furosemide (Rx)

Brand and Other Names:Lasix
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injectable solution

  • 10mg/mL

oral solution

  • 10mg/mL
  • 8mg/mL

tablet

  • 20mg
  • 40mg
  • 80mg

Edema

Edema associated with congestive heart failure (CHF), liver cirrhosis, and renal disease, including nephrotic syndrome

20-80 mg PO once daily; may be increased by 20-40 mg q6-8hr; not to exceed 600 mg/day

Alternative: 20-40 mg IV/IM once; may be increased by 20 mg q2hr; individual dose not to exceed 200 mg/dose

Refractory CHF may necessitate larger doses

Hypertension, Resistant

20-80 mg PO divided q12hr

Acute Pulmonary Edema/Hypertensive Crisis/Increased Intracranial Pressure

0.5-1 mg/kg (or 40 mg) IV over 1-2 minutes; may be increased to 80 mg if there is no adequate response within 1 hour;not to exceed 160-200 mg/dose  

Hyperkalemia in Advanced Cardiac Life Support (ACLS)

40-80 mg IV

Hypermagnesemia in ACLS

20-40 mg IV q3-4hr PRN

Dosing Modifications

Acute renal failure: 1-3 g/day may be necessary to attain desired response; avoid use in oliguric states

Hepatic impairment: Monitor, especially with high dosages

Dosing Considerations

Use for fluid retention refractory to thiazides or impaired renal function

Overdose management

  • Normal saline may be used for volume replacement
  • Dopamine or norepinephrine may be used to treat hypotension
  • If dysrhythmia due to decreased potassium or magnesium is suspected, replace aggressively
  • Discontinue treatment if no symptoms are apparent after 6 hours

Dosage Forms & Strengths

injectable solution

  • 10mg/mL

oral solution

  • 10mg/mL
  • 8mg/mL

tablet

  • 20mg
  • 40mg
  • 80mg

Edema

Infants and children: 1-2 mg/kg IV/IM/PO once initially; increased by 1-2 mg/kg q6-8hr (PO) or 1 mg/kg q2hr (IV/IM); individual dose not to exceed 6 mg/kg  

Neonates (<28 days): 0.5-1 mg/kg IV/IM q8-24hr; individual dose not to exceed 2 mg/kg

Resistant Hypertension

<1 year: Safety and efficacy not established

1-17 years: 0.5-2 mg/kg PO q24hr or q12hr; individual dose not to exceed 6 mg/kg/dose  

Excessive diuresis may cause dehydration and electrolyte loss in elderly; lower initial dosages and more gradual adjustments are recommended (eg, 10 mg/day PO)

Increase in blood urea nitrogen (BUN) and loss of sodium may cause confusion in elderly; monitor renal function and electrolytes

Edema

20 mg/day PO/IV/IM initially; increased slowly until desired response is obtained

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Interactions

Interaction Checker

and furosemide

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              • amikacin

                furosemide, amikacin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • ethacrynic acid

                furosemide, ethacrynic acid. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Increased risk of ototoxicity.

              • gentamicin

                furosemide, gentamicin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • lofexidine

                lofexidine, furosemide. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              • neomycin PO

                furosemide, neomycin PO. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • paromomycin

                furosemide, paromomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • potassium phosphates, IV

                furosemide decreases effects of potassium phosphates, IV by increasing renal clearance. Avoid or Use Alternate Drug. Furosemide lowers phosphate serum levels by enhancing renal excretion. Use alternatives if available.

              • pretomanid

                pretomanid will increase the level or effect of furosemide by Other (see comment). Avoid or Use Alternate Drug. In vitro studies demonstrated that pretomanid significantly inhibits OAT3; monitor for increased adverse effects and consider dosage reduction for OAT3 substrates.

              • squill

                furosemide increases toxicity of squill by Other (see comment). Avoid or Use Alternate Drug. Comment: Potassium depletion may enhance toxicity of squill.

              • streptomycin

                furosemide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • tobramycin

                furosemide, tobramycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • triclofos

                triclofos, furosemide. unspecified interaction mechanism. Avoid or Use Alternate Drug. Combination may result in sweating, hot flashes, variable BP.

              Monitor Closely (160)

              • acebutolol

                acebutolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • aceclofenac

                aceclofenac increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • acemetacin

                acemetacin increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • albuterol

                albuterol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • aldesleukin

                aldesleukin increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • aliskiren

                aliskiren decreases levels of furosemide by unspecified interaction mechanism. Use Caution/Monitor.

              • amifostine

                amifostine, furosemide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

              • amiloride

                amiloride increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • arformoterol

                arformoterol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • aspirin

                aspirin increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • aspirin rectal

                aspirin rectal increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • atenolol

                atenolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • avanafil

                avanafil increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • beclomethasone, inhaled

                beclomethasone, inhaled increases toxicity of furosemide by increasing elimination. Use Caution/Monitor. Corticosteroids may increase the hypkalemic effects of loop diuretics.

              • benazepril

                benazepril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • bendroflumethiazide

                furosemide and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.

              • betaxolol

                betaxolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • bisoprolol

                bisoprolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • bretylium

                furosemide, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.

              • bumetanide

                bumetanide and furosemide both decrease serum potassium. Use Caution/Monitor.

              • buprenorphine, long-acting injection

                buprenorphine, long-acting injection decreases effects of furosemide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Opioids can reduce diuretic efficacy by inducing antidiuretic hormone release.

              • cabozantinib

                furosemide will increase the level or effect of cabozantinib by Other (see comment). Use Caution/Monitor. MRP2 inhibitors increase cabozantinib toxicity

              • candesartan

                candesartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • captopril

                captopril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • carbenoxolone

                furosemide and carbenoxolone both decrease serum potassium. Use Caution/Monitor.

              • carbidopa

                carbidopa increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.

              • carvedilol

                carvedilol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cefprozil

                furosemide will increase the level or effect of cefprozil by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • celecoxib

                celecoxib increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • celiprolol

                celiprolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorothiazide

                furosemide and chlorothiazide both decrease serum potassium. Use Caution/Monitor.

              • chlorthalidone

                furosemide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.

              • cholestyramine

                cholestyramine decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • ciprofibrate

                ciprofibrate, furosemide. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. Increased risk in hypoalbuminemia.

              • cisplatin

                furosemide, cisplatin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive ototoxicity.

              • citalopram

                furosemide, citalopram. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.

              • cornsilk

                cornsilk increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).

              • cyclopenthiazide

                furosemide and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.

              • cyclosporine

                cyclosporine increases toxicity of furosemide by Other (see comment). Use Caution/Monitor. Comment: Concomitant use of cyclosporine and furosemide is associated with increased risk of gouty arthritis secondary to furosemide-induced hyperurecemia and cyclosporine impairment of renal urate excretion.

              • deflazacort

                furosemide and deflazacort both decrease serum potassium. Use Caution/Monitor.

              • dichlorphenamide

                dichlorphenamide and furosemide both decrease serum potassium. Use Caution/Monitor.

              • diclofenac

                diclofenac increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • diflunisal

                diflunisal increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • digoxin

                digoxin increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                furosemide increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Hypokalemia increases digoxin effects.

              • dobutamine

                dobutamine and furosemide both decrease serum potassium. Use Caution/Monitor.

              • dopexamine

                dopexamine and furosemide both decrease serum potassium. Use Caution/Monitor.

              • drospirenone

                drospirenone increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • empagliflozin

                empagliflozin, furosemide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of empagliflozin with diuretics results in increased urine volume and frequency of voids, which might enhance the potential for volume depletion.

              • enalapril

                enalapril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • ephedrine

                ephedrine and furosemide both decrease serum potassium. Use Caution/Monitor.

              • epinephrine

                epinephrine and furosemide both decrease serum potassium. Use Caution/Monitor.

              • epinephrine racemic

                epinephrine racemic and furosemide both decrease serum potassium. Use Caution/Monitor.

              • eprosartan

                eprosartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • esmolol

                esmolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ethacrynic acid

                ethacrynic acid and furosemide both decrease serum potassium. Use Caution/Monitor.

              • etodolac

                etodolac increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fenofibrate micronized

                fenofibrate micronized, furosemide. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. Increased risk in hypoalbuminemia.

              • fenofibric acid

                fenofibric acid, furosemide. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. Increased risk in hypoalbuminemia.

              • fenoprofen

                fenoprofen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fentanyl

                fentanyl decreases effects of furosemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • fentanyl intranasal

                fentanyl intranasal decreases effects of furosemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • fentanyl transdermal

                fentanyl transdermal decreases effects of furosemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • fentanyl transmucosal

                fentanyl transmucosal decreases effects of furosemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • flurbiprofen

                flurbiprofen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • formoterol

                formoterol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • fosinopril

                fosinopril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • gentamicin

                furosemide and gentamicin both decrease serum potassium. Use Caution/Monitor.

              • hyaluronidase

                hyaluronidase, furosemide. Other (see comment). Use Caution/Monitor. Comment: Drug combination has been found to be incompatible.

              • hydrochlorothiazide

                furosemide and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.

              • ibuprofen

                ibuprofen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ibuprofen IV

                ibuprofen IV increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • imidapril

                imidapril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • indacaterol, inhaled

                furosemide, indacaterol, inhaled. serum potassium. Use Caution/Monitor. Combination may increase risk of hypokalemia.

                indacaterol, inhaled, furosemide. Other (see comment). Use Caution/Monitor. Comment: Caution is advised in the coadministration of indacaterol neohaler with non-potassium-sparing diuretics.

              • indapamide

                furosemide and indapamide both decrease serum potassium. Use Caution/Monitor.

              • indomethacin

                indomethacin increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • insulin degludec

                furosemide decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.

              • insulin degludec/insulin aspart

                furosemide decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.

              • insulin inhaled

                furosemide decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.

              • irbesartan

                irbesartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • isoproterenol

                isoproterenol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • juniper

                juniper, furosemide. Other (see comment). Use Caution/Monitor. Comment: Juniper may potentiate or interfere with diuretic therapy. Juniper has diuretic effects, but may cause kidney damage at large doses.

              • ketoprofen

                ketoprofen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ketorolac

                ketorolac increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ketorolac intranasal

                ketorolac intranasal increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • labetalol

                labetalol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • levalbuterol

                levalbuterol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • levodopa

                levodopa increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.

              • lily of the valley

                furosemide increases toxicity of lily of the valley by Other (see comment). Use Caution/Monitor. Comment: Increased risk of cardiac toxicity due to K+ depletion.

              • lisinopril

                lisinopril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • lornoxicam

                lornoxicam increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • losartan

                losartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lurasidone

                lurasidone increases effects of furosemide by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

              • maitake

                maitake increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).

              • maraviroc

                maraviroc, furosemide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.

              • meclofenamate

                meclofenamate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • mefenamic acid

                mefenamic acid increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • meloxicam

                meloxicam increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metaproterenol

                metaproterenol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • methyclothiazide

                furosemide and methyclothiazide both decrease serum potassium. Use Caution/Monitor.

              • metolazone

                furosemide and metolazone both decrease serum potassium. Use Caution/Monitor.

              • metoprolol

                metoprolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • moexipril

                moexipril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • mometasone inhaled

                mometasone inhaled increases toxicity of furosemide by Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may increase hypokalemic effect of loop diuretics.

              • nabumetone

                nabumetone increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nadolol

                nadolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • naproxen

                naproxen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nebivolol

                nebivolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nitroglycerin rectal

                nitroglycerin rectal, furosemide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .

              • norepinephrine

                norepinephrine and furosemide both decrease serum potassium. Use Caution/Monitor.

              • oliceridine

                oliceridine decreases effects of furosemide by Other (see comment). Use Caution/Monitor. Comment: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. Monitor for signs of diminished diuresis and/or effects on blood pressure and increase dosage of the diuretic as needed. .

              • olmesartan

                olmesartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • olodaterol inhaled

                furosemide and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.

              • ombitasvir/paritaprevir/ritonavir & dasabuvir

                ombitasvir/paritaprevir/ritonavir & dasabuvir will increase the level or effect of furosemide by unspecified interaction mechanism. Use Caution/Monitor. Adjust furosemide dose according to individual response

              • ospemifene

                furosemide, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

              • oxaprozin

                oxaprozin increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • parecoxib

                parecoxib increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • penbutolol

                penbutolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • perindopril

                perindopril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • pindolol

                pindolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pirbuterol

                pirbuterol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • piroxicam

                piroxicam increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • potassium acid phosphate

                potassium acid phosphate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • potassium chloride

                potassium chloride increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • potassium citrate

                potassium citrate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • propranolol

                propranolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • quinapril

                quinapril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • ramipril

                ramipril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • sacubitril/valsartan

                sacubitril/valsartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • salicylates (non-asa)

                salicylates (non-asa) increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • salmeterol

                salmeterol and furosemide both decrease serum potassium. Use Caution/Monitor.

              • salsalate

                salsalate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • sodium phosphates, IV

                furosemide decreases effects of sodium phosphates, IV by increasing renal clearance. Modify Therapy/Monitor Closely. Furosemide lowers phosphate serum levels by enhancing renal excretion. Use alternatives if available.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of furosemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of furosemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

                furosemide and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.

              • sodium zirconium cyclosilicate

                sodium zirconium cyclosilicate will increase the level or effect of furosemide by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate administration by at least 2 hr. Medications that are weak acids (eg, furosemide) are more readily absorbed with elevated gastric pH.

              • sotalol

                sotalol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • spironolactone

                spironolactone increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • succinylcholine

                succinylcholine increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • sucralfate

                sucralfate decreases effects of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Simultaneous administration of sucralfate and furosemide Injection may reduce the natriuretic and antihypertensive effects of furosemide; patients receiving both drugs should be observed closely to determine if desired diuretic and/or antihypertensive effect of furosemide achieved; intake of furosemide and sucralfate should be separated by at least 2 hr.

              • sulfasalazine

                sulfasalazine increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • sulindac

                sulindac increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tadalafil

                tadalafil increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • telmisartan

                telmisartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • terbutaline

                terbutaline and furosemide both decrease serum potassium. Use Caution/Monitor.

              • timolol

                timolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tobramycin inhaled

                tobramycin inhaled, furosemide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent use if possible; theorized mechanisms include rapid injection of loop diuretics, existing renal impairment, or volume depletion leading to increased aminoglycoside concentration within the nephron.

              • tolfenamic acid

                tolfenamic acid increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tolmetin

                tolmetin increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tolvaptan

                tolvaptan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • torsemide

                furosemide and torsemide both decrease serum potassium. Use Caution/Monitor.

              • trandolapril

                trandolapril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • triamterene

                triamterene increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • trientine

                furosemide decreases levels of trientine by increasing renal clearance. Use Caution/Monitor.

              • umeclidinium bromide/vilanterol inhaled

                umeclidinium bromide/vilanterol inhaled and furosemide both decrease serum potassium. Modify Therapy/Monitor Closely. Electrocardiographic changes and/or hypokalemia associated with non?potassium-sparing diuretics may worsen with concomitant beta-agonists, particularly if recommended dose is exceeded

              • valsartan

                valsartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • vilanterol/fluticasone furoate inhaled

                vilanterol/fluticasone furoate inhaled and furosemide both decrease serum potassium. Modify Therapy/Monitor Closely. Beta-agonists may acutely worsen ECG changes and/or hypokalemia resulting from non-potassium-sparing diuretics

              • xipamide

                xipamide increases effects of furosemide by pharmacodynamic synergism. Use Caution/Monitor.

              Minor (134)

              • aceclofenac

                aceclofenac decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • acemetacin

                acemetacin decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • agrimony

                agrimony increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • albuterol

                albuterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • arformoterol

                arformoterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • aspirin

                aspirin decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • aspirin rectal

                aspirin rectal decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • birch

                birch increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • bitter melon

                bitter melon, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • brimonidine

                brimonidine increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • budesonide

                budesonide, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • calcium acetate

                furosemide decreases levels of calcium acetate by increasing renal clearance. Minor/Significance Unknown.

              • calcium carbonate

                furosemide decreases levels of calcium carbonate by increasing renal clearance. Minor/Significance Unknown.

              • calcium chloride

                furosemide decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.

              • calcium citrate

                furosemide decreases levels of calcium citrate by increasing renal clearance. Minor/Significance Unknown.

              • calcium gluconate

                furosemide decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.

              • carbenoxolone

                furosemide, carbenoxolone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.

              • cefaclor

                cefaclor increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefadroxil

                cefadroxil increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefamandole

                cefamandole increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefazolin

                cefazolin increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefdinir

                cefdinir increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefditoren

                cefditoren increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefepime

                cefepime increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefixime

                cefixime increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefotetan

                cefotetan increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefoxitin

                cefoxitin increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefpirome

                cefpirome increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefpodoxime

                cefpodoxime increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefprozil

                cefprozil increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • ceftazidime

                ceftazidime increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • ceftibuten

                ceftibuten increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • ceftriaxone

                ceftriaxone increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cefuroxime

                cefuroxime increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • celecoxib

                celecoxib decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • cephalexin

                cephalexin increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.

              • cephaloridine

                furosemide, cephaloridine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive nephrotoxicity.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • colestipol

                colestipol decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • corticotropin

                corticotropin, furosemide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

              • cortisone

                cortisone, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • cosyntropin

                cosyntropin, furosemide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

              • deflazacort

                deflazacort, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • dexamethasone

                dexamethasone, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • diclofenac

                diclofenac decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • diflunisal

                diflunisal decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • dobutamine

                dobutamine, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • dopexamine

                dopexamine, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • duloxetine

                furosemide, duloxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • ephedrine

                ephedrine, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • epinephrine

                epinephrine, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • epinephrine racemic

                epinephrine racemic, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • epoprostenol

                epoprostenol increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

              • escitalopram

                furosemide, escitalopram. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • ethotoin

                ethotoin decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • etodolac

                etodolac decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • fenoprofen

                fenoprofen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • fludrocortisone

                fludrocortisone, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • fluoxetine

                furosemide, fluoxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • flurbiprofen

                flurbiprofen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • fo-ti

                fo-ti increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia (theoretical).

              • folic acid

                furosemide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.

              • formoterol

                formoterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • forskolin

                forskolin increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • fosphenytoin

                fosphenytoin decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • germanium

                germanium decreases effects of furosemide by unknown mechanism. Minor/Significance Unknown. Case report.

              • goldenrod

                goldenrod increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • hydrocortisone

                hydrocortisone, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • ibuprofen

                ibuprofen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • ibuprofen IV

                ibuprofen IV decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • indomethacin

                indomethacin decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • isoproterenol

                isoproterenol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • ketoprofen

                ketoprofen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • ketorolac

                ketorolac decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • ketorolac intranasal

                ketorolac intranasal decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • L-methylfolate

                furosemide decreases levels of L-methylfolate by increasing renal clearance. Minor/Significance Unknown.

              • levalbuterol

                levalbuterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • levomilnacipran

                furosemide, levomilnacipran. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • levothyroxine

                furosemide increases toxicity of levothyroxine by Other (see comment). Minor/Significance Unknown. Comment: High doses (greater than 80 mg) of furosemide may inhibit binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by overall decrease in total thyroid hormone levels.

              • liothyronine

                furosemide increases toxicity of liothyronine by Other (see comment). Minor/Significance Unknown. Comment: High doses (greater than 80 mg) of furosemide may inhibit binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by overall decrease in total thyroid hormone levels.

              • liotrix

                furosemide increases toxicity of liotrix by Other (see comment). Minor/Significance Unknown. Comment: High doses (greater than 80 mg) of furosemide may inhibit binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by overall decrease in total thyroid hormone levels.

              • lornoxicam

                lornoxicam decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • magnesium chloride

                furosemide decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.

              • magnesium citrate

                furosemide decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.

              • magnesium hydroxide

                furosemide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium oxide

                furosemide decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium sulfate

                furosemide decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.

              • meclofenamate

                meclofenamate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • mefenamic acid

                mefenamic acid decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • meloxicam

                meloxicam decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • metaproterenol

                metaproterenol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • metformin

                metformin decreases levels of furosemide by unspecified interaction mechanism. Minor/Significance Unknown.

                furosemide increases levels of metformin by unspecified interaction mechanism. Minor/Significance Unknown. Patient should be closely observed for loss of blood glucose control; when drugs are withdrawn from a patient receiving metformin, patient should be observed closely for hypoglycemia.

              • methylprednisolone

                methylprednisolone, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • milnacipran

                furosemide, milnacipran. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • minoxidil

                furosemide increases effects of minoxidil by pharmacodynamic synergism. Minor/Significance Unknown.

              • nabumetone

                nabumetone decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • naproxen

                naproxen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • nefazodone

                furosemide, nefazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • noni juice

                noni juice increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

              • norepinephrine

                norepinephrine, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • octacosanol

                octacosanol increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • oxaprozin

                oxaprozin decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • parecoxib

                parecoxib decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • paroxetine

                furosemide, paroxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • penicillin G aqueous

                furosemide increases levels of penicillin G aqueous by decreasing renal clearance. Minor/Significance Unknown.

              • penicillin VK

                furosemide increases levels of penicillin VK by decreasing renal clearance. Minor/Significance Unknown.

              • phenobarbital

                phenobarbital decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • phenytoin

                phenytoin decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pirbuterol

                pirbuterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • piroxicam

                piroxicam decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • prednisolone

                prednisolone, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • prednisone

                prednisone, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • reishi

                reishi increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • salicylates (non-asa)

                salicylates (non-asa) decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • salmeterol

                salmeterol, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • salsalate

                salsalate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • sertraline

                furosemide, sertraline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • shepherd's purse

                shepherd's purse, furosemide. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.

              • sulfadiazine

                furosemide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • sulfamethoxazole

                furosemide increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • sulfasalazine

                sulfasalazine decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • sulfisoxazole

                furosemide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • sulindac

                sulindac decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • terbutaline

                terbutaline, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

                furosemide, terbutaline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.

              • thiamine

                furosemide decreases levels of thiamine by increasing renal clearance. Minor/Significance Unknown.

              • tizanidine

                tizanidine increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

              • tolfenamic acid

                tolfenamic acid decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • tolmetin

                tolmetin decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • trazodone

                furosemide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • treprostinil

                treprostinil increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • triamcinolone acetonide injectable suspension

                triamcinolone acetonide injectable suspension, furosemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • venlafaxine

                furosemide, venlafaxine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • zoledronic acid

                furosemide, zoledronic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypocalcemia.

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              Adverse Effects

              >10%

              Hyperuricemia (40%)

              Hypokalemia (14-60%)

              Frequency Not Defined

              Anaphylaxis

              Anemia

              Anorexia

              Diarrhea

              Dizziness

              Glucose intolerance

              Glycosuria

              Headache

              Hearing impairment

              Hyperuricemia

              Hypocalcemia

              Hypokalemia

              Hypomagnesemia

              Hypotension

              Increased patent ductus arteriosus during neonatal period

              Muscle cramps

              Nausea

              Photosensitivity

              Rash

              Restlessness

              Tinnitus

              Urinary frequency

              Urticaria

              Vertigo

              Weakness

              Postmarketing Reports

              Toxic epidermal necrolysis, Stevens-Johnson Syndrome, erythema multiforme, drug rash with eosinophila and systemic symptoms, acute generalized exanthematous pustulosis, exfoliative dermatitis, bullous pemphigoid purpura, pruritus

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              Warnings

              Black Box Warnings

              Agent is potent diuretic that, if given in excessive amounts, may lead to profound diuresis with water and electrolyte depletion

              Careful medical supervision is required; dosing must be adjusted to patient's needs

              Contraindications

              Documented hypersensitivity to furosemide or sulfonamides

              Anuria

              Cautions

              Use caution in systemic lupus erythematosus, liver disease, renal impairment

              Concomitant ethacrynic acid therapy (increases risk of ototoxicity)

              Risks of fluid or electrolyte imbalance (including causing hyperglycemia, hyperuricemia, gout), hypotension, metabolic alkalosis, severe hyponatremia, severe hypokalemia, hepatic coma and precoma, hypovolemia (with or without hypotension)

              Do not commence therapy in hepatic coma and in electrolyte depletion until improvement is noted

              IV route twice as potent as PO

              Food delays absorption but not diuretic response

              May exacerbate lupus

              Possibility of skin sensitivity to sunlight

              Prolonged use in premature neonates may cause nephrocalcinosis

              Efficacy is diminished and risk of ototoxicity increased in patients with hypoproteinemia (associated with nephrotic syndrome); ototoxicity is associated with rapid injection, severe renal impairment, use of higher than recommended doses, concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs

              To prevent oliguria, reversible increases in BUN and creatinine, and azotemia, monitor fluid status and renal function; discontinue therapy if azotemia and oliguria occur during treatment of severe progressive renal disease

              FDA-approved product labeling for many medications have included a broad contraindication in patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely to occur

              In cirrhosis, electrolyte and acid/base imbalances may lead to hepatic encephalopathy; prior to initiation of therapy, correct electrolyte and acid/base imbalances, when hepatic coma is present

              High doses (> 80 mg) of furosemide may inhibit binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by overall decrease in total thyroid hormone levels

              In patients at high risk for radiocontrast nephropathy furosemide can lead to higher incidence of deterioration in renal function after receiving radiocontrast compared to high-risk patients who received only intravenous hydration prior to receiving radiocontrast

              Observe patients regularly for possible occurrence of blood dyscrasias, liver or kidney damage, or other idiosyncratic reactions

              Cases of tinnitus and reversible or irreversible hearing impairment and deafness reported

              Hearing loss in neonates has been associated with use of furosemide injection; in premature neonates with respiratory distress syndrome, diuretic treatment with furosemide in the first few weeks of life may increase risk of persistent patent ductus arteriosus (PDA), possibly through a prostaglandin-E-mediated process

              Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in elderly patients

              Increases in blood glucose and alterations in glucose tolerance tests (with abnormalities of fasting and 2 hour postprandial sugar) have been observed, and rarely, precipitation of diabetes mellitus reported

              Patients with severe symptoms of urinary retention (because of bladder emptying disorders, prostatic hyperplasia, urethral narrowing), the administration of furosemide can cause acute urinary retention related to increased production and retention of urine; these patients require careful monitoring, especially during initial stages of treatment

              Hypokalemia may develop with furosemide, especially with brisk diuresis, inadequate oral electrolyte intake, when cirrhosis is present, or during concomitant use of corticosteroids, ACTH, licorice in large amounts, or prolonged use of laxatives

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              Pregnancy & Lactation

              Pregnancy category: C; treatment during pregnancy necessitates monitoring of fetal growth because of risk for higher fetal birth weights

              Lactation: Drug excreted into breast milk; use with caution; may inhibit lactation

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Loop diuretic; inhibits reabsorption of sodium and chloride ions at proximal and distal renal tubules and loop of Henle; by interfering with chloride-binding cotransport system, causes increases in water, calcium, magnesium, sodium, and chloride

              Absorption

              Bioavailability: 47-64% (PO)

              Onset: 30-60 min (PO/SL); 30 min (IM); 5 min (IV)

              Peak effect: <15 min (IV); 1-2 hr (PO/SL)

              Duration: 2 hr (IV); 6-8 hr (PO)

              Distribution

              Protein bound: 91-99%

              Vd: 0.2 L/kg

              Metabolism

              Metabolized in liver (~10%)

              Metabolite: Glucuronide (2-amino-4-chloro-5-sulfamoylanthranilic acid [saluamine]) (activity unknown)

              Elimination

              Half-life: 30-120 min (normal renal function); 9 hr (end-stage renal disease)

              Dialyzable: No

              Renal clearance: 2 mL/min/kg

              Excretion: Urine (PO, 50%; IV, 80%)

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              Administration

              IV Incompatibilities

              Solution: Fructose10W, invert sugar 10% in multiple electrolyte #2

              Additive: Amiodarone (at high concentrations of both drugs), buprenorphine, chlorpromazine, diazepam, dobutamine, eptifibatide, erythromycin lactobionate, gentamicin(?), hydrocortisone(?), isoproterenol, meperidine, metoclopramide, netilmicin, papaveretum, prochlorperazine, promethazine

              Syringe: Caffeine, doxapram, doxorubicin, eptifibatide, metoclopramide, milrinone, droperidol, vinblastine, vincristine

              Y-site: Alatrofloxacin, amiodarone (incompatible at furosemide 10 mg/mL; possibly compatible at 1 mg/mL), chlorpromazine, ciprofloxacin, cisatracurium (incompatible at cisatracurium >2 mg/mL; possibly compatible at 0.1 mg/mL), clarithromycin, diltiazem, diphenhydramine, dobutamine, dopamine, doxorubicin (incompatible at furosemide 10 mg/mL and doxorubicin 2 mg/mL; possibly compatible at furosemide 3 mg/mL and doxorubicin 0.2 mg/mL), droperidol, eptifibatide, esmolol, famotidine(?), fenoldopam, gatifloxacin, gemcitabine, gentamicin(?), hydralazine, idarubicin, labetalol, levofloxacin, meperidine, metoclopramide, midazolam, milrinone, morphine, netilmicin, nicardipine, ondansetron, quinidine, thiopental, vecuronium, vinblastine, vincristine, vinorelbine

              Not specified: Tetracycline

              IV Compatibilities

              Additive: Cimetidine, epinephrine, heparin, nitroglycerin, potassium chloride, verapamil

              Syringe: Heparin

              Y-site: Epinephrine, fentanyl, heparin, norepinephrine, nitroglycerin, potassium chloride, verapamil(?), vitamins B and C

              IV Preparation

              Solution: No preparation needed (available form: 10 mg/mL)

              IV Administration

              Injection: Inject directly or into tubing of actively running IV over 1-2 minutes

              Administer undiluted IV injections at rate of 20-40 mg/min; not to exceed 4 mg/min for short-term intermittent infusion; in children, give 0.5 mg/kg/min, titrated to effect

              Use infusion solution within 24 hours

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Lasix oral
              -
              20 mg tablet
              Lasix oral
              -
              80 mg tablet
              Lasix oral
              -
              40 mg tablet
              furosemide injection
              -
              10 mg/mL solution
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL solution
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide injection
              -
              10 mg/mL vial
              furosemide oral
              -
              80 mg tablet
              furosemide oral
              -
              20 mg tablet
              furosemide oral
              -
              20 mg tablet
              furosemide oral
              -
              40 mg tablet
              furosemide oral
              -
              80 mg tablet
              furosemide oral
              -
              80 mg tablet
              furosemide oral
              -
              80 mg tablet
              furosemide oral
              -
              40 mg tablet
              furosemide oral
              -
              20 mg tablet
              furosemide oral
              -
              40 mg tablet
              furosemide oral
              -
              20 mg tablet
              furosemide oral
              -
              20 mg tablet
              furosemide oral
              -
              40 mg tablet
              furosemide oral
              -
              40 mg tablet
              furosemide oral
              -
              20 mg tablet
              furosemide oral
              -
              80 mg tablet
              furosemide oral
              -
              40 mg tablet
              furosemide oral
              -
              80 mg tablet
              furosemide oral
              -
              10 mg/mL solution
              furosemide oral
              -
              10 mg/mL solution
              furosemide oral
              -
              40 mg/5 mL (8 mg/mL) solution
              furosemide oral
              -
              10 mg/mL solution
              furosemide oral
              -
              10 mg/mL solution

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

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              Patient Education
              furosemide injection

              FUROSEMIDE - INJECTION

              (fure-OH-se-mide)

              COMMON BRAND NAME(S): Lasix

              USES: This medication is known as a diuretic (like a "water pill"). It helps your body get rid of extra water by increasing the amount of urine you make. Getting rid of extra water decreases the strain on your heart and blood vessels, thereby lowering high blood pressure and reducing your risk of strokes, heart attacks, and kidney problems. This effect can also improve symptoms such as trouble breathing and swelling (edema). This injectable form of furosemide is used when the drug cannot be taken by mouth, especially in patients with severe medical conditions.

              HOW TO USE: This medication is given by injection into a muscle or slowly into a vein as directed by your doctor. The dosage is based on your age, medical condition, and response to treatment. In children, the dosage is also based on weight.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.Tell your doctor if your condition persists or worsens.

              SIDE EFFECTS: Dizziness, lightheadedness, headache, blurred vision, loss of appetite, stomach upset, diarrhea, or constipation may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may lead to dehydration and electrolytes imbalance. Tell your doctor right away if you have any of these unlikely but serious symptoms: muscle cramps, weakness, confusion, severe dizziness, drowsiness, unusual dry mouth, unusual increased thirst, nausea/vomiting, fast/irregular heartbeat, fainting, seizures.Tell your doctor right away if you have any serious side effects, including: signs of kidney problems (such as change in the amount of urine), easy bleeding/bruising, hearing loss, ringing in the ears, numbness/tingling of the arms/legs, stomach/abdominal pain, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using furosemide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, gout, lupus.If you have diabetes, furosemide may make it harder to control your blood sugar levels. Monitor your blood sugar levels regularly and inform your doctor of the results.This drug may reduce the potassium levels in your blood. Ask your doctor about adding potassium to your diet. A potassium supplement may be prescribed by your doctor.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist that you are taking this medication.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).To minimize dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Babies born early (premature infants) and children may be more sensitive to certain effects of this drug, such as kidney stones.Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially dizziness.Furosemide should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.This drug passes into breast milk and may affect milk production. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: desmopressin, ethacrynic acid, lithium.Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).This medication may interfere with certain lab tests (such as thyroid hormone levels), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: a severe decrease in amount of urine, weakness, fast/irregular heartbeat.

              NOTES: Do not share this medication with others.Laboratory and/or medical tests (e.g., kidney function tests, blood mineral levels such as sodium/potassium) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.