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Furosemide Tablets

Function and Efficacy

(1) Effect on water and electrolyte excretion. It can increase the excretion of water, sodium, chloride, potassium, calcium, magnesium, phosphorus, etc. Unlike thiazide diuretics, loop diuretics such as furosemide have a clear dose-effect relationship. As the dose increases, the diuretic effect is significantly enhanced, and the drug dosage range is large. This type of drug mainly inhibits the active reabsorption of NaCl by the thick-walled segment of the renal tubular loop of Medullary. As a result, the concentrations of Na and Cl- in the tubular fluid increase, while the concentrations of Na and Cl- in the medullary interstitial fluid decrease, which reduces the osmotic pressure gradient difference and the renal tubular concentrating function, thereby increasing the excretion of water, Na, and Cl-. Due to the decrease in Na reabsorption, the Na concentration in the distal tubule increases, which promotes the increase in Na-K and Na-H exchange, and increases the excretion of K and H. As for the mechanism by which furosemide inhibits the reabsorption of Cl- in the thick-walled segment of the ascending limb of the renal tubular loop, it was previously believed that there was a chloride pump in this area. Current studies have shown that there is a Na and Cl- paired transport system related to Na-KATPase on the outside of the basement membrane of this area. Furosemide reduces the reabsorption of Na and Cl- by inhibiting the function of this system. In addition, furosemide may also inhibit the reabsorption of Na and Cl- by the proximal and distal tubules and promote the secretion of K by the distal tubules. Furosemide increases the excretion of Ca2 and Mg2 by inhibiting the reabsorption of Ca2 and Mg2 by the loop of Henle. Short-term use of the drug can increase uric acid excretion, while long-term use can cause hyperuricemia. (2) Effects on hemodynamics. Furosemide can inhibit the activity of prostaglandin degrading enzymes, increase the content of prostaglandin E2, and thus have a vasodilatory effect. Dilation of renal blood vessels, reduction of renal vascular resistance, and increase of renal blood flow, especially deep renal cortical blood flow, are of great significance in the diuretic effect of furosemide and are also the theoretical basis for its use in preventing acute renal failure. In addition, unlike other diuretics, loop diuretics increase tubular fluid flow while the glomerular filtration rate does not decrease, which may be related to the reduction of chloride flowing through the macula densa, thereby weakening or blocking the glomerular-tubular balance. Furosemide can dilate pulmonary capacitance veins and reduce pulmonary capillary permeability. In addition, its diuretic effect reduces the amount of blood returning to the heart and reduces the left ventricular end-diastolic pressure, which is helpful for the treatment of acute left heart failure. Since furosemide can reduce pulmonary capillary permeability, it provides a theoretical basis for its treatment of adult respiratory distress syndrome.

Ingredients

The main ingredient of this product is furosemide. Its chemical name is 2-[(2-furanmethyl)amino]-5-(sulfamoyl)-4-chlorobenzoic acid.

Name Description Content CAS NO. Manufacturer
FurosemideIngredients

Increase the excretion of water, sodium, chloride, potassium, calcium, magnesium, phosphorus, etc.; inhibit the active reabsorption of NaCl by the thick-walled segment of the renal tubular loop of Henle, reduce the osmotic pressure gradient difference of the medullary interstitial fluid, and lead to increased excretion of water and electrolytes; inhibit the reabsorption of Ca2+ and Mg2+ by the loop of Henle and increase their excretion; short-term use of the drug increases uric acid excretion, and long-term use may cause hyperuricemia; dilate renal blood vessels, reduce renal vascular resistance, and increase renal blood flow; dilate pulmonary capacitance veins, reduce pulmonary capillary permeability, reduce the amount of blood returning to the heart, and reduce left ventricular end-diastolic pressure.

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54-31-9 49

Appearance

This product is white tablets.

Indication

1. Edema diseases include congestive heart failure, cirrhosis, kidney disease (nephritis, nephropathy and acute and chronic renal failure caused by various reasons), especially when other diuretics are ineffective, this type of drug may still be effective. Used in combination with other drugs to treat acute pulmonary edema and acute cerebral edema. 2. Hypertension In the step therapy of hypertension, this type of drug is not the first choice for the treatment of primary hypertension, but when thiazide drugs are ineffective, especially when accompanied by renal insufficiency or hypertensive crisis, this type of drug is particularly suitable. 3. Prevention of acute renal failure It is used for insufficient renal blood perfusion caused by various reasons, such as dehydration, shock, poisoning, anesthesia accidents and circulatory insufficiency. Timely application while correcting insufficient blood volume can reduce acute tubular necrosis.

Usage and Dosage

Adults: (1) Treatment of edema. The starting dose is 20-40 mg orally, once a day. If necessary, add 20-40 mg after 6-8 hours until a satisfactory diuretic effect is achieved. Although the maximum dose can reach 600 mg per day, it should generally be controlled within 100 mg, taken in 2-3 times. This is to prevent excessive diuresis and adverse reactions. For some patients, the dose can be reduced to 20-40 mg, once every other day, or taken continuously for 2-4 days per week, 20-40 mg per day. (2) Treatment of hypertension. Start with 40-80 mg per day, taken in 2 times, and adjust the dose as appropriate. (3) Treatment of hypercalcemia. Take 80-120 mg orally per day, taken in 1-3 times. Children: For the treatment of edema, start with 2 mg/kg of body weight, taken orally, and if necessary, add 1-2 mg/kg every 4-6 hours. The interval between doses should be extended for newborns.

Adverse Reactions

Common symptoms are related to water and electrolyte disorders, especially when used in large doses or for a long time, such as postural hypotension, shock, hypokalemia, hypochloremia, hypochloremic alkalosis, hyponatremia, hypocalcemia, and related thirst, fatigue, muscle aches, arrhythmias, etc. Rare symptoms include allergic reactions (including rash, interstitial nephritis, and even cardiac arrest), blurred vision, xanthoopia, photosensitivity, dizziness, headache, sodium difference, nausea, vomiting, abdominal pain, diarrhea, pancreatitis, muscle rigidity, bone marrow suppression leading to granulocytopenia, thrombocytopenic purpura and aplastic anemia, liver damage, paresthesia of fingers (toes), hyperglycemia, positive urine sugar, aggravation of existing diabetes, and hyperuricemia. Tinnitus and hearing impairment are more common when large doses are injected intravenously rapidly (doses greater than 4-15 mg per minute), and are mostly temporary, with a few being irreversible, especially when used simultaneously with other ototoxic drugs. In cases of hypercalcemia, it can cause kidney stones. There are also reports that this drug can aggravate idiopathic edema.

Precautions

Not yet clear

Special Population Medication

Precautions for children: The half-life of this drug in newborns is significantly prolonged, so the interval between doses for newborns should be extended. Precautions for pregnancy and lactation: 1. This drug can pass through the placental barrier, so pregnant women, especially those in the first 3 months of pregnancy, should avoid using it as much as possible. It has no preventive effect on pregnancy-induced hypertension syndrome. Animal experiments have shown that this product can cause fetal hydronephrosis, increased miscarriage and fetal mortality. 2. This drug can be secreted through breast milk, so lactating women should use it with caution. Precautions for the elderly: When the elderly use this drug, they are more likely to experience hypotension, electrolyte imbalance, thrombosis and renal damage.

Drug Interactions

(1) Adrenal glucose, mineralocorticoids, adrenocorticotropic hormone and estrogen can reduce the diuretic effect of this drug and increase the chance of electrolyte disorders, especially hypokalemia. (2) Nonsteroidal anti-inflammatory analgesics can reduce the diuretic effect of this drug and increase the chance of renal damage. This is related to the fact that the former inhibits prostaglandin synthesis and reduces renal blood flow. (3) When used in combination with sympathomimetic drugs and anticonvulsant drugs, the diuretic effect is weakened. (4) When used in combination with clofibrate (clofibrate), the effects of both drugs are enhanced, and muscle soreness and stiffness may occur. (5) When used in combination with dopamine, the diuretic effect is enhanced. (6) Drinking alcohol, alcohol-containing preparations and drugs that can cause a decrease in blood pressure can enhance the diuretic and hypotensive effects of this drug; when used in combination with barbiturates and anesthetics, it is easy to cause orthostatic hypotension. (7) This drug can reduce uric acid excretion and increase blood uric acid. Therefore, when used in combination with drugs for the treatment of gout, the dose of the latter should be appropriately adjusted. (8) Reduce the efficacy of hypoglycemic drugs. (9) Reduce the effects of anticoagulants and antifibrinolytic drugs, mainly due to the decrease in blood volume after diuresis, which leads to an increase in the concentration of coagulation factors in the blood, and the improvement of liver blood supply and the increase of liver synthesis of coagulation factors due to diuresis. (10) This drug enhances the effect of non-depolarizing muscle relaxants, which is related to the decrease in blood potassium. (11) When used in combination with antibiotics such as amphotericin, cephalosporin, and aminoglycosides, nephrotoxicity and ototoxicity increase, especially when there is existing renal damage. (12) When used in combination with antihistamines, ototoxicity increases, and tinnitus, dizziness, and vertigo are likely to occur. (13) Nephrotoxicity increases significantly when used in combination with lithium, which should be avoided as much as possible. (14) After taking chloral hydrate, intravenous injection of this drug can cause sweating, facial flushing, and increased blood pressure, which is related to the increase in thyroid hormone conversion from bound to free state, leading to enhanced decomposition. (15) When used in combination with sodium bicarbonate, the chance of hypochloremic alkalosis increases.

Storage

Keep away from light, sealed and stored in a dry place.

Packaging Specification

20mg

Validity Period

18 months

Manufacturer

Taishan City Xinning Pharmaceutical Co., Ltd.

  • Founded in:

    2005-06-24
  • Address:

    No. 223, Renxiao Road, Taicheng Town, Taishan City
  • Tax NO.:

    91440781776913130X
  • Registered Funds:

    100 million yuan
  • Email:

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