FRUSEMIDE

It is a strong diuretic but lacks specific anti-hypertensive

action. ( has no direct effect on resistance vessels).
Thus anti hypertensive 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 a single dose. if satisfactory
results are not obtained than 20-40 mg after 6 hrs.
INFANT & CHILDREN : 2mg /kg body wt 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
Hyponatraemia
Hepatic coma
Hypovolaemia with/without hypotension.
SPECIAL PRECAUTIONS :
Electrolyte imbalance (monitor serum electrolyte)
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.
Dizzinesss.
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.