect of Levosulpiride. Risk X: Avoid combination

Licorice: May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

Lithium: Loop Diuretics may decrease the serum concentration of Lithium. Loop Diuretics may increase the serum concentration of Lithium. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Mecamylamine: Sulfonamides may enhance the adverse/toxic effect of Mecamylamine. Risk X: Avoid combination

Methotrexate: May diminish the therapeutic effect of Loop Diuretics. Loop Diuretics may increase the serum concentration of Methotrexate. Methotrexate may increase the serum concentration of Loop Diuretics. Risk C: Monitor therapy

Methoxsalen (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Methoxsalen (Systemic). Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Netilmicin (Ophthalmic): Loop Diuretics may enhance the nephrotoxic effect of Netilmicin (Ophthalmic). Risk X: Avoid combination

Neuromuscular-Blocking Agents: Loop Diuretics may diminish the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Loop Diuretics may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitisinone: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: May diminish the diuretic effect of Loop Diuretics. Loop Diuretics may enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. Management: Monitor for evidence of kidney injury or decreased therapeutic effects of loop diuretics with concurrent use of an NSAID. Consider avoiding concurrent use in CHF or cirrhosis. Concomitant use of bumetanide with indomethacin is not recommended. Risk D: Consider therapy modification

Nonsteroidal Anti-Inflammatory Agents (Topical): May diminish the therapeutic effect of Loop Diuretics. Risk C: Monitor therapy

Norepinephrine: Furosemide may diminish the therapeutic effect of Norepinephrine. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Opioid Agonists: May enhance the adverse/toxic effect of Diuretics. Opioid Agonists may diminish the therapeutic effect of Diuretics. Risk C: Monitor therapy

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Risk C: Monitor therapy

Pretomanid: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Probenecid: May diminish the diuretic effect of Loop Diuretics. Probenecid may increase the serum concentration of Loop Diuretics. Risk C: Monitor therapy

Promazine: Loop Diuretics may enhance the QTc-prolonging effect of Promazine. Risk X: Avoid combination

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Reboxetine: May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

RisperiDONE: Loop Diuretics may enhance the adverse/toxic effect of RisperiDONE. Risk C: Monitor therapy

Salicylates: May diminish the diuretic effect of Loop Diuretics. Loop Diuretics may increase the serum concentration of Salicylates. Risk C: Monitor therapy

Semaglutide: Furosemide may diminish the therapeutic effect of Semaglutide. Semaglutide may increase the serum concentration of Furosemide. Risk C: Monitor therapy

Sodium Phosphates: Diuretics may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Sucralfate: May decrease the serum concentration of Furosemide. Sucralfate may impair the absorption of furosemide. Management: Separate orally administered furosemide from sucralfate administration by at least 2 hours. Risk D: Consider therapy modification

Taurursodiol: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk X: Avoid combination

Teriflunomide: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Thyroid Products: Furosemide may decrease the protein binding of Thyroid Products. This may lead to a transient increase in free thyroid hormone concentrations and to a later decrease in total thyroid hormone concentrations. Risk C: Monitor therapy

Tobramycin (Oral Inhalation): Loop Diuretics may enhance the nephrotoxic effect of Tobramycin (Oral Inhalation). Loop Diuretics may enhance the ototoxic effect of Tobramycin (Oral Inhalation). Risk C: Monitor therapy

Topiramate: Loop Diuretics may enhance the hypokalemic effect of Topiramate. Risk C: Monitor therapy

Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Risk C: Monitor therapy

Xipamide: May enhance the adverse/toxic effect of Loop Diuretics. Specifically, the risk of hypovolemia, electrolyte disturbances, and prerenal azotemia may be increased. Risk C: Monitor therapy

Zoledronic Acid: Loop Diuretics may enhance the hypocalcemic effect of Zoledronic Acid. Risk C: Monitor therapy

Pregnancy Considerations

Furosemide crosses the placenta (Beerman 1978; Riva 1978).

Monitor fetal growth if used during pregnancy (ESC [Regitz-Zagrosek 2018]).

Chronic maternal hypertension is associated with adverse events in the fetus/infant. The risk of birth defects, low birth weight, premature delivery, stillbirth, and neonatal death may be increased with chronic hypertension in pregnancy. Actual risks may be related to duration and severity of maternal hypertension. If a diuretic is needed for the treatment of hypertension in pregnancy, other agents are preferred (ACOG 203 2019). Low dose furosemide may be considered in patients with preeclampsia and oliguria (ESC [Regitz-Zagrosek 2018]).

The treatment of edema associated with chronic heart failure during pregnancy is similar to that of nonpregnant patients. Use of diuretics may be considered but use with caution due to the potential reduction in placental blood flow. Patients diagnosed after delivery can be treated according to heart failure guidelines (ESC [Bauersachs 2016]; ESC [Regitz-Zagrosek 2018]).

Breastfeeding Considerations

Furosemide is present in breast milk.

The manufacturer recommends that caution be used if administered to a breastfeeding woman. In general, large doses of loop diuretics have the potential to decrease milk volume and suppress lactation; use should be avoided when possible (ACOG 203 2019; WHO 2002).

Dietary Considerations

May cause potassium loss; potassium supplement or dietary changes may be required.

Monitoring Parameters

Monitor fluid status and kidney function in an attempt to prevent oliguria, azotemia, and reversible increases in BUN and creatinine; close medical supervision of aggressive diuresis required; monitor fluid intake and output (inpatient setting) and weight daily; serum electrolytes (especially during rapid diuresis; therapy should not be initiated unless serum electrolytes, especially potassium, are normalized), kidney function; BP, orthostasis; monitor hearing with high doses or rapid IV administration.

Mechanism of Action

Primarily inhibits reabsorption of sodium and chloride in the ascending loop of Henle and proximal and distal renal tubules, interfering with the chloride-binding cotransport system, thus causing its natriuretic effect (Rose 1991).

Pharmacokinetics

Onset of action: Diuresis: Oral, sublingual (SL): 30 to 60 minutes.

Symptomatic improvement with acute pulmonary edema: Within 15 to 20 minutes; occurs prior to diuretic effect.

Peak effect: Oral, SL: 1 to 2 hours; IV: 0.5 hours.

Duration: Oral, SL: 6 to 8 hours; IV: 2 hours.

Protein binding: 91% to 99%; primarily to albumin.

Metabolism: Minimally hepatic.

Bioavailability: Oral tablet: 47% to 64%; Oral solution: 50%; SL administration of oral tablet: ~60%; results of a small comparative study (n=11) showed bioavailability of SL administration of tablet was ~12% higher than oral administration of tablet (Haegeli 2007).

Half-life elimination: Normal kidney function: 0.5 to 2 hours; End-stage kidney disease: 9 hours.

Excretion: Urine (Oral: 50%, IV: 80%) within 24 hours; feces (as unchanged drug); nonrenal clearance prolonged in kidney impairment.

Pricing: US

Cartridge Kit (Furoscix Subcutaneous)

80 mg/10 mL (per each): $986.40

Solution (Furosemide Injection)

10 mg/mL (per mL): $0.18 - $2.69

Solution (Furosemide Oral)

8 mg/mL (per mL): $0.10

10 mg/mL (per mL): $0.17

Tablets (Furosemide Oral)

20 mg (per each): $0.09 - $0.51

40 mg (per each): $0.09 - $0.59

80 mg (per each): $0.44 - $1.57

Tablets (Lasix Oral)

20 mg (per each): $0.94

40 mg (per each): $1.32

80 mg (per each): $2.13

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • A Xi Ya (CN);
  • A-Basedock (JP);
  • Accent (JP);
  • Aefur (PH);
  • Ai Ge (CN);
  • Akoset (MY);
  • Anfuramide (JP);
  • Aquarid (ZA);
  • Aquasin (ZW);
  • Arasemide (JP);
  • Asax (CL);
  • Biomisen (MX);
  • Busemida (CR, DO, GT, HN, NI, PA, SV);
  • Dailix (KR);
  • Daiteren F (JP);
  • Depix (JP);
  • Desal (PL);
  • Dirine (MY);
  • Diural (DK, NO, SE);
  • Diuren (ZW);
  • Diuresal (AE, BF, BH, BJ, CI, CY, ET, GH, GM, GN, IQ, IR, JO, KE, KW, LB, LR, LY, MA, ML, MR, MU, MW, NE, NG, OM, SA, SC, SD, SL, SN, SY, TN, TZ, UG, YE, ZM, ZW);
  • Diurmessel (CR, DO, GT, HN, NI, PA, SV);
  • Diusemide (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, QA, SC, SD, SL, SN, TN, TZ, UG, ZM, ZW);
  • Diuvar (ID);
  • Edemid (HR);
  • Errolon (AR);
  • Femide 500 (TH);
  • Foliront (JP);
  • Fretic (PH);
  • Fru (IN);
  • Frusedan (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZA, ZM, ZW);
  • Frusema (PH);
  • Frusid (HK, NZ);
  • Fruside (ZW);
  • Frusim (IN);
  • Frusovit (LK);
  • Fudesix (GR);
  • Fulsix (JP);
  • Fuluvamide (JP);
  • Furanthril (DE);
  • Furanturil (BG);
  • Furesis (FI);
  • Furetic (TH);
  • Furide (TW);
  • Furix (DK, NO, SE);
  • Furolix (LB);
  • Furomen (FI);
  • Furomex (CZ);
  • Furon (AT, CZ, HU);
  • Furorese (CZ, LU);
  • Furoretic (EG);
  • Furose (PH);
  • Furosedon (JP);
  • Furosemid (HR, HU);
  • Furosemid Pharmavit (HU);
  • Furosemid-ratiopharm (LU);
  • Furosemide-Eurogenerics (LU);
  • Furosemix (LU);
  • Furosix (BR);
  • Furostad (AT);
  • Furovenir (IL);
  • Fursemid (HR);
  • Fursemid[inj.] (HR);
  • Furusemide (JP);
  • Fuseride (TH);
  • Fusid (DE, IL);
  • Fusimex (PH);
  • Glosix (ID);
  • Impugan (DK, ID, SE);
  • Indiurex (PH);
  • Jufurix (DE);
  • Katlex (JP);
  • Kutrix (JP);
  • Lafurex (EG);
  • Lasilix (FR, MA, MT);
  • Lasix (AE, AT, AU, BB, BE, BF, BH, BJ, BM, BR, BS, BZ, CH, CI, CR, CU, CY, DK, DO, EC, EG, ET, GB, GH, GM, GN, GR, GT, GY, HK, HN, HR, IE, IN, IQ, IR, IT, JM, JO, KE, KR, KW, LB, LK, LR, LU, LY, MA, ML, MR, MU, MW, MX, MY, NE, NG, NI, NL, NZ, OM, PA, PE, PH, PK, PR, PT, PY, QA, RU, SA, SC, SD, SE, SG, SI, SL, SN, SR, SV, SY, TH, TN, TR, TT, TW, TZ, UG, UY, VE, VN, YE, ZM, ZW);
  • Lasix Retard (EE, IS, LT, NO, PT, SE);
  • Lasix[inj.] (HR);
  • Laveric (ID);
  • Lowpston (JP);
  • Luseck (JP);
  • Maoread (JP);
  • Naclex (ID);
  • Nadis (TW);
  • Odement (EG);
  • Odemex (CR, DO, GT, HN, NI, PA, SV);
  • Oedemex (AE, BH, CH, CY, IQ, IR, JO, KW, LY, OM, SA, SY, YE);
  • Pharmix (PH);
  • Promedes (JP);
  • Radisemide (AE, BF, BH, BJ, CI, CY, ET, GH, GM, GN, IQ, IR, JO, KE, KW, LR, LY, MA, ML, MR, MU, MW, NE, NG, OM, SA, SC, SD, SL, SN, SY, TN, TZ, UG, YE, ZM);
  • Radouna (JP);
  • Rasitol (MY, PH, SG, TW);
  • Releef (TZ);
  • Retep (AR);
  • Rosemide (PH);
  • Rosis (TW);
  • Roxemid (ID);
  • Salinex (IN);
  • Salurex (MT);
  • Salurin (AE, KW, SA);
  • Salutex (GR);
  • Seguril (ES);
  • Silax (ID);
  • Sofudac (ZW);
  • Solax (PY);
  • Synephron (JP);
  • Trofurit (HU);
  • Uremide (AU, NZ);
  • Uresix (ID);
  • Urex (AU, HK, JP, NZ);
  • Urex-M (AU);
  • Urimeg (PY);
  • Urinal (BH, JO);
  • Usix (VN);
  • Vusimide (MY)


For country code abbreviations (show table)
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