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Furosemide (Lasix ® )
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Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]
| [All doses] [50 ml] [As directed]
May administer undiluted.
Maximum rate = 4mg/ min IV.
Stability / Miscellaneous
| EXP: 1 DAY (RT).
Label: Do not Refrigerate.
Recommended routes: IM, IV-push, Continuous infusion.
Dosing: 20 to 40 mg initially. Increase by 20 mg increments q1 to 2 hours until response.
Continuous infusion: 20 to 160 mg/hr.
DOSAGE AND ADMINISTRATION
Therapy should be individualized according to patient response to gain maximal therapeutic response and to determine the minimal dose needed to maintain that response. Close medical supervision is necessary. If the physician elects to use high dose parenteral therapy, add the furosemide to either Sodium Chloride Injection, USP, 0.9%, Lactated Ringer’s Injection, USP, or Dextrose (5%) Injection, USP, after pH has been adjusted to above 5.5, and administer as a controlled intravenous infusion at a rate not greater than 4 mg/min. Furosemide injection is a buffered alkaline solution with a pH of about 9 and drug may precipitate at pH values below 7. Care must be taken to ensure that the pH of the prepared infusion solution is in the weakly alkaline to neutral range. Acid solutions, including other parenteral medications (e.g., labetalol, ciprofloxacin, amrinone, milrinone) must not be administered concurrently in the same infusion because they may cause precipitation of the furosemide. In addition, furosemide injection should not be added to a running intravenous line containing any of these acidic products.
Acute Pulmonary Edema
IIf necessary, additional therapy (e.g., digitalis, oxygen) may be administered concomitantly.
Pediatric Patients- Parenteral therapy should be used only in patients unable to take oral medication or in emergency situations and should be replaced with oral therapy as soon as practical.
The usual initial dose of furosemide injection (intravenously or intramuscularly) in infants and children is 1 mg/kg body weight and should be given slowly under close medical supervision. If the diuretic response to the initial dose is not satisfactory, dosage may be increased by 1 mg/kg not sooner than 2 hours after the previous dose, until the desired diuretic effect has been obtained. Doses greater than 6 mg/kg body weight are not recommended.
Literature reports suggest that the maximum dose for premature infants should not exceed 1 mg/kg/day. WARNINGS: Pediatric Use: In premature neonates with respiratory distress syndrome, diuretic treatment with furosemide in the first few weeks of life may increase the risk of persistent patent ductus arteriosus (PDA), possibly through a prostaglandin-E-mediated process.
Literature reports indicate that premature infants with post-conceptual age (gestational plus postnatal) less than 31 weeks receiving doses exceeding 1 mg/kg/24 hours may develop plasma levels which could be associated with potential toxic effects including ototoxicity.
Hearing loss in neonates has been associated with the use of furosemide injection
Furosemide injection should be inspected visually for particulate matter and discoloration before administration. Do not use if solution is discolored.
Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.] Do not freeze.
Protect CARPUJECT from light. Do not remove cartridges from package until time of use.
Do not use the injection if it is discolored or contains a precipitate.
Source: [package insert]