Description
Furosemide injection is used to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease (cirrhosis), kidney disease, or other medical conditions.
Furosemide injection is also used to treat congestion (blockage) caused by excess amount of fluid in patients with chronic heart failure.
Furosemide belongs to a group of medicines called loop diuretics or "water pills". It works by acting on the kidneys to increase the flow of urine.
This medicine is available only with your doctor's prescription.
This product is available in the following dosage forms:
- Solution
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of furosemide injection to treat fluid retention and swelling in children. However, premature babies are more likely to have unwanted effects (eg, kidney stones, hearing problems), which may require caution in patients receiving furosemide injection.
Appropriate studies have not been performed on the relationship of age to the effects of furosemide injection to treat congestion caused by excess amount of fluid in the pediatric population. Safety and efficacy have not been established.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of furosemide injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving furosemide injection.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Desmopressin
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aceclofenac
- Acemetacin
- Albiglutide
- Albuterol
- Alogliptin
- Amikacin
- Amikacin Liposome
- Amtolmetin Guacil
- Arsenic Trioxide
- Aspirin
- Azilsartan
- Azilsartan Medoxomil
- Balsalazide
- Benazepril
- Benzhydrocodone
- Bepridil
- Bismuth Subsalicylate
- Bromfenac
- Bromocriptine
- Bufexamac
- Buprenorphine
- Canagliflozin
- Candesartan
- Capreomycin
- Captopril
- Cefepime
- Ceftazidime
- Celecoxib
- Chloral Hydrate
- Chlorpropamide
- Choline Salicylate
- Cisplatin
- Clonixin
- Codeine
- Dapagliflozin
- Dasabuvir
- Dexibuprofen
- Dexketoprofen
- Dichlorphenamide
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aliskiren
- Carbamazepine
- Cephaloridine
- Clofibrate
- Cyclosporine
- Dibekacin
- Fludrocortisone
- Germanium
- Ginseng
- Gossypol
- Licorice
- Pancuronium
- Tubocurarine
- Vecuronium
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Allergy to medical adhesives or
- Anuria (not able to pass urine) or
- Liver disease (eg, cirrhosis, ascites)—Should not be used in patients with this condition.
- Allergy to sulfa drugs (eg, sulfamethoxazole, sulfasalazine, sulfisoxazole, Azulfidine®, Bactrim®, Gantrisin®, or Septra®) or
- Blood or bone marrow problems or
- Dehydration or
- Electrolyte imbalance (eg, hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia) or
- Enlarged prostate or
- Gout or
- Hearing problems (eg, tinnitus) or
- Hyperuricemia (high uric acid in the blood) or
- Hypovolemia (low blood volume) or
- Liver disease, severe (eg, hepatic coma) or
- Systemic lupus erythematosus (SLE) or
- Trouble urinating—Use with caution. May make these conditions worse.
- Diabetes—This medicine may increase the amount of sugar in the blood.
- Hypertension (high blood pressure)—Your dose of antihypertensive medicines may need to be adjusted to prevent your blood pressure from falling too low.
- Hypoproteinemia (low protein in the blood) from a kidney problem or
- Radiocontrast nephropathy (kidney problem), history of—May cause side effects to become worse.
- Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Proper Use
A nurse or other trained health professional will give you or your child this medicine in a hospital. It is given through a needle placed into one of your veins, or as a shot into a muscle or under your skin, usually in the stomach area.
Your doctor will give you a few doses of this medicine until your condition improves, and then switch you or your child to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.
You or your caregiver may be trained to prepare and apply the medicine at home. Be sure that you understand how to use the medicine. Do not use more medicine or use it more often than your doctor tells you to.
To use the prefilled cartridge with the single-use on-body infusor:
- Wash your hands with soap and water before and after using this medicine.
- You will be shown the body areas where the on-body infusor can be worn. Use a different body area each time you wear the infusor. Keep track of the application site to make sure you rotate body areas. This will help prevent skin problems from the injections. Do not apply into areas where the skin is bruised, hardened, irritated, red, tender, or broken.
- Do not apply lotions oils, or ointments to the stomach area. Avoid putting the on-body infusor where belts, waistbands, or other types of clothing that may rub against, disturb, or dislodge. Application site should be hairless or nearly hairless. You may shave the skin or cut the hair.
- Check the liquid in the prefilled cartridge. It should be clear to slightly yellow. Do not use the cartridge if the liquid is cloudy or discolored.
- Do not use if the packaging is opened, dropped, broken, or damaged. Do not use the medicine within 12 inches of mobile phones, tablets, computers, or wireless devices (eg, TV remote control, bluetooth keyboard or mouse).
- Do not touch the blue start button until the on-body infusor is on the skin. Do not touch or fully open the cartridge holder until you are ready. Do not remove until the injection is complete (indicator turns solid green light, beeping sound, and white plunger rod filling the window).
- Do not let the on-body infusor get wet from water or any other liquids. Do not shower, bathe, swim, or exercise that will make you sweat while wearing the on-body infusor. Allow the medicine to deliver for at least 5 hours.
- If the on-body infusor falls off, call your doctor right away. Do not reapply or reuse it. Do not apply new on-body infusor unless your doctor tells you to.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For injectable dosage form (prefilled cartridge):
- For congestion caused by excess amount of fluid:
- Adults—30 milligrams (mg) injected under your skin for the first hour, followed by 12.5 mg per hour for 4 hours. Each cartridge contains 80 mg furosemide. The amount of medicine delivered is pre-programmed with a single-use on-body infusor.
- Children—Use and dose must be determined by your doctor.
- For congestion caused by excess amount of fluid:
Storage
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep the medicine in its original carton until you are ready to use it. Protect it from light.
Precautions
It is very important that your doctor check you or your child closely while you are receiving this medicine. This is to make sure this medicine is working properly. Blood or urine tests may be needed to check for unwanted effects.
This medicine may cause you or your child to lose more potassium from your body than normal (hypokalemia). This is more likely to occur if you have liver disease (eg, cirrhosis), or if you are using this medicine together with steroids (cortisone-like medicines), adrenocorticotropic hormone (ACTH), large amounts of licorice, or laxatives for a long time. Tell your doctor if you become sick with severe or continuing nausea, vomiting, or diarrhea, and drink fluids to prevent getting dehydrated. Check with your doctor right away if you have dry mouth, increased thirst, muscle cramps, or nausea or vomiting.
This medicine may cause hearing problems. Check with your doctor right away if you have continuing ringing or buzzing or other unexplained noise in the ears, dizziness, feeling of fullness in the ears, hearing loss, loss of balance, or trouble hearing.
Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.
This medicine may cause an increase in blood sugar levels. If you or your child are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.
This medicine may make your skin more sensitive to sunlight. Use a sunscreen, hat, and protective clothing when you are outdoors. Avoid sunlamps and tanning beds.
Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
Do not take other medicines unless they have been discussed with your doctor. This especially includes prescription or nonprescription (over-the-counter) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Rare
- Chest pain or tightness
- chills
- cough or hoarseness
- fever
- general feeling of tiredness or weakness
- headache
- lower back or side pain
- painful or difficult urination
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- swollen or painful glands
- trouble breathing
- unusual bleeding or bruising
- unusual tiredness or weakness
Incidence not known
- Back or leg pains
- black, tarry stools
- bladder spasm
- bleeding gums
- blistering, peeling, or loosening of the skin
- bloody or cloudy urine
- blurred vision
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- clay-colored stools
- cold sweats
- confusion
- constipation
- continuing ringing or buzzing or other unexplained noise in the ears
- coughing up blood
- diarrhea
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
- dry mouth
- fast heartbeat
- fever with or without chills
- flushed, dry skin
- fruit-like breath odor
- hearing loss
- increased hunger or thirst
- increased or decreased urination
- indigestion
- itching
- joint stiffness or swelling
- loss of appetite
- nausea or vomiting
- nosebleeds
- pain where a shot was given
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale skin
- pinpoint red spots on the skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- red, irritated eyes
- red skin lesions, often with a purple center
- scaly skin
- skin rash
- sweating
- swelling of the feet or lower legs
- swollen glands
- unpleasant breath odor
- unusual weight loss
- yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
- Feeling of constant movement of self or surroundings
- hives or welts
- increased sensitivity of the skin to sunlight
- muscle spasm
- redness or other discoloration of the skin
- restlessness
- sensation of spinning
- severe sunburn
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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