Hypertension, congestive heart failure, edema, renal ailments and cirrhosis of the liver are treated/managed through various medications. Among the various medications used, loop diuretics are regarded as potent with impressive outcomes. Edema that is a result of various conditions is effectively tackled by loop diuretics, that are known to work fast, delivering desired results within a short duration. It is typically regarded as safe for adults as well as the young. As with all medications, undesirable effects are a possibility with diuretics. Here is a detailed, in depth look at the side effects of furosemide and measures to keep it under control or reduce the possibility of the effects.
Overview of the diuretic and side effects of furosemide
Belonging to the category of loop diuretics, furosemide is an effective medication prescribed for treating various conditions as mentioned above. Before we look at the side effects of furosemide, it helps to understand more about the mechanism of action of the medication and its various uses. The diuretic works by increasing the amount of water that is shed by the body. This is achieved through the kidneys, helping in delivering the desired outcomes. Known as a derivative of anthranilic acid, it is known to prevent the reabsorption of electrolytes from the kidneys, thereby resulting in increased excretion of water from the body.
By virtue of its relatively fast onset of action and the sort duration of the effects, it is regarded as a safe treatment option for adults as well as for pediatric patients of conditions that result in edema. It is s preferred choice when there is a need for a drug with potent diuretic properties. It is typically taken as an oral formulation, though it is also available as an injectable. It can be administered either intramuscularly or intravenously in patients who are not in a position to be administered oral; formulations. For instance, in emergencies, there may be a need to administer injections to patients in serious conditions.
Ideal dosage to prevent side effects of furosemide
One of the most common reasons for side effects of furosemide or other medications is the incorrect dosage or improper use of drugs. The recommended dosage depends on various factors – the age of the patient, the formulation chosen, the condition of the patient, the intensity of the condition, the presence/absence of other existing conditions, the use of other medications, and the reaction of the patient to the initial doses of the medication. Here is a look at the ideal dosages that need to be taken for various conditions. Bear in mind, that this is a reference value and not to be taken as the recommended dosage. The actual dosage will be as per the recommendations in the prescription; the information shared below is primarily the upper and lower limit of the medication.
The medication is available as tablets in strengths of 20 mg, 40 mg and 80 m, while the oral solutions come in strengths of 10 mg per 1 ml and 40 mg per 5 ml. Adult patients diagnosed with hypertension are prescribed an initial dosage of 80 mg per day, which is split into two doses of 40 mg twice daily. To prevent side effects of furosemide senior patients above the age of 65 years are typically started off on lower doses. This is mainly to factor in the reduced abilities of the kidneys to process the drug. As a consequence of reduced ability, the drug remains in the body for a longer time, which in turn may result in increased side effects. This is typically handled by altering the dosage or the schedule to ensure that lesser amounts of the drug are in the body.
This is also applicable for patients with kidney ailments, as the kidneys are responsible for the processing and elimination of the drug from the body. Patients with renal impairments are generally started off on a lower dosage which is then followed by gradual increase. Depending on how the patient reacts to the increase in dosage, the schedule and strength is altered. The idea is to ensure that the drug is safe without undesirable effects. The dosage for various conditions such as edema, alters as per the age group and condition. For children the dosage is also calculated on the basis of body weight subject to a maximum upper limit in strength.
Warnings associated with the drug and side effects of furosemide
There are specific FDA health warnings associated with the medication. For instance, there is a black box warning to doctors and users about the potential side effects of furosemide. As a result of its mechanism of action of increasing the excretion of urine from the body, the diuretic may result in acute dehydration if excessive dosages are taken. Change in fluid levels in the body may trigger undesirable effects. Blood pressure levels may reduce significantly, as a result of the water pill. For instance, the patient may feel faint or dizzy when rising from a reclining position. The warning also points to the possibility of reduced potassium levels as a result of taking the medication. This could impact various functions in the body. Commonly observed symptoms of low potassium levels include weakness in the muscles, vomiting and nausea. Additionally, the thyroid levels of the individual on water pills may reduce, which can be observed in symptoms such as fatigue, abnormal weight gain, and overall feeling of dip in temperature. The skin and hair of patients on loop diuretics may also appear dry during this period.
Commonly reported side effects of furosemide
With all the above information, it is time to look at the side effects of furosemide. There are commonly reported undesirable effects of medications, and there are side effects that are rare in occurrence. The commonly reported effects may resolve without the need for medical intervention in most instance. However, if the effects are persistent in nature or if the intensity is severe, it may require medical attention. In the case of rare occurrences, the side effects are typically serious in nature and may require some form of intervention.
Commonly reported effects include bouts of diarrhea not attributed to any other condition. This may or may not be accompanied by vomiting and nausea. On a contrasting note, patients may also end up with constipation as a result of the medication. Here, the symptoms may include cramps in the stomach. Other common side effects of furosemide include throbbing headache and a spinning sensation where the surroundings appear to be spinning around. Blurred vision is also a possibility in patients on the medication, while many frequently report dizziness that could be mild in nature. Finally, the outbreak of rashes has also been reported in a small section of patients on the medication.
Side effects of furosemide that are serious in nature
In addition to the above, there are serious side effects of furosemide as compiled below. Excessive consumption may result in dehydration that can be identified through symptoms such as thirsty feeling, a dry mouth, and general weakness. This is attributed to the loss of electrolytes with the fluids, and the resultant imbalance. Individuals may feel drowsy as a result of this weakness, while some may feel restless. Pain int eh muscles and cramps are other manifestations that indicate dehydration. Additionally, the individual could also feel a perceptible increase in heart beat rate or an abnormal rate of heart beat. Vomiting and nausea are also other symptoms that indicate serious side effects of furosemide.
As mentioned earlier, the patient may also end up with lower levels of thyroid hormones, that can be easily identified through associated symptoms. Another undesirable effect that is regarded as serious in nature is the inflammation of the pancreas, that is known medically as pancreatitis. Patients who experience pain while eating or drinking or with a fever that is not attributable to other conditions are to seek medical assistance to check for the condition. Other indications of the condition include nausea and vomiting. Damage to the liver are other possible side effects of furosemide that can be identified through a distinct discoloration of the whites of the eyes and the skin. The color changes to yellowish tint, indicating possible issues in the liver.
Finally, the individual may also experience peeling of the skin, or the formation of blisters on the skin that are not attributed to any other condition. Loss of hearing or a ringing sensation int eh ears is also a possible side effect of the medication. This is regarded as serious, as this could either be te3mporary in nature or could also be a lifelong impact. It is important to note that the above is a compilation of side effects of furosemide and does not necessarily mean that all individuals on the medication will experience side effects. Some may end up with undesirable effects, while some may not experience any effects at all. Similarly, the gravity of the side effects may also differ from person to person.
Side effects of furosemide – drug interactions
In addition to the above, the drug is also known to interact with other medications. This includes prescription drugs, OTC formulations, herbal products, vitamin supplement and natural remedies. The drug may interact with antibiotics and increase the risk of hearing damage. The medication may also have an impact on drugs recommended for treating seizures. Similarly, side effects of furosemide include drug interactions with cancer drugs resulting in possible kidney complications. Finally, the diuretic is also known to interact with immunosuppressants and medications belonging to mood stabilizers category, muscle relaxants and medications for controlling blood pressure levels.