Lasix

Lasix is a well-established diuretic that has the international name Furosemide and is manufactured by the largest Indian company Sanofi India Limited.

[1],

Indications Lasix

This drug has already managed to gain recognition, both in a medical environment that widely uses it in many treatment protocols, and among patients, giving them considerable relief. Indications for the use of Lasix are quite extensive.

• Puffiness syndrome, which occurs against the background of cardiac or renal insufficiency. Pathology is chronic.
• Forced diuresis, resulting from poisoning with chemical compounds.
• Acute form of renal dysfunction, which includes the period of gestation by a female child or in case of burn injury (the drug raises the level of excretion).
• Edemas that appear due to the defeat of the patient's body by nephrotic illnesses (with treatment on the foreground comes the relief of the underlying disease).
• Pathological changes in the liver leading to edema (in addition to the main treatment).
• Severe form of hypertension.
• Intoxication of the body.
• Edema of the brain and lungs.
• Hypertensive crisis.
• Hypercalcemia - an increase in the calcium content in the blood plasma.
• Eclampsia is a disease that develops during the period of gestation, delivery and after birth. This pathology provokes an increase in blood pressure, the indices of which reach very high figures, which carries a threat to the life of both the mother and the child.

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Release form

The active substance of this drug is furosemide (frusemide). On the pharmacological market, the form of the drug is represented by some variety.

Tablets: one unit contains 40 mg of the active compound. The tablet is white or slightly milky in color. On the surface of each unit there is an inscription - "DLI". The preparation of Lasix is presented in the form of 50 or 250 pieces. Packages are issued and with five strips of ten tablets each. To carry out injections on drug store shelves, you can find the drug in solution: one ampoule contains 2 ml of liquid, which contains 20 mg of Lasix directly. The packing box has 10 or 50 ampoules.

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Pharmacodynamics

Base substance Lasix is a sulfonamide derivative and refers to sufficiently powerful and fast-acting diuretics. Pharmacodynamics Lasik due to the excellent ability to close in the counter-rotary exchanger, called in medicine by Henle's loop, the movement of ions of such chemical elements as chlorine (Cl-), potassium (K +), sodium (Na +). Therefore, the diuretic effectiveness of the drug depends on the amount of active substance Lasix entering the cavity of the renal tubules. The secondary effect of the drug is that the osmotically bound water can increase the volume of the patient's urine output. There is also an activation of potassium secretions in the most remote part of the renal canal. In parallel with this, there is an increase in the output of magnesium (Mg2 +) and calcium (Ca2 +) ions.

Due to the rapid expansion of the veins, in case of sudden onset of heart failure, Lasix allows you to quickly stop the attack. In this case, there is a decrease in blood load on the pulmonary artery and the left ventricle, reducing its fullness. Possesses the drug under consideration and hypotensive properties, contributing to the increased removal of sodium from the patient's body, reducing vasospasms and reducing the amount of circulating blood.

Therapeutic efficacy after taking 40 ml of the drug occurs within an hour after the administration of the drug. The duration of its action is observed from three to six hours. In the case of intravenous administration, the effect is already visible after five to ten minutes, and the duration of the action is from two to three hours, if the renal function is reduced, the work of Lasix is observed up to eight hours.

[6], [7], [8]

Pharmacokinetics

The main substance of the drug is very actively absorbed by the mucosa of the gastrointestinal tract, so the pharmacokinetics of Lasix are quite encouraging. After the introduction into the body, the time through which its maximum concentration in the plasma is reached is from one to one and a half hours. During the research, healthy volunteers showed bioavailability of the drug from 50% to 70%. In sick people this figure is somewhat lower and is capable of descending to 30%, since the result is influenced by other pathological factors in the overall health of the patient's body. The quantitative distribution of furosemide in systems shows 0.1 to 0.2 l per kilogram of body weight. The furosemide compound is predominantly albumin (the protein component of the blood plasma).

The active substance Lasix is excreted, basically, by the organism not changed. Glucuronated metabolites of the drug released by the kidneys are approximately 10-20%. The rest leaves the human body through the intestines with biliary secretion. The half-life of Lasix, depending on the patient's condition, is approximately one hour to one and a half. Furosemide easily overcomes the placental barrier and, without any obstacles, enters the breast milk. In this case, its quantitative component in the blood of the newborn is identical to the concentration in the mother's plasma.

In the case of kidney dysfunction, the pharmacokinetics of Lasix are weakened, the elimination half-life is prolonged and can reach even 24 hours. If liver enzymes are insufficient in the patient's body, the half-life of furosemide becomes longer, and this figure can vary from 30 to 90%. Primarily, the reason for this change is the growth in the volume of redistribution.

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Dosing and administration

There are necessary tips, which can be attributed to any reception of the drug. The drug Lasix is especially effective if it enters the patient's body on an "empty stomach". Drink it is necessary amount of water. Do not chew the tablet. Primarily it is necessary to start with minimal doses, trying to achieve a therapeutic effect, if this can not be done, the amount of the drug is increased.

The method of application and dose is prescribed by the attending physician. Doing self-categorically is not recommended.

The daily dosage for adults should not exceed 1.5 g. For children, it is calculated by the formula 2 mg, taken per kilogram of the weight of a small patient, but the calculated figure should not exceed 40 mg per day. The duration of the treatment course is strictly individual and is established by the attending physician.

It is also necessary to voice more narrow recommendations for adult patients.

• The starting dose for puffiness due to chronic heart failure is 20-80 mg, taken during the day and divided into two or three injections.
• The starting amount of the substance with puffiness due to chronic renal failure is difficult to specify, since it depends on various indicators: the degree of renal dysfunction, the level of sodium in the blood. If this pathology is already chronic, the dosage of furosemide should be selected especially carefully: from a minimum and slightly increasing it to achieve a therapeutic effect. Usually the daily dosage of Lasix in patients on hemodialysis is in the range of 0.25 - 1.5 g.
• If at the time of prescribing the patient has a kidney failure and is in acute form, then before starting taking furosemide, it is necessary, first of all, to eliminate such problems as failures in the water-electrolyte balance, to suppress hypertension or hypovolemia. In this situation, it is advisable to administer Lasix intravenously and begin with a dosage of 40 mg. If the therapeutic effect is not achieved, the dosage is increased. A continuous supply of the drug directly into the vein is possible. The rate of administration may range from 50 to 100 mg furosemide per hour. When the desired result is achieved, the patient must be transferred to the tablet preparation.
• If the cause of edema is nephrotic syndrome, then the starting daily dosage of the drug is prescribed in the range of 10 to 80 mg. The drug is allowed to take in one step or split it into several.
• Due to liver diseases, furosemide is prescribed as an auxiliary therapy to prevent the development of various complications. The starting daily dosage of the drug in this case is from 20 to 80 mg. The medicine is administered in one or two doses. Dosage varies depending on the response of the patient's body.
• In the case of hypertension, the doctor is able to use Lasik as a monotherapy, but the drug in the treatment protocol can be used in combination with other antihypertensive medications. On average, in such a situation, furosemide is prescribed in the range of 20 to 40 mg, taken once a day during the day.

[12], [13]

Use Lasix during pregnancy

A woman is waiting for a child and does not want to drink anything that can harm her baby. Therefore, the question: "Is it possible, whether the use of Lasix during pregnancy?" Sounds reasonably justified. Physicians are not categorical in the use of furosemide in the period of gestation, but allow its use only in a fairly short period of time. If a woman is breastfeeding a baby, for the period of taking the medication, breastfeeding should be stopped. After all, for the active substance of the drug, there is no problem to penetrate the placental barrier, and then it also easily enters the mother's milk. Therefore, without special need and explicit medical need, doctors do not prescribe Lasik to pregnant women. But if such a necessity has arisen and the drug is prescribed, careful monitoring of the condition of the pregnant woman and her fetus is necessary during its application.

Contraindications

Any non-homeopathic remedy is a combination of chemical compounds that are able to bring both benefit and harm to the human body in certain doses, therefore there are also contraindications to the use of Lasix.

• Hypersensitivity of the patient's body to the components of the drug, especially to sulfonylamides and sulfonamides.
• Stenosis of the urethra.
• Kidney dysfunction, until the complete excretion of urine (anuria).
• Arterial hypotension.
• Acute form of glomerulonephritis.
• Hypokalemia - a drop in the level of potassium ions in the blood.
• Hyponatremia is a decrease in the concentration of sodium ions in the plasma.
• Hepatic predkomatoznoe and coma.
• Gout.
• Violation of the water-electrolyte-salt balance.
• Severe form of hepatic dysfunction.
• Overlapping of the urinary tract by the stone.
• Aortic or mitral stenosis in the decompensated phase.
• Myocardial infarction in its acute form.
• Systemic lupus erythematosus.
• The increase in venous tension is more than 10 units.
• Hypovolemia.
• Pancreatitis - a malfunction in the pancreas.
• Diabetes.
• Intoxication with cardiac glycosides.
• Stenosing arteriosclerosis of cerebral arteries.
• Pregnancy (especially its first trimester).
• Breastfeeding time.
• Caution elderly people.
• Age of children up to three years.

Side effects Lasix

From any drug, at its or his reception, wait for positive influence on concrete pathological fact. But the body is a single whole and using the drug to stop a specific problem, we get side effects of Lasix, which can manifest themselves in various symptoms. The level of its manifestation depends on the state of the patient's organism and its immune forces in confrontation.

• The cardiovascular system can respond to the administration of furosemide with orthostatic hypotension or low blood pressure, rapid heart rate, and malfunctioning rhythm.
• The gastrointestinal tract may respond with nausea and an increase in the frequency of vomiting reflexes, impaired appetite, diarrhea, constipation, thirst and dryness of the oral cavity, exacerbation of pancreatitis.
• From the side of the nervous system, you can expect the appearance of headaches and dizziness, loss of strength and drowsiness, as well as some confusion of consciousness, myasthenia gravis.
• There may be problems with hearing and vision.
• The genitourinary system can also react: this is a delay in urination, hematuria, oliguria, a decrease in potency in men.
• On reception Lazix the organism of the patient is capable to react and an allergic reaction in various forms of its display. This reaction can lead the patient even to anaphylactic shock.
• The circulatory system is also capable of suffering. This is expressed by a decrease in the quantitative index of leukocytes and platelets in the blood. There may be aplastic anemia or agranulocytosis.
• Suffers and water-electrolyte-salt exchange.

Due to the fact that some side effects of Lasik in case of a combination of unforeseen factors can threaten the general health, and even the life of the patient, with the appearance of even a minor side symptomatology, it is necessary to notify your treating doctor urgently about them.

Overdose

How not to twist, but Lasix consists of their chemical compounds. Therefore, any of its overdose is fraught with unpleasant, and sometimes dangerous consequences. Symptomatic effects of taking large amounts of this drug include:

• A sharp drop in blood pressure.
• Acute vascular insufficiency or collapse.
• Rapid dehydration (dehydration).
• Interruptions in the rhythmic work of the heart muscle.
• Reduction of the volume of circulating blood (hypovolemia).
• Shock condition.
• Lethargy in behavior and drowsiness.
• The increase in the number of erythrocytes in the blood, associated with a decrease in the volume of plasma (hemoconcentration).
• Confusion of consciousness.
• Minor paralysis of the extremities.
• Acute form of renal dysfunction, up to the onset of anuria (complete cessation of urine output).
• Thrombosis and / or thromboembolism.

If a similar symptomatology begins to appear after taking Lasik, then it is necessary to inform your doctor in advance. There is no specific single-use antidote for Laxix overdose for today. Therefore, only the doctor will be able to introduce an adjustment of the drug and prescribe measures to eliminate the effects of an overdose. If, after "poisoning" furosemide, not so much time has passed, the first thing to do is to reduce the absorption of the drug in the mucosa of the gastrointestinal tract. This can be done by inducing vomiting or using a gastric lavage. Only after this, the patient needs to take an adsorption preparation, for example, activated charcoal.

Even after such activities, the doctor will schedule therapy aimed at restoring the water-electrolyte-salt balance, as well as the acidity of the digestive tract.

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Interactions with other drugs

It is necessary to be sensitive enough to prescribe the dosage of any drug, if it is used, as a therapeutic monotherapy, but it is even more accurate to approach this question if the drug is to be administered together with other drugs. Therefore, before you include in the protocol of treatment, it is worth familiarizing with the consequences of interaction of Lasix with other drugs.

The use of Lasix together with non-steroidal anti-inflammatory drugs (NSAIDs) reduces its diuretic effectiveness. This increases the possibility of poisoning the patient with cardiac glycosides, which can lead to hypokalemia, which develops on the basis of glucocorticoids. Such a tandem is capable of producing oto- and / or nephrotoxic manifestations. The intake of furosemide can increase the effectiveness of the properties of curare-like drugs, activate the reabsorption of lithium Li +, which occurs in the renal ducts (the clearance of lithium ions decreases, which increases the risk of intoxication).

Lasix enhances the quality of theophylline and diazoxide, while completely or partially blocking the action of allopurinol, as well as hypoglycemic drugs. The administration of furosemide together with antihypertensive drugs, enhances the effect of the second, and also increases musculo-neuralgic blocking, which is provoked by depolarized muscle relaxants (called suxamethonium in medicine), while reducing the potential of nonpolar muscle relaxants (tubocurarins).

There is a drop in mutual effectiveness, using the drug in question together with pressor amines. Promotes an increase in the concentration of the active substance Lasix in the blood, the use of therapeutic drugs to prevent tubular secretion.

Joint use of glucocorticosteroids (GCS) and Lasix, can cause digitalis intoxication, which develops on the basis of hypokalemia. The active substance of the drug in question can increase the toxicity of salicylates. It is very accurate to choose a dose of furosemide if it is administered intravenously, because this drug is easily deflected towards alkalinity. Therefore, drugs used with it in tandem should have a pH below 5.5.

To obtain the possibility of rapid progression of nephrotoxic and / or ototoxic manifestation of aminoglycosides may be facilitated by their paired application with the basic substance of Lasix. This tandem is not recommended, except for a severe medical necessity (with the dosage of aminoglycosides significantly reduced). The same recommendations can be given for joint use with ototoxic drugs.

It is not recommended to inject Lasik into the patient's body during the day after taking chloral hydrate, since this combination leads to uncomfortable symptoms: high sweating, increased blood pressure, nausea, increased heart rate, hyperemia of the skin.

Very carefully we need to calculate the amount of risperidone used together with any strong diuretics, including with Lasik. A sufficiently high percentage of deaths in elderly people is recorded, in the anamnesis of which the acquired dementia (dementia) is diagnosed.

Furosemide enhances the effect of certain cephalosporins, leading to an increased risk of developing a nephrotoxic component of cephalosporins. Reduces the properties of the diuretic phenytoin. Joint use of Lasix with methotrexate or probenecid reduces the effectiveness of the first, while the diuretic reduces the quantitative release of the breakdown products of these drugs by the kidneys, which provokes the development of various side effects.

The intake of furosemide and sucralfate must be spread over time (an interval of at least two hours), since such a tandem reduces the ability of the diuretic to be absorbed, reducing its effectiveness. The use of Lasix and cyclosporin A dramatically provokes the development of progressive gouty arthritis, which is caused by hyperuricemia, as well as failures in excretion of uric acid salts from the body.

The use of furosemide in conjunction with radiocontrast substances can provoke the proliferation of contrast nephropathy compounds.

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Storage conditions

The preparation should be kept indoors, protected from direct sunlight, while the temperature regime should not exceed the mark of 30 ° C. These are the conditions for storing Lasix. In this case, the storage of the medicinal product should not be available to children.

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Shelf life

Different forms of release have their expiration date, and it ranges from four to five years. Before taking the drug, be sure to look at the packaging and clarify it. If the expiration date has expired, do not use the drug.

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