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DIURETICS, LOOP (Systemic)
Some commonly used brand names are:
In the U.S.—
Loop diuretics are given to help reduce the amount of water in the body. They work by acting on the kidneys to increase the flow of urine.
Furosemide is also used to treat high blood pressure (hypertension) in those patients who are not helped by other medicines or in those patients who have kidney problems.
High blood pressure adds to the work load of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.
Loop diuretics may also be used for other conditions as determined by your doctor.
This medicine is available only with your doctor"s prescription, in the following dosage forms:
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For loop diuretics, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to bumetanide, ethacrynic acid, furosemide, sulfonamides (sulfa drugs), or thiazide diuretics (water pills). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Studies have not been done in pregnant women. However, studies in animals have shown this medicine to cause harmful effects.
In general, diuretics are not useful for normal swelling of feet and hands that occurs during pregnancy. Diuretics should not be taken during pregnancy unless recommended by your doctor.
Breast-feeding—These medicines have not been reported to cause problems in nursing babies. Furosemide passes into breast milk; it is not known whether bumetanide or ethacrynic acid passes into breast milk.
Children—Although there is no specific information comparing the use of loop diuretics in children with use in any other age group, these medicines are not expected to cause different side effects in children than they do in adults.
Older adults—Dizziness, lightheadedness, or signs of too much potassium loss may be more likely to occur in the elderly, who are more sensitive to the effects of this medicine. Elderly patients may also be more likely to develop blood clots.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking loop diuretics, it is especially important that your health care professional know if you are taking any other medicines.
Other medical problems—The presence of other medical problems may affect the use of loop diuretics. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
This medicine may cause you to have an unusual feeling of tiredness when you begin to take it. You may also notice an increase in the amount of urine or in your frequency of urination. After you have taken the medicine for a while, these effects should lessen. In general, to keep the increase in urine from affecting your sleep:
However, it is best to plan your dose or doses according to a schedule that will least affect your personal activities and sleep. Ask your health care professional to help you plan the best time to take this medicine.
To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.
For patients taking the oral liquid form of furosemide:
For patients taking this medicine for high blood pressure :
If this medicine upsets your stomach, it may be taken with meals or milk. If stomach upset (nausea, vomiting, or stomach pain) continues or gets worse, or if you suddenly get severe diarrhea, check with your doctor.
Dosing—The dose of loop diuretics will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of loop diuretics. If your dose is different, do not change it unless your doctor tells you to do so.
The number of tablets or teaspoonfuls of solution that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking loop diuretics .
Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—To store this medicine:
Precautions While Using This Medicine
It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly.
This medicine may cause a loss of potassium from your body :
To prevent the loss of too much water and potassium, tell your doctor if you become sick, especially with severe or continuing nausea and vomiting or diarrhea.
Before having any kind of surgery (including dental surgery) or emergency treatment, make sure the medical doctor or dentist in charge knows that you are taking this medicine.
Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position . This is more likely to occur in the morning. Getting up slowly may help . When you get up from lying down, sit on the edge of the bed with your feet dangling for 1 or 2 minutes. Then stand up slowly. If the problem continues or gets worse, check with your doctor.
The dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are taking this medicine, be careful to limit the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for long periods of time .
For diabetic patients :
For patients taking this medicine for high blood pressure :
For patients taking furosemide :
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Black, tarry stools; blood in urine or stools; cough or hoarseness; fever or chills; joint pain; lower back or side pain; painful or difficult urination; pinpoint red spots on skin; ringing or buzzing in ears or any loss of hearing—more common with ethacrynic acid; skin rash or hives; stomach pain (severe) with nausea and vomiting; unusual bleeding or bruising; yellow eyes or skin; yellow vision—for furosemide only
Signs and symptoms of too much potassium loss
Dryness of mouth; increased thirst; irregular heartbeat; mood or mental changes; muscle cramps or pain; nausea or vomiting; unusual tiredness or weakness; weak pulse
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Dizziness or lightheadedness when getting up from a lying or sitting position
Less common or rare
Blurred vision; chest pain—with bumetanide only; confusion—with ethacrynic acid only; diarrhea—more common with ethacrynic acid; headache; increased sensitivity of skin to sunlight—with furosemide only; loss of appetite—more common with ethacrynic acid; nervousness—with ethacrynic acid only; premature ejaculation or difficulty in keeping an erection—with bumetanide only; redness or pain at place of injection; stomach cramps or pain
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, loop diuretics are used in certain patients with the following medical conditions:
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.
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