Buy Lasix online
Brand names: Frusol, Frudix, Frusemide, Frusenex, Frusid, Furosedon
Active ingredient: Furosemide
Lasix - quick diuretic, a derivative of sulfonamide. The diuretic effect of the drug Lasix is associated with inhibition of sodium chloride reabsorption in the loop of Henle department. Secondary effects in relation to an increase in sodium excretion are the increase urine output (due to osmotically bound water), and increased secretion of potassium in the distal tubule. Simultaneously increases excretion of calcium ions and magnesium. Repeated administration of the drug Lasix its diuretic activity is not reduced, because the drug interrupts the tubular-glomerular feedback in the Macula densa (tubular structure, which is closely associated with the juxtaglomerular complex). Lasix is a dose-dependent stimulation of the renin-angiotensin-aldosterone system. In heart failure Lasix rapidly reduces preload (due to varicose veins), reduces the pressure in the pulmonary artery pressure and left ventricular filling. This booming effect seems to be mediated via effects of prostaglandins and hence the condition for its development is no violation in the synthesis of prostaglandins, which in addition to the realization of this effect also requires adequate preservation of renal function. Dose diuresis and natriuresis occurs when taking Lasix in a dose of from 10 mg to 100 mg. (healthy volunteers). After intravenous administration of 20 mg of the drug Lasix diuretic effect occurs within 15 minutes and lasts for about 3 hours. The relationship between the concentrations of unbound (free), furosemide and natriuretic effect is shaped sigmoidal curve with the minimum effective rate of excretion of furosemide of about 10 mcg / min So prolonged infusion of furosemide is more efficient than repeated bolus administration. Furthermore, above a certain bolus dose not observed a significant increase of the effect. By reducing the tubular secretion of furosemide or binding of the drug to being in the tubular lumen albumin (eg, nephrotic syndrome) the effect of furosemide reduced.
The volume of distribution of furosemide is 0.1-0.2 l / kg body weight and varies greatly depending on the underlying disease. Furosemide is very much bound to plasma proteins (98%), mainly albumin. Furosemide is excreted mainly in unchanged form and mainly by secretion in the proximal tubule. After intravenous administration of furosemide 60-70% of the administered dose is excreted in this way. Terminal half-life after intravenous administration of furosemide is about 1-1.5 hours. Furosemide crosses the placental barrier and is excreted in breast milk. Concentrations in the fetus and newborn are the same as in the mother.
Indications for use Edema syndrome in patients with chronic heart failure. Edema in acute heart failure. Edema syndrome in patients with chronic renal failure. Acute renal insufficiency, including that burns during pregnancy and (to maintain the liquid excretion). Edema in nephrotic syndrome (nephrotic syndrome is in the foreground treatment of the underlying disease). Edema in liver disease (if necessary, in addition to the treatment of aldosterone antagonists). Swelling of the brain. Hypertensive crisis. Maintenance of forced diuresis in case of poisoning with chemical compounds that are excreted by the kidneys unchanged.
Hypersensitivity to the active substance or to any component of the formulation; in patients who are allergic to sulfonamides (sulfa antimicrobials or sulfonylureas) may develop "cross" allergic to furosemide. Renal failure with anuria not responding to furosemide administration. Hepatic precoma and coma. Expressed hypokalemia. Expressed hyponatremia. Hypovolemia (hypotension with or without), or dehydration. Pronounced disturbances of outflow of urine from any cause (including one-sided defeat of the urinary tract). Pregnancy . Lactation.
When arterial hypotension; under conditions where excessive reduction of blood pressure is especially dangerous (stenosing coronary and / or cerebral arteries); in acute myocardial infarction (increased risk of developing cardiogenic shock) with latent or manifest diabetes; gout; with hepatorenal syndrome; with hypoproteinemia (eg, nephrotic syndrome, when possible to reduce the diuretic effect and boost the risk of ototoxic action of furosemide, therefore titration in these patients should be performed with extreme caution); in violation of the outflow of urine (prostatic hyperplasia, narrowing of the urethra or hydronephrosis); with hearing loss, pancreatitis, diarrhea, with ventricular arrhythmias in history, in systemic lupus erythematosus; in preterm infants (possibility of forming calcium kidney stones (nephrolithiasis) and the deposition of calcium salts in the renal parenchyma (nephrocalcinosis), so you need regular monitoring of renal function and renal ultrasound).
Pregnancy and lactation
Furosemide crosses the placental barrier, so it should not be administered during pregnancy. If for health reasons Lasix appointed pregnant, it is necessary to carefully monitor the fetus. During breastfeeding is contraindicated receiving furosemide. Furosemide inhibits lactation.
Dosing and Administration
In the appointment of Lasix recommended to use the lowest dose sufficient to achieve the desired therapeutic effect. The drug is administered intravenously and intramuscularly in exceptional cases (when is not possible to use the drug intravenously or orally). Intravenous administration of the drug Lasix is carried out only when the drug inside is not possible or there is a violation of drug absorption in the small intestine, or, if necessary, to obtain the most rapid effect. When using intravenous administration of the drug Lasix is always recommended as a possible early transfer of the patient to the use of oral forms of Lasix. A solution for parenteral administration having a pH of about 9 and does not possess buffering properties. At pH below 7, the active substance will drop out in the precipitate, so the dilution of the drug Lasix should strive to the pH of the solution ranged from neutral to weakly alkaline. Can be used for dilution with saline. A dilute solution of the drug Lasix should be used as soon as possible. The maximum recommended daily dose for intravenous administration for adults is 1500 mg. In children, the recommended dose for parenteral administration is 1 mg / kg body weight (no more than 20 mg per day). The duration of treatment is determined by the doctor individually depending on the evidence.
Specific recommendations for the dosing regimen in adults:
Edema syndrome in patients with chronic heart failure. The recommended initial dose is 20-80 mg per day. The required dose should be chosen depending on the diuretic response. It is recommended that the daily dose was administered two or three times. Edema in acute heart failure. The recommended initial dose is 20-40 mg as an intravenous bolus. If necessary, the dose Lasix may be adjusted depending upon the therapeutic effect. Edema syndrome in patients with chronic renal failure. Natriuretic response to furosemide depends on several factors, including the severity of renal failure, and sodium content in the blood, so the effect of the dose can not be accurately predicted. In patients with chronic renal failure requires careful titration, by its gradual increase, so that the fluid loss occurred gradually (early treatment possible loss of liquid to about 2 kg of body weight per day). In patients on hemodialysis, the usual maintenance dose is 250-1500 mg / day. When administered intravenously, the dose of furosemide may be defined as follows: begin treatment with intravenous drip administration at 0.1 mg per minute, and then gradually increase the injection rate every 30 minutes, depending upon the therapeutic effect. Acute renal failure (to maintain the liquid excretion). Before starting treatment with Lasix should be eliminated hypovolemia, hypotension and significant violations of electrolyte and acid-base status. It is recommended that the patient as soon as possible was transferred to the intravenous administration of the drug Lasix on pills (pills Lasix dosage depends on the chosen intravenous dose). The recommended initial intravenous dose is 40 mg. If, after its introduction is not achieved desired diuretic effect, Lasix can be administered as a continuous intravenous infusion, from the speed of administration is 50-100 mg per hour. Edema in nephrotic syndrome. The recommended initial dose is 20-40 mg per day. The required dose should be chosen depending on the diuretic response. Edema in liver disease. Furosemide is is appointed in addition to treatment of aldosterone antagonists in case of insufficient effectiveness. To prevent the development of complications, such as violation of orthostatic circulatory regulation or of electrolyte or acid-base status requires careful selection of the dose, so that the fluid loss occurred gradually (early treatment possible loss of liquid to about 0.5 kg of body weight per day). If intravenous administration is absolutely necessary, the initial dose for intravenous administration of 20-40 mg. Hypertensive crisis, cerebral edema. The recommended initial dose is 20-40 mg by intravenous bolus injection. The dosage may be adjusted depending on the effect. Maintenance of forced diuresis in case of poisoning. Furosemide is administered after intravenous infusion of electrolyte solutions. The recommended initial dose for intravenous administration of 20-40 mg. Dose dependent reaction furosemide. Prior to and during treatment with Lasix be monitored and recover loss of fluid and electrolytes.