Apo-Furosemide

Country of origin - Canada, Vector-Farm Russia
Pharm-Group - Loop diuretics

Manufacturers - Apotex Inc (Canada), Vector-Farm (Russia)
International name - Furosemide
Synonyms - Diusemide, Difurex, Kinex, Lasix, Novo-Semid, Tasek, Tasimaid, Urix, Florix, Frusemide, Furon, Furorese, Furosemide, Furosemide (Mifar), Furosemide Lannacher, Furosemide Nycomed, Furosemide-Milve, Furosemide-Ratiopharm, Furosemide -Teva, Fursemid
Dosage forms - tablets 20 mg, tablets 40 mg
Composition - Active substance - furosemide.

Indications for use - Chronic heart failure, pulmonary edema, hypertensive crisis, edematous-ascitic syndrome in liver cirrhosis, renal failure, nephrotic syndrome, severe hypernatremia, hypercalcemia and hypermagnesemia.

Contraindications - Hypersensitivity (including to sulfonamides), hepatic coma, severe electrolyte imbalance, hypokalemia, severe liver and kidney failure, oliguria for more than 24 hours, anuria, gout, hyperuricemia, diabetes mellitus or impaired carbohydrate tolerance , decompensated mitral or aortic stenosis, increased pressure in the jugular vein over 10 mm Hg, hypertrophic cardiomyopathy with obstruction of the left ventricular outflow tract, hypotension, myocardial infarction, systemic lupus erythematosus, pancreatitis, metabolic alkalosis.

Side effect - Hypotension, incl. postural, collapse, thromboembolism, thrombophlebitis (mainly in the elderly), hypokalemia, hypomagnesemia, hyponatremia, impaired glucose tolerance, hyperuricemia, gout, increased LDL cholesterol (at high doses), impaired acid-base balance (hypochloremic alkalosis), hypercalciuria, impaired liver function , intrahepatic cholestasis, pancreatitis, diarrhea, constipation, nausea, vomiting, anorexia, inner ear damage, hearing loss, blurred vision, confusion, nervousness, headache, dizziness, paresthesia, weakness, muscle spasm, bladder spasm, chills, fever , thrombocytopenia, aplastic anemia, leukopenia, systemic vasculitis, interstitial nephritis, hematuria, necrotizing angiitis, exfoliative dermatitis, erythema multiforme, impotence, photosensitivity, urticaria, itching.

Interaction - Aminoglycosides, ethacrynic acid and cisplatin increase ototoxicity (especially in cases of impaired renal function). Increases the risk of kidney damage against the background of amphotericin B. When prescribing high doses of salicylates, the risk of developing salicylism (competitive renal excretion), cardiac glycosides - hypokalemia and associated arrhythmia, and corticosteroids - electrolyte imbalance increases. Reduces the muscle relaxant activity of tubocurarine and potentiates the effect of succinylcholine. Reduces renal clearance (and increases the likelihood of intoxication) of lithium. Under the influence of furosemide, the effect of ACE inhibitors and antihypertensive drugs, warfarin, diazoxide, theophylline increases, and the effect of antidiabetic drugs, norepinephrine is weakened. Sucralfate and indomethacin (due to inhibition of PG synthesis, disruption of plasma renin levels and aldosterone excretion) reduce effectiveness. Probenecid increases serum concentrations (blocks excretion).

Overdose - Symptoms: hypotension, decreased central nervous system, hypokalemia and hypochloremic alkalosis. Treatment: maintenance of vital functions.

Special instructions - In the presence of ascites without peripheral edema, it is recommended to use in doses that provide additional diuresis in a volume of no more than 700-900 ml per day in order to avoid the development of oliguria, azotemia and disturbances in electrolyte metabolism. In order to exclude the “rebound” phenomenon in the treatment of arterial hypertension, it is prescribed at least 2 times a day. WITH