Indications

Frusin (Furosemide) is a loop diuretic indicated for treating fluid retention and hypertension.

• Fluid retention (edema): Associated with chronic congestive cardiac failure, acute congestive cardiac failure, chronic renal failure, acute renal failure, nephrotic syndrome, and liver disease.
• Hypertension: As a single agent or in combination with other antihypertensive drugs.
• Hypertensive crisis.
• Support of forced diuresis.

Pharmacology

Furosemide is a highly effective diuretic that works by inhibiting the reabsorption of sodium and chloride in the thick ascending limb of the loop of Henle in the kidney. This action is independent of acid-base balance changes and leads to a significant increase in urine output. It has a rapid onset of action, typically within an hour of oral administration or 5 minutes of IV injection.

Dosage & Administration

• Edema (Adults): Initial dose is 40 mg daily, which can be adjusted. For resistant edema, doses can be as high as 80-120 mg daily. In severe cases, doses may be titrated up to 600 mg/day.
• Edema (Children): Neonates receive 0.5-2 mg/kg every 12-24 hours. Children aged 1 month to 12 years receive 0.5-2 mg/kg 2-3 times daily, with a maximum of 12 mg/kg daily (not to exceed 80 mg daily).
• Hypertension (Adults): Initial dose is 80 mg, usually divided into two 40 mg doses.
• Hypertension (Children): 1-3 mg/kg daily, up to a maximum of 40 mg/day.
• Advanced Chronic Renal Failure: A single oral dose of 250 mg may be used initially.
• Parenteral Administration: For adults, 20-50 mg can be given intramuscularly or intravenously.

Interaction

• ACE inhibitors: Adding ACE inhibitors to Frusin therapy can cause a marked drop in blood pressure.
• Lithium: Concurrent use may increase serum lithium levels, leading to toxicity.
• Nephrotoxic antibiotics: Furosemide may increase the toxic effects of these antibiotics.

Contraindications

Frusin is contraindicated in patients with anuria (no urine production), electrolyte deficiency, pre-comatose states associated with liver cirrhosis, and hypersensitivity to furosemide or sulphonamides.

Side Effects

Prolonged use can cause electrolyte and water imbalances, including alkalosis, and may lead to uric acid retention or acute gout. It can also provoke hyperglycemia and glycosuria.

Pregnancy & Lactation

Frusin is classified as Pregnancy Category C. It should be used with caution in the first trimester of pregnancy and in nursing mothers, as it may inhibit lactation or pass into breast milk.

Precautions & Warnings

• Use with caution in patients with prostatic hypertrophy or impaired urination due to the increased risk of acute urinary retention.
• Patients should be monitored for an undesirable drop in blood pressure, especially when driving or operating machinery.

Overdose Effects

Overdose can lead to hypovolemia, dehydration, and cardiac arrhythmias. There is no specific antidote, and management is supportive, including gastric lavage or activated charcoal to limit absorption.

Therapeutic Class

Frusin belongs to the class of loop diuretics.

Storage Conditions

Protect from light. Keep out of the reach of children.