Diuretics, Loop (Systemic)

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:

• If you are to take a single dose a day, take it in the morning after breakfast.
• If you are to take more than one dose a day, take the last dose no later than 6 p.m., unless otherwise directed by your doctor.

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:

• This medicine is to be taken by mouth even if it comes in a dropper bottle. If this medicine does not come in a dropper bottle, use a specially marked measuring spoon or other device to measure each dose accurately, since the average household teaspoon may not hold the right amount of liquid.

For patients taking this medicine for high blood pressure :

• In addition to the use of the medicine your doctor has prescribed, appropriate treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which factors are most important for you. You should check with your doctor before changing your diet.
• Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
• Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

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 .

For bumetanide
• For oral dosage form (tablets):
  • To lower the amount of water in the body:
    • Adults - 0.5 to 2 milligrams (mg) once a day. Your doctor may increase your dose if needed.
    • Children - Dose must be determined by your doctor.
• For injection dosage form:
  • To lower the amount of water in the body:
    • Adults - 0.5 to 1 mg injected into a muscle or a vein every two to three hours as needed.
    • Children - Dose must be determined by your doctor.

For ethacrynic acid
• For oral dosage form (oral solution or tablets):
  • To lower the amount of water in the body:
    • Adults - 50 to 200 milligrams (mg) a day. This may be taken as a single dose or divided into smaller doses.
    • Children - At first, 25 mg a day. Your doctor may increase your dose as needed.
• For injection dosage form:
  • To lower the amount of water in the body:
    • Adults - 50 mg injected into a vein every two to six hours as needed.
    • Children - Dose is based on body weight and must be determined by your doctor. The usual dose is 1 mg per kilogram (kg) (0.45 mg per pound) of body weight injected into a vein.

For furosemide
• For oral dosage form (oral solution or tablets):
  • To lower the amount of water in the body:
    • Adults - At first, 20 to 80 milligrams (mg) once a day. Then, your doctor may increase your dose as needed. Your doctor may tell you to take a dose once a day, two or three times a day, or every other day.
    • Children - Dose is based on body weight and must be determined by your doctor. The usual dose is 2 mg per kilogram (kg) (0.91 mg per pound) of body weight for one dose. Then, your doctor may increase your dose every six to eight hours as needed.
  • For high blood pressure:
    • Adults - 40 mg two times a day. Your doctor may increase your dose.
• For injection dosage form:
  • To lower the amount of water in the body:
    • Adults - At first, 20 to 40 mg injected into a muscle or a vein for one dose. Then, your doctor may increase your dose every two hours as needed. Once the medicine is working, the dose is injected into a muscle or a vein one or two times a day.
    • Children - Dose is based on body weight and must be determined by your doctor. The usual dose is 1 mg per kg (0.45 mg per pound) of body weight injected into a muscle or a vein for one dose. Your doctor may increase your dose every two hours as needed.
  • For very high blood pressure:
    • Adults - 40 to 200 mg injected into a vein.

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:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the oral liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.