Frusemide

It is a strong diuretic but lacks specific anti-hypertensive action (has no direct effect on resistance vessels).Thus antihypertensive efficacy is directly related to diuretic potency.Fall in BP is due only to reduced plasma extracellular fluid volume.

Indications

Oedema in congestive heart failure, hepatic and renal disease. Cerebral oedema, forced diuresis for poisoning, toxaemia of pregnancy. Hypertension and hypertensive crisis.

Dosage

Adult: 20-80 mg as single dose. If satisfactory results are not obtained then 20-40 mg after 6 hrs. Infants & Children upto 12 yrs: 2 mg/kg bodywt increased by 1-2 mg/kg 6-8 hrs after the previous dose. Max. 40 mg/day.

Contra-Indications

Renal failure with anuria, potassium deficiency (i.e. malnutrition, diarrhoea). Hypersensitivity to frusemide & sulphonamides, hypokalaemia and/or hyponatraemia & hepatic coma. Hypovolaemia with/without hypotension.

Special Precautions

Electrolyte imbalance (monitor serum electrolytes). Paediatrics: Can be used safely. Pregnancy: Contraindicated. lactation: Used if clearly indicated. Elderly: Increased risk of side effects. Dose to be reduced.

Side Effects

Vertigo, visual impairment, sodium deficiency may cause orthostatic hypotension, calf muscle cramps, anorexia, weakness, dizziness, drowsiness, vomiting, hyperuricaemia reduced glucose tolerance, deafness.

Drug Interactions

Aminoglycoside antibiotics may enhance the risk of deafness, potentiates anti-hypertensives, causes litihum toxicity in those receiving both drugs. With cotrimoxazole produces thrombocytopenia. NSAIDs diminish the diuretic effects.