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Loop Diuretic Pregnancy: Caution — avoid in first trimester; use in second/third trimester only if essential

Furosemide

Brand names: Lasix

Adult dose

Dose: 20–80 mg
Route: Oral / IV / IM
Frequency: Once or twice daily
Max: 600 mg/day (severe cases under specialist care)
Oedema/heart failure: 20–40 mg once daily initially. IV: 20–40 mg slow IV injection (1 mg/min). High-dose infusion for refractory fluid overload. Electrolyte replacement often needed.

Paediatric dose

Dose: 0.5–2 mg/kg
Route: Oral / IV
Frequency: Once or twice daily
Max: 6 mg/kg/day
0.5–2 mg/kg/dose. Oral for chronic use; IV for acute management.

Dose adjustments

Renal

Higher doses may be needed in renal impairment to achieve diuretic response. Avoid in anuric acute renal failure.

Hepatic

Caution in hepatic cirrhosis — hypokalaemia may precipitate hepatic encephalopathy. Start at low dose with potassium monitoring.

Paediatric weight-based calculator

0.5–2 mg/kg/dose. Oral for chronic use; IV for acute management.

Clinical pearls

  • Ototoxicity risk with rapid IV injection — give slowly (max 4 mg/min)
  • In severe heart failure, consider continuous IV infusion over repeated boluses
  • Monitor electrolytes regularly — replace potassium as needed; consider potassium-sparing diuretic combination

Contraindications

  • Anuria (except to test renal responsiveness)
  • Addison's disease
  • Electrolyte depletion (until corrected)
  • Pre-comatose liver failure

Side effects

  • Hypokalaemia
  • Hyponatraemia
  • Hypomagnessaemia
  • Dehydration/hypovolaemia
  • Ototoxicity (high IV doses)
  • Hyperuricaemia/gout
  • Hyperglycaemia
  • Postural hypotension

Interactions

  • Digoxin (hypokalaemia increases toxicity risk)
  • ACE inhibitors/ARBs (excessive hypotension — 'first-dose' effect)
  • NSAIDs (reduce diuretic effect + risk of AKI)
  • Aminoglycosides (additive ototoxicity)
  • Lithium (toxicity — avoid)

Monitoring

  • U&E (especially potassium) before and regularly during treatment
  • Fluid balance
  • Weight daily in fluid overload
  • Blood pressure

Reference: BNFc; BNF 90; NICE NG106 (Chronic Heart Failure); BNFc. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.