Composition:
Each 2 ml ampoule contains:
Furosemide ..................................... 20 mg.
Each 4 ml ampoule contains:
Furosemide .................................... 40 mg.
Each tablet contains:
Furosemide...................................... 40 mg

Properties:
Furosemide is a potent diuretic, with rapid onset of action & bioavailability about 60 - 70 %.
The half life of Furosemide is up to about 2 hours.
Furosemide inhibits the reabsorption of electrolytes in the ascending limb of the loop of Henle and also in the distal tubules. It may also have a direct effect on the proximal tubules.
Furosemide increase the excretion of sodium, potassium, calcium and chloride ions and enhances water excretion.
Furosemide has no clinically effect on carbonic anhydrase enzyme.

Indications:
Injection is indicated in conditions where adequate diuresis is not obtained with oral administration.
Edema due to cardiac and hepatic disease (ascites).
Edema due to renal disease (when the nephrotic syndrome therapy of the underlying disease has precedence).
Acute cardiac insufficiency, especially in pulmonary edema (administration in conjunction with other therapeutic measures).
Supportive measures in brain edema.
Edema due to burns.
Hypertensive crisis (in addition to other anti-hypertensive measures)
To support forced diuresis in poisoning.
Contraindications:
Anuria.Hepatic coma.Severe hypokalemia.Hyponatraemia and/or hypovolaemia with/without hypotension.Hypersensitivity to sulfonamides.Liver or renal failure.
Use in pregnancy & lactation:
Furosemide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Because it appears in breast milk, caution should be exercised when Furosemide is administered to a nursing mother.

Precautions:
The drug may cause hypokalemia & hyponatraemia,it aggravates diabetes mellitus & gout, The drug is unsafe for use in acute porphyria.

Side effects:
Hyponatraemia, hypokalemia, hypochloremic alkalosis, increased calcium excretion & hypotension are the most common side effects. Less commonly nausea, gastro - intestinal disturbances, hyperuricemia ( gout ) may occur .

Dosage:
Ampoule Dose:
Adults and adolescents over 15 years:
The initial dose:20 - 40 mg I.V or I.M., if the diuretic effect is not satisfactory after a single dose of 20 - 40 mg, the dose may be stepwise increased, at two hour intervals by 20 mg each time until satisfactory diuresis is obtained.
The individual dose thus established should then be given once or twice daily.
Acute pulmonary edema: An initial dose of 40 mg is administered intravenously. and then If needed, a further dose of 20 - 40 mg is injected after 20 minutes.
Forced diuresis: 20 - 40 mg is given in addition to infusion of electrolyte solution. Further treatment depends on the elimination of urine and must include substitution of the fluid and electrolyte losses in poisoning with acid or basic substances.The elimination rate may be further increased by alkalinization or acidification of the urine.
Infants and children under 15 years:
Parenteral administration (if necessary, continuous drip infusion) is indicated only in life-threatening conditions.
For intravenous or intramuscular injection: The dosage schedule is 1 mg / kg body weight up to a maximum daily dose of 20 mg.
Therapy should be changed to oral administration as soon as possible.
Tablets dose:
Adults:
In the treatment of edema, the usual initial dose for adults is 20 - 80 mg once daily, if no response is obtained the dose may be raised by 20 - 40 mg and given no sooner than 6 - 8 hours after the previous dose until the desired diuretic effect has been obtained .
Mild cases may respond to 20 mg daily or 40 mg on alternative days.
Some patients may require gradual titration of the Furosemide dosage up to 600 mg daily.
In the treatment of hypertension, Furosemide is given in doses of 40 - 80 mg / day, either alone or in conjunction with other antihypertensive agents, with reduction of at least 50% of antihypertensive drug.
Infants and children:
The usual oral initial dose is 1-3 mg / kg body weight once daily or on alternative days, dose may be increased by 1 - 2 mg / kg given no sooner than 6 - 8 hours after the previous dose until the desired diuretic effect has been obtained. Maximum dose is 6 mg / kg body weight ( 40 mg daily ).
Storage:
Keep at temperature not exceeding 30°C.
Keep medicine out of reach of children

Presentation:
Box of 3 ampoules 20 mg or 40 mg.
Box of 100 ampoules 20 mg or 40 mg.
Box of 10 ampoules 20 mg.