Frusemide (Furosemide)

Frusemide (Furosemide) is a loop diuretic medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

• Heart failure — relieving breathlessness and swelling of the legs and lungs
• Oedema — fluid retention from liver cirrhosis (ascites), kidney disease or nephrotic syndrome
• High blood pressure — usually when kidney function is reduced or other medicines are insufficient
• Acute pulmonary oedema — emergency hospital treatment of fluid in the lungs (injection form)

Most side effects relate to fluid and salt loss:

• Increased urination for several hours after the dose (expected)
• Thirst, dry mouth, dizziness or light-headedness, especially on standing
• Low potassium — muscle cramps, weakness, palpitations
• Low sodium or magnesium, dehydration
• Increased uric acid — can trigger gout
• Raised blood sugar in some patients
• Less common but serious: ringing in the ears or hearing problems (high doses), severe skin reactions, marked reduction in urine output — seek medical help

• Attend all follow-ups — regular blood tests for potassium, sodium and kidney function are essential on this medicine.
• Weigh yourself as advised and report a gain of more than about 1.5–2 kg over 2–3 days, or rapid loss.
• Eat potassium-containing foods (banana, coconut water, leafy greens) if your doctor advises; some patients need a potassium supplement or a potassium-sparing combination.
• In hot weather, diarrhoea or vomiting, dehydration develops quickly — contact your doctor; the dose may need a temporary change.
• Rise slowly from sitting or lying to avoid falls, especially in the elderly.
• Tell your doctor if you have diabetes, gout, prostate enlargement or difficulty passing urine.
• Plan the dose timing around travel so toilet access is not a problem.

• NSAID painkillers (ibuprofen, diclofenac): blunt the diuretic effect and strain the kidneys
• Digoxin: low potassium caused by frusemide increases digoxin toxicity — potassium must be monitored
• Aminoglycoside antibiotics (gentamicin, amikacin): combined risk of hearing damage and kidney injury
• Lithium: levels can rise to toxic range
• Other blood pressure medicines, ACE inhibitors/ARBs: additive pressure drop; kidney function watched when starting
• Corticosteroids: add to potassium loss
• Diabetes medicines: frusemide may raise blood sugar slightly

Tell your doctor about all medicines, supplements and herbal products you use.

• Allergy to frusemide or sulphonamide-derived medicines
• Severe dehydration or very low blood volume
• Complete inability to pass urine (anuria) or kidney failure not producing urine
• Severe low potassium or low sodium until corrected
• Hepatic coma or pre-coma in liver disease (used only under specialist care)

Pregnancy: Frusemide crosses the placenta and is used in pregnancy only for clear medical reasons (such as heart failure or pulmonary oedema), under specialist supervision. It is not used to treat ordinary pregnancy swelling or pregnancy-induced hypertension, where it can reduce placental blood flow. Always inform your doctor if you are or may be pregnant.

Lactation: Frusemide passes into breast milk and may reduce milk production. If it is essential for the mother, the doctor will weigh the options — sometimes feeds are timed around doses or an alternative is chosen.

Store below 30°C in a cool, dry place, protected from light — frusemide is light-sensitive, so keep tablets in the original pack until use. Keep out of the reach of children. Do not use after the expiry date.