Fumide , Furomide , Lasix, Luramide 
Classifications: electrolytic and water balance agent; loop diuretic
Pregnancy Category: C


20 mg, 40 mg, 80 mg tablets; 10 mg/mL, 40 mg/5 mL oral solution; 10 mg/mL injection


Rapid-acting potent sulfonamide "loop" diuretic and antihypertensive with pharmacologic effects and uses almost identical to those of ethacrynic acid. Exact mode of action not clearly defined; decreases renal vascular resistance and may increase renal blood flow.

Therapeutic Effects

Inhibits reabsorption of sodium and chloride primarily in loop of Henle and also in proximal and distal renal tubules; an antihypertensive that decreases edema and intravascular volume. Reportedly less ototoxic than ethacrynic acid.


Treatment of edema associated with CHF, cirrhosis of liver, and kidney disease, including nephrotic syndrome. May be used for management of hypertension, alone or in combination with other antihypertensive agents, and for treatment of hypercalcemia. Has been used concomitantly with mannitol for treatment of severe cerebral edema, particularly in meningitis.


History of hypersensitivity to furosemide or sulfonamides; increasing oliguria, anuria, fluid and electrolyte depletion states; hepatic coma; pregnancy (category C), lactation.

Cautious Use

Infants, older adults; hepatic cirrhosis, nephrotic syndrome; cardiogenic shock associated with acute MI; history of SLE, history of gout; patients receiving digitalis glycosides or potassium-depleting steroids.

Route & Dosage

Adult: PO 20–80 mg in 1 or more divided doses up to 600 mg/d if needed IV/IM 20–40 mg in 1 or more divided doses up to 600 mg/d
Child: PO 2 mg/kg, may be increased by 1–2 mg/kg q6–8h (max: 6 mg/kg/dose) IV/IM 1 mg/kg, may be increased by 1 mg/kg q2h if needed (max: mg/kg/dose)
Neonate: PO 1–4 mg/kg q12–24h IV/IM 1–2 mg/kg q12–24h

Adult: PO 10–40 mg b.i.d. (max: 480 mg/d)


  • Note: Verify correct IV concentration and rate of infusion/injection with physician before administration to infants or children.

PREPARE: Direct: Give undiluted.  

ADMINISTER: Direct: Give undiluted at a rate of 20 mg or a fraction thereof over 1 min. With high doses a rate of 4 mg/min is recommended to decrease risk of ototoxicity.  

INCOMPATIBILITIES Solution/additive: Buprenorphine, chlorpromazine, ciprofloxacin, diazepam, diphenhydramine, dobutamine, doxapram, doxorubicin, droperidol, erythromycin, gentamicin, isoproterenol, labetalol, meperidine, metoclopramide, milrinone, netilmicin, pancuronium, prochlorperazine, promethazine, quinidine, thiamine vinblastine, vincristine. Y-site: Amrinone, amsacrine, azithromycin, ciprofloxacin, diazepam, diltiazem, dobutamine, diphenhydramine, dopamine, doxorubicin, droperidol, esmolol, filgrastim, fluconazole, gemcitabine, gentamicin, hydralazine, idarubicin, methocarbamol, metoclopramide, midazolam, milrinone, morphine, netilmicin, nicardipine, ondansetron, quinidine, thiopental, tobramycin, vecuronium, vinblastine, vincristine, vinorelbine, TPN.

Adverse Effects (1%)

CV: Postural hypotension, dizziness with excessive diuresis, acute hypotensive episodes, circulatory collapse. Metabolic: Hypovolemia, dehydration, hyponatremia hypokalemia, hypochloremia metabolic alkalosis, hypomagnesemia, hypocalcemia (tetany), hyperglycemia, glycosuria, elevated BUN, hyperuricemia. GI: Nausea, vomiting, oral and gastric burning, anorexia, diarrhea, constipation, abdominal cramping, acute pancreatitis, jaundice. Urogenital: Allergic interstitial nephritis, irreversible renal failure, urinary frequency. Hematologic: Anemia, leukopenia, thrombocytopenic purpura; aplastic anemia, agranulocytosis (rare). Special Senses: Tinnitus, vertigo, feeling of fullness in ears, hearing loss (rarely permanent), blurred vision. Skin: Pruritus, urticaria, exfoliative dermatitis, purpura, photosensitivity, porphyria cutanea tarde, necrotizing angiitis (vasculitis). Body as a Whole: Increased perspiration; paresthesias; activation of SLE, muscle spasms, weakness; thrombophlebitis, pain at IM injection site.

Diagnostic Test Interference

Furosemide may cause elevations in BUN, serum amylase, cholesterol, triglycerides, uric acid and blood glucose levels, and may decrease serum calcium, magnesium, potassium, and sodium levels.


Drug: other diuretics enhance diuretic effects; with digoxin increased risk of toxicity because of hypokalemia; nondepolarizing neuromuscular blocking agents (e.g., tubocurarine) prolong neuromuscular blockage; corticosteroids, amphotericin B potentiate hypokalemia; decreased lithium elimination and increased toxicity; sulfonylureas, insulin blunt hypoglycemic effects; nsaids may attenuate diuretic effects.


Absorption: 60 of oral dose absorbed from GI tract. Peak: 60–70 min PO; 20–60 min IV. Onset: 30–60 min PO; 5 min IV. Duration: 2 h. Distribution: Crosses placenta. Metabolism: Small amount metabolized in liver. Elimination: Rapidly excreted in urine; 50% of oral dose and 80% of IV dose excreted within 24 h; excreted in breast milk. Half-Life: 30 min.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug