Lasix M

Lasix M - Precautions | Dosage | Effects

This article was medically reviewed by M.Pharm, Marko Tanaskovic on August 12, 2018. To read more about an author, click here.

Lasix M is a medicine that is approved for use in Australia and contains the active substance fursemide (also known as furosemide). Lasix M exhibits a diuretic effect (increases the elimination of water from the body) and is classified as a water pill (diuretics).

Indications

Lasix M is a medicine used to treat high blood pressure when administration of hydrochlorothiazide or other thiazides has not given the appropriate therapeutic effects. Lasix M can be used alone or in combination with other medicines.

Lasix M is also used in the treatment of edemas resulting from other diseases (such as: nephrotic syndrome, liver cirrhosis and congestive heart failure).

Precautions

Although Lasix M is indicated for the treatment of edema caused by liver cirrhosis, great caution must be exercised when this medicine is used in these patients (it is recommended to be administered only in hospital conditions). It is necessary to carefully monitor the electrolyte balance (levels of sodium, potassium, calcium, magnesium and chlorine in the blood) as well as the liver function after the initiation of the Lasix M treatment. Cases of hepatic coma induced by Lasix M have been reported in as much as 11.6% of patients suffering from liver cirrhosis who have taken Lasix M. The frequency of electrolyte imbalance in patients with liver cirrhosis who use Lasix M is as high as 23.3%. Cases of severe hypokalaemia (low blood potassium levels) have been reported after administration of Lasix M tablets. Hypokalemia is a serious condition and can endanger the patient's life due to arrhythmias that can cause. Tell your doctor if you notice signs and symptoms of hypokalaemia, such as: muscle weakness, muscle cramps, low blood pressure, tachyarrhythmias, atrial or ventricular extrasystoles. The risk of hypokalaemia is higher in patients taking an adrenocortiocotropic hormone, digoxin (medicine used in the treatment of heart failure), or corticosteroids (such as dexamethasone, prednisolone, betamethasone or methylprednisolone). Lasix M tablets are absolutely contraindicated in patients who are allergic to the active substance fursemide or other chemically similar drugs, such as sulfonamides (antibiotics). Lin B. et all investigated the risk of hearing loss in patients who use diuretics (thiazides or furosemide). The study was conducted on 54 721 women and it was found that the incidence of hearing loss as an adverse effect of these drugs was 25 cases per 1000 person-years. The risk of hearing loss is higher in patients:

  • Who have hypertension.
  • Who take aminoglycoside antibiotics, such as streptomycin, kanamycin, amikacin, gentamicin, and tobramycin.
  • Who take ethacrynic acid.
  • Who have hypoproteinemia (which often follows nephrotic syndrome).

Tell your doctor if you notice any hearing impairments.

Cases of thrombocytopenia (low blood platelet counts) associated with use of Lasix M have been reported. Contact your doctor if you notice easy bruising, frequent nosebleeds, or prolonged bleeding from cuts.

Dosage

Adults

The recommended dose in the treatment of edema is 20-80 mg per day. Lasix M tablets should be taken once a day, in the morning or twice a day (in the morning and between 2-4PM). It is not recommended to take the tablets in the evening, because Lasix M increases the frequency of urination and can disturb the sleep of the patient. In very severe edema, the dose may be increased up to 600 mg per day. The recommended dose for the treatment of hypertension (when Lasix M is taken alone) is 40 mg twice a day or 80 mg once a day. The dose should be adjusted if patients are taking other antihypertensive medications and individualized according to the antihypertensive effect achieved.

Children

The initial dose in the treatment of edema is 2 mg / kg of body weight. The dose may be increased to a maximum of 6 mg / kg of body weight depending on the severity of the edema.

Use of Lasix M in the Period of Pregnancy and Lactation

In studies on rabbits in which Lasix M was administered at doses up to 8 times higher than the maximum recommended dose in humans, an increased incidence of fetal death was observed. Studies on mice and rabbits revealed an increased incidence of hydronephrosis (kidney swelling due to urine accumulation). There are no data on the use of Lasix M tablets during pregnancy, and its use during the pregnancy is not recommended. Contact your doctor if you think you are pregnant or if you are planning a pregnancy. If your doctor decides that you should use Lasix M during pregnancy, careful monitoring of fetal growth is necessary.

Lasix M passes into breast milk, and it is not recommended to use Lasix M tablets during breastfeeding.

Interactions

Lasix M tablets should not be used concurrently with the following medicines:

  • Aminoglycoside antibiotics, such as: streptomycin, gentamicin, amikacin, kanamycin and tobramycin. Concurrent use with these medicines increases the risk of ototoxic effects.
  • Etacrynic acid - water pill. Concurrent use increases the risk of ototoxic effects.
  • Cisplatin - medicine used in the treatment of cancer. Concurrent use increases the risk of damage to the kidneys and hearing.
  • Tubocurarine - muscle-relaxing medicine. Lasix M may reduce the effects of tubocurarine.
  • Lithium - antipsychotic. Lasix M reduces renal excretion of lithium which leads to an increase in lithium levels in the blood and, consequently, an increase in the risk of side effects.
  • Sucralfate - medicine used in gastric ulcer therapy. Sucralfate may reduce the antihypertensive effect of Lasix M.
  • Phenytoin - antiepileptic medicine. Phenytoin reduces intestinal absorption of Lasix M tablets which reduces the concentration of Lasix M in the blood. This leads to a decrease in the efficacy of Lasix M.
  • Methotrexate - medicine used in the treatment of cancer. Methotrexate may reduce the effectiveness of Lasix M.
  • Cyclosporine - immunosuppressive medicine. Concurrent use increases the risk of gout attack.
  • Non-steroidal anti-inflammatory drugs, such as: acetylsalicylic acid (Aspirin), diclofenac, ibuprofen, indomethacin and others. Concurrent use can result in weight gain, as well as an increase in creatinine and potassium levels in the serum.
  • Antiarrhythmics - medicines used in the treatment of irregular heartbeat (arrhythmia). Concurrent use increases the risk of arrhythmias.
  • Cisapride - medicine used in the treatment of gastroesophageal reflux. Concurrent use increases the risk of arrhythmias.

Tell your doctor about all the medicines you are taking.

Side Effects

Lasix M tablets may cause the following side effects:

  • Muscle cramps.
  • Liver damage accompanied by jaundice.
  • Inflammation of pancreas which is manifested with the following symptoms:
    • Pain in the upper part of the stomach that gets worse after a meal.
    • Nausea.
    • Vomiting.
    • Tachycardia.
    • Fever.
  • Interstitial nephritis manifested with the following symptoms:
    • Fever.
    • Nausea.
    • Vomiting.
    • Confusion.
    • Presence of blood in the urine.
    • Urinary retention.
    • Weight gain (due to urine retention).
    • High blood pressure.
  • Diarrhea.
  • Xanthopsia (seeing things in yellow).
  • Blurred vision.
  • Ringing in the ears.
  • Loss of hearing.
  • Vertigo.
  • Tingling of the hands and feet.
  • Decrease in the number of erythrocytes, leukocytes or platelets in the blood.
  • Photosensitivity.
  • Allergic reactions.

Tell your doctor if you are experiencing any side effects.

References

  1. Naranjo C, Pontigo E, Valdenegro C, et all. Furosemide-induced adverse reactions in cirrhosis of the liver. Clin Pharmacol Ther. 1979. 25(2): 154-60.
  2. Ruisz W, Stollberger C, Finsterer J, et all. Furosemide-induced severe hypokalemia with rhabdomyolysis without cardiac arrest. BMC Women's Health. 2013. 13: 30.
  3. FDA
  4. Lin B, Curhan S, Wang M, et all. Hypertension, Diuretic Use, and Risk of Hearing Loss. The American Journal of Medicine. 2016. 129(4): 416-22.
  5. Ferrari E, Taillan B, Dricci M, et all. Thrombocytopenia induced by treatment with furosemide. Press Med 1991. 20(8): 385.

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