Furosemide Injection 20MG / 2ML Diuretics Medicines BP / USP

FUROSEMIDE 20 MG/2ml INJECTION

COMPOSITION:

Each 2ml ampoule contains 20 mg furosemide.

PHARMACOLOGICAL ACTION:
Furosemide is a high-ceiling diuretic acting primarily by inhibiting electrolyte and fluid reabsorption in the thick ascending limb of the Loop of Henle as well as in the proximal tubule. It is approximately 90% protein bound, has a half life of about 1 - 2 hours and has a duration of action in the range of 3 - 6 hours. It is excreted mainly by the kidneys and liver and the remainder in the faeces. The excretion of potassium, titratible acid, ammonia, calcium and magnesium are enhanced and the concentration of uric acid in plasma is increased.
In patients with pulmonary oedema, venous capacitance is increased, thereby decreasing left ventricular filling pressure.

INDICATIONS:
Cardiac oedema: All forms of cardiac oedema in conjunction with adequate glycoside therapy.
Ascites due to cirrhosis of the liver, mechanical obstruction or cardiac failure.
Renal oedema (in nephrotic syndrome usually in conjunction with ACTH or corticosteroids).
Pulmonary oedema.
Cerebral oedema.
Forced diuresis e.g. management of barbiturate poisoning.
Burns: to reduce local oedema and to prevent oliguria from progressing to complete anuria.

CONTRA-INDICATIONS:
Patients who are hypersensitive to furosemide or sulphonamides.
Increased azotaemia and oliguria occurring during treatment of severe progressive renal disease – the drug should be discontinued. In hepatic coma and in states of electrolyte depletion, hypovolaemia and hypotension, therapy with Furosemide Injection should not be instituted until the basic condition is corrected or improved.
Lactating women.

WARNINGS:
Fluid and electrolyte imbalance should be monitored during therapy.

DOSAGE AND DIRECTIONS FOR USE:
Intravenous or intramuscular administration of furosemide is indicated in all cases where intestinal absorption is impaired or prompt diuresis is required. The rapid and powerful effect produced by intravenous injection may result in a transitory fall in plasma volume.
Intravenous injection should be given slowly (over 1 to 2 minutes).
The recommended adult dose by this route is 20 to 40 mg, repeated if necessary after not less than 2 hours. The usual pediatric dose is 1 mg/kg.
Pulmonary oedema: Initial dose 40 mg intravenously. If necessary, the injection may be repeated after approximately 60 to 90 minutes.

SIDE-EFFECTS AND SPECIAL PRECAUTIONS:
With parenteral use of furosemide in high doses reversible deafness and tinnitus have been reported when the infusion is faster than 4 mg per minute. Permanent deafness may develop in patients with impaired renal function.
Various forms of skin reactions including rashes, urticaria, exfoliative dermatitis, paraesthesia, pruritis, purpura, photosensitivity and erythema multiforme may occur.
Nausea, vomiting, diarrhoea, blurred vision, dizziness, headache, pancreatitis, muscle spasm, cramps, hypotension and allergic reactions may occur.
Furosemide should be used with care in patients with prostatic hypertrophy or impairment of micturition.
Anaemia, leucopenia, agranulocytosis, aplastic anaemia and thrombocytopenia (with purpura) may occur.

STORAGE INSTRUCTIONS:
Store below 25°C. Protect from light. Keep out of reach of children.