Lasix - a drug with a diuretic action, which is used in acute and chronic heart failure, disorders of the kidneys. The main active ingredient is furosemide. It is prescribed with a marked swelling of tissues.
Diuretic Lasix affects the excretory system, allows you to get rid of excess fluid in the body, so that the patient's condition improves significantly.
During the long-term administration of the drug, drugs are additionally prescribed, which restore the water-electrolyte balance in the body.
Pharmacy sales terms
It is released on prescription.
How much does Lasix cost? The average price in pharmacies is at the level of 60 rubles.
Release form and composition
The drug is available in the form of:
- white tablets of 40 mg;
- clear colorless solution for injection of 10 mg per 1 ml, with dark glass ampoules of 2 ml. The package contains 10 ampoules;
- for children, granules are produced for the preparation of a suspension, which is taken orally.
The active substance of the drug - furosemide - is a loop diuretic, a diuretic with a pronounced, fast-on, short-term, strong effect and a moderate decrease in pressure.
The composition of the tablets includes 40 mg of furosemide and other dry ingredients. The composition of the solution includes furosemide in the amount of 10 mg per 1 milliliter, hydroxide and sodium chloride, medical water.
Lasix disrupts the processes of reabsorption of Na and Cl ions in the loop of Henle, as a result of an increase in the release of Na ions, the excretion of water increases and the secretion of K ions in the distal renal tubule increases. In addition, due to the increased excretion of sodium chloride from the body and furosemide has a hypotensive effect.
The onset of diuresis after taking the pills is marked for an hour and lasts for 6 to 8 hours. The peak of the diuretic effect is observed after taking the tablets after 1-2 hours. The effect after intravenous administration appears 5 minutes after the injection, it reaches its maximum in half an hour, and lasts about 2 hours.
In patients with heart failure, Lasix reduces the preload on the heart, as it expands the large veins. The diuretic effect of the drug depends on the dosage. Against the background of the course of therapy, the effect is not observed. The drug does not change the glomerular filtration rate and retains its effectiveness when it is low.
Indications for use
Most often Lasix prescribed for the treatment of edema of various etiologies:
- pulmonary edema;
- swelling caused by cirrhosis of the liver;
- swelling of the brain while eliminating the effects of strokes and removing aneurysms;
- nephrotic edema, accompanied by partial or complete renal failure.
The secondary functions of the drug are used in the treatment of the following diseases:
- Arterial hypertension - the drug quickly reduces pressure, but does not make it pathologically low.
- Hypertensive crisis - helps to quickly and effectively reduce pressure, without prejudice to the cardiovascular system.
- Acute renal failure - helps to normalize the work of the kidneys, which have failed as a result of an acute infectious disease.
- Artificial diuresis - the drug helps to increase the discharge of urine with extensive intoxication, allowing the body to quickly and without significant losses recover from the harmful effects of toxic substances.
The drug is taken orally only by prescription. Before starting therapy, it is recommended to carefully study the instructions for the tablets. Lasix is contraindicated in the following conditions:
- severe hyponatremia;
- hepatic precoma, coma;
- severe hypokalemia;
- allergic responses;
- pregnancy and breastfeeding;
- renal failure in anuria that does not respond to the administration of lasix;
- pronounced impairment of the urethra in any pathology (including unilateral lesions of the urinary tract).
- hepatorenal syndrome;
- diabetes mellitus (latent, manifested);
- hearing loss;
- diarrhea syndrome;
- violation of urinary outflow (hydronephrosis, narrowing of the urethra, prostatic hyperplasia);
- systemic lupus erythematosus;
- myocardial infarction, acute stage (increased risk of cardiogenic shock);
- stenosing lesions of the cerebral, coronary arteries and other conditions in which excessively reduced blood pressure is extremely dangerous;
- ventricular arrhythmia.
In addition, the drug is not prescribed to premature babies because of the risk of deposition of calcium salts in the renal parenchyma (nephrocalcinosis), because of the possibility of the formation of calcium-containing stones in the renal system (nephrolithiasis).
Use during pregnancy and lactation
Indications for Lasix are pre-eclampsia of pregnant women - a serious condition, accompanied by edema, high blood pressure, rapid weight gain, proteinuria.
Reception of Lasix during the first 12 weeks of pregnancy is prohibited. In exceptional cases, the doctor may allow the use of the drug after assessing the ratio of "potential benefits to the mother and the possible risk to the fetus."
During lactation at the time of taking the drug, breastfeeding should be discontinued.
Dosage and method of use
The instructions for use indicated: Lasix tablets are taken orally, before meals, without chewing, with a small amount of liquid.
Dosing of the drug is determined by the doctor on the basis of clinical indications, it is recommended to prescribe the smallest doses that ensure the achievement of the desired effect. For adults, the maximum daily dose is recommended in the amount of 1500 mg, for children - at the rate of 2 mg per 1 kg of weight, but not higher than 40 mg. Individual clinically effective dose is selected taking into account the diuretic response.
When prescribing a dosing regimen in adults, it is necessary to adhere to the following recommendations for edema syndrome in the background:
- Chronic heart failure - the initial daily dose is 20-80 mg in 2-3 doses;
- Chronic renal failure - the initial daily dose of 40-80 mg in 1-2 doses (due to the possible loss of fluid at the beginning of treatment up to 2 kg of body weight per day, the dose is selected with a gradual increase to prevent a sharp loss of fluid in the patient), maintenance dose for hemodialysis - 250-1500 mg per day;
- Liver diseases - when monotherapy fails with aldosterone antagonists, Lasix is additionally prescribed at an initial dose of 20-80 mg per day, treatment should be accompanied by regular monitoring of the level of fluid loss; nephrotic syndrome - the initial dose of 40-80 mg per day in 1-2 doses.
- In hypertension, the drug is used in monotherapy and in combination with antihypertensive drugs as a maintenance dose of 20-40 mg per day. Treatment of arterial hypertension on the background of chronic renal failure involves the appointment of higher doses.
In acute renal failure, Lasix is indicated only after the elimination of hypovolemia, hypotension and significant acid-base and electrolyte disorders.
Against the background of Lasix, water-electrolyte disorders often develop, which are manifested by an insufficient amount of potassium, calcium, magnesium, chlorine in the body, and the biochemical properties of the blood are disturbed, and the level of creatinine, cholesterol, glucose, uric acid and other parameters in the blood plasma increases.
Lasix may cause the following side effects:
- blood clots;
- anaphylactic shock (extremely rare);
- allergic skin reactions: itching, dermatitis, erythema;
- on the part of the blood system: a decrease in the level of leukocytes, platelets, neutrophils, an increase in the number of eosinophils, and other hemolytic changes.
The degree of overdose depends on the amount of fluid and electrolytes lost. As a result of an overdose with Lasix, dehydration, heart rhythm and conduction disturbances, and hypovolemia can be observed. Signs of excessive consumption of the drug is a reduction in blood pressure, thrombosis, apathy, flaccid paralysis, renal failure, confusion.
Treatment is directed to the normalization of the acid-base and water-electrolyte balance of the body.
Before you start using the drug, read the specific instructions:
- Lasix Solution should not be mixed in the same syringe with other drugs.
- Before starting treatment with Lasix, it is necessary to exclude the presence of pronounced violations of urine outflow, even unilateral ones. Patients with a partial violation of the outflow of urine should be under close supervision.
- During therapy, it is necessary to regularly monitor serum concentrations of potassium, creatinine and sodium, especially in patients with a high risk of developing electrolyte imbalances due to additional fluid and electrolyte losses, for example, due to diarrhea, vomiting, or intense sweating.
- Before and during the use of the drug should be monitored and, in the case of development, eliminate dehydration or hypovolemia, as well as clinically significant violations of the acid-base and / or electrolyte state. Sometimes this requires a brief cancellation of furosemide.
- During treatment it is recommended to eat foods rich in potassium, for example, potatoes, meat, tomatoes, spinach, cauliflower, bananas, dried fruits. In some cases, additional prescribed potassium or potassium-sparing drugs.
- Selection of doses to patients with ascites, developed on the background of cirrhosis of the liver, is carried out in the hospital, since violations of the water-electrolyte state can lead to hepatic coma.
- Premature babies require regular ultrasound examination of the kidneys and control of their function, since There is the likelihood of nephrolithiasis and nephrocalcinosis.
Some side effects (for example, symptoms accompanying a significant reduction in blood pressure) may interfere with the speed of reactions and ability to concentrate, which can be dangerous when working with machinery and driving vehicles. Especially it concerns the beginning of treatment and the period of increasing the dose, as well as cases of concomitant use of antihypertensive drugs or alcoholic beverages.
When using the drug, you must consider the interaction with other drugs:
- It is believed that in this way, furosemide interacts with other NSAIDs.
- With simultaneous use with astemizole increases the risk of arrhythmia.
- With simultaneous use with vancomycin may increase oto-and nephrotoxicity.
- There are reports of the development of hyponatremia with simultaneous use with carbamazepine.
- With simultaneous use with colestiramine, colestipol decreases the absorption and diuretic effect of furosemide.
- With simultaneous use of lithium carbonate may increase the effects of lithium due to the increase in its concentration in the blood plasma.
- With simultaneous use of probenecid, the renal clearance of furosemide decreases.
- With simultaneous use with sotalol, hypokalemia and the development of ventricular arrhythmias of the “pirouette” type are possible.
- With simultaneous use with theophylline, the concentration of theophylline in the blood plasma may change.
- With simultaneous use with phenytoin, the diuretic effect of furosemide is significantly reduced.
- After the on / in the introduction of furosemide during therapy with chloral hydrate may increase sweating, a feeling of heat, blood pressure instability, tachycardia.
- With simultaneous use with cisapride may increase hypokalemia.
- With simultaneous use with NSAIDs, which are selective inhibitors of COX-2, this interaction is expressed to a much lesser extent or virtually absent.
- With simultaneous use of aminoglycoside groups with antibiotics (including with gentamicin, tobramycin), the nephrototoxic effect can be enhanced.
- It is assumed that furosemide may reduce the nephrotoxic effect of cyclosporine.
- Furosemide reduces the clearance of gentamicin and increases plasma concentrations of gentamicin, as well as tobramycin.
- When used simultaneously with antibiotics of the cephalosporins group, which can cause renal dysfunction, there is a risk of increased nephrotoxicity.
- With simultaneous use with beta-adrenomimetikami (including fenoterol, terbutalina, salbutamol) and with GCS may increase hypokalemia.
- With simultaneous use with hypoglycemic agents, insulin may decrease the effectiveness of hypoglycemic agents and insulin, because Furosemide has the ability to increase the content of glucose in the blood plasma.
- With simultaneous use with ACE inhibitors increases antihypertensive effect. Possible pronounced arterial hypotension, especially after taking the first dose of furosemide, apparently due to hypovolemia, which leads to a transient increase in the hypotensive effect of ACE inhibitors. The risk of renal dysfunction increases and the development of hypokalemia is not excluded.
- With simultaneous use with digoxin, digitoxin, it is possible to increase the toxicity of cardiac glycosides, associated with the risk of developing hypokalemia in patients receiving furosemide.
- When applied simultaneously with furosemide, the effects of non-depolarizing muscle relaxants are enhanced.
- With simultaneous use with indomethacin, other NSAIDs, it is possible to reduce the diuretic effect, apparently due to inhibition of prostaglandin synthesis in the kidneys and sodium retention in the body under the influence of indomethacin, which is a nonspecific inhibitor of COX; reduced antihypertensive effect.
- With simultaneous use with cisplatin may increase ototoksicheskogo action.
We picked up some reviews of people who took Lasix:
- Gennady. Lasix is a fairly good and powerful diuretic drug that allows you to quickly deal with edema, intoxication and other pathologies. But this drug has one “but” —that is a potassium-sparing diuretic that removes potassium from our body, which is not good, because potassium nourishes the heart muscle, and with prolonged therapy with lasix, we can aggravate our condition. It is more frequent and more correct to use lasic in the period of abundant intravenous infusions, for example, when you are in the hospital and you are dug through with various solutions of drugs. So, it is better to use veroshpiron for long-term therapy.
- Natalia. I went in for sports all my life, there were no health problems, but apparently my age is taking its course, last year I experienced the first hypertensive crisis. Fortunately, there was a daughter nearby, who quickly looked around and called an ambulance. An ambulance doctor immediately injected Lasix, intravenously, they took me to the hospital and dripped for another 5 days, but this time with a dropper.All this time I have been drinking Aspark and electrolyte to restore the body's potassium and magnesium standards. Now I am constantly observed by a neurologist and a cardiologist, periodically drinking Lasix tablets. This drug really helped me.
- Martha. The doctor forbade me to take lasix - he says that he is too strong and may have a bad effect on blood salts. And before, I often got rid of edema with it. Now the doctor prescribed me another medicine, which is much more expensive ...
Among the drugs that can have a similar strong diuretic and weak hypotensive effect, distinguish the following analogs:
Before using analogues consult your doctor.
Storage conditions and shelf life
Lasix's solution is stored in a dark place at a temperature not exceeding 25 degrees. Do not use after the expiration date (3 years).
Lasix tablets are stored for 4 years in a dark place at a temperature not higher than 30 degrees.