Furosemide

Furosemide (INN) or frusemide (former BAN) is a loop diuretic used in the treatment of congestive heart failure and oedema. It is most commonly marketed by Aventis Pharma under the brand name Lasix. It has also been used to prevent thoroughbred race horses from bleeding through the nose during races.

Along with some other diuretics, furosemide is also included on the World Anti-Doping Agency's banned drug list due to its alleged use as a masking agent for other drugs.

Mechanism of action

Like other loop diuretics, furosemide acts by inhibiting the Na-K-2Cl symporter in the thick ascending loop of Henle. It also has inhibitory activity on carbonic anhydrase.

Clinical use in humans

Furosemide, as a loop diuretic, is principally used in the following indications (Aventis, 1998):

  • oedema associated with heart failure, hepatic cirrhosis, renal impairment, nephrotic syndrome
  • Hypertension
  • Adjunct in cerebral/pulmonary oedema where rapid diuresis is required (IV injection)

    It is also sometimes used in the management of severe hypercalcemia in combination with adequate rehydration (Rossi, 2004).

    Although disputed, it is considered ototoxic: "usually with large parenteral doses and rapid administration and in renal impairment"

    Drug Interactions

    Furosemide has potential interactions with the following medications:

  • Aminoglycoside antibiotics such as Garamycin
  • Aspirin and other salicylates
  • Other diuretics (eg. Ethacrynic acid)
  • Indomethacin
  • Lithium
  • Synergistic effects with other antihypertensives (eg. Doxazosin)
  • Sucralfate

    Use in horses

    Apparently, sometime in the early 1970s, furosemide's ability to prevent or at least greatly reduce the incidence of bleeding by horses during races was discovered accidentally. Pursuant to the racing rules of most states, horses that bleed from the nostrils three times are permanently barred from racing (for their own protection). Clinical trials followed, and by decade's end, racing commissions in some states began legalizing its use on race horses. On September 1, 1995, New York became the last state in the United States to approve such use, after years of refusing to consider doing so. Some states allow its use for all racehorses; some allow it only for confirmed "bleeders." Its use for this purpose is still prohibited in many other countries, however.

    Brand names

    Some of the brand names under which furosemide is marketed include: Aisemide®, Beronald®, Desdemin®, Discoid®, Diural®, Diurapid®, Dryptal®, Durafurid®, Errolon®, Eutensin®, Frusetic®, Frusid®, Fulsix®, Fuluvamide®, Furesis®, Furo-Puren®, Furosedon®, Hydro-rapid®, Impugan®, Katlex®, Lasilix®, Lasix®, Lodix®, Lowpston®, Macasirool®, Mirfat®, Nicorol®, Odemase®, Oedemex®, Profemin®, Rosemide®, Rusyde®, Salix®, Trofurit®, Urex®

    Founded around 1964.

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