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Lasix (furosemide) Disease Interactions

There are 8 disease interactions with Lasix (furosemide):

Loop Diuretics (Includes Lasix) ↔ Anuria

Severe Potential Hazard, High plausibility

Applies to: Anuria

The use of loop diuretics is contraindicated in patients with anuria.

References

  1. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
View all 4 references

Loop Diuretics (Includes Lasix) ↔ Cirrhosis

Severe Potential Hazard, High plausibility

Applies to: Cirrhosis, Hepatic Coma

Loop diuretic therapy should be initiated in the hospital under strict observation in patients with liver cirrhosis and ascites. Sudden alteration of fluid and electrolyte balance may precipitate hepatic encephalopathy and coma in such patients, who are also at increased risk for the development of hypokalemia. Supplemental potassium and/or concomitant use of an aldosterone antagonist or potassium-sparing agent may help prevent hypokalemia and metabolic alkalosis. Loop diuretics should be withheld in patients with hepatic coma until the condition improves.

References

  1. Lieberman FL, Reynolds TB "The use of ethacrynic acid in patients with cirrhosis and ascites." Gastroenterology 49 (1965): 531-8
  2. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  3. Schwartz FD, Pillay VK, Kark RM "Ethacrynic acid: its usefulness and untoward effects." Am Heart J 79 (1970): 427-8
View all 8 references

Loop Diuretics (Includes Lasix) ↔ Electrolyte Losses

Severe Potential Hazard, High plausibility

Applies to: Hypocalcemia, Hypokalemia, Hyponatremia, Magnesium Imbalance, Diarrhea, Electrolyte Abnormalities, Hyperaldosteronism, Malnourished, Ventricular Arrhythmia, Vomiting, Dehydration

The use of loop diuretics, particularly at high dosages or during chronic therapy, is commonly associated with loss of electrolytes, including potassium, sodium, chloride, magnesium, and calcium. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Excessive diuresis, as indicated by rapid weight loss, may induce dehydration and hypovolemia, which can result in acute hypotension, orthostasis, circulatory collapse, vascular thrombosis and embolism, and abrupt reduction in glomerular filtration and renal blood flow. Severe dehydration is most likely to occur in the elderly and in patients under prolonged sodium restriction. Therapy with loop diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower diuretic dosage, potassium supplementation, or combined use with a potassium-sparing diuretic. Similarly, to prevent excessive dehydration and hyponatremia, sodium intake should be liberalized if clinically feasible.

References

  1. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
View all 26 references

Loop Diuretics (Includes Lasix) ↔ Ototoxicity

Severe Potential Hazard, High plausibility

Applies to: Hearing Loss

Tinnitus and hearing loss, both reversible and permanent, have been reported with the use of loop diuretics. Ototoxic effects have generally been associated with rapid intravenous or intramuscular injection, severe renal impairment, unusually high dosages (i.e. several times the usual recommended dosages), and/or concomitant use of other ototoxic agents. Therapy with loop diuretics should be administered cautiously in patients with preexisting vestibular and/or auditory impairment, since it may delay the recognition or confound the diagnosis of a drug-induced ototoxic effect. High-dose parenteral therapy should be administered as controlled infusion.

References

  1. Hybels RL "Drug toxicity of the inner ear." Med Clin North Am 63 (1979): 309-19
  2. Schwartz FD, Pillay VK, Kark RM "Ethacrynic acid: its usefulness and untoward effects." Am Heart J 79 (1970): 427-8
  3. Pillay VK, Schwartz FD, Aimi K, Kark RM "Transient and permanent deafness following treatment with ethacrynic acid in renal failure." Lancet 1 (1969): 77-9
View all 40 references

Loop Diuretics (Includes Lasix) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Impaired effectiveness and possible delayed excretion of loop diuretics may occur in patients with severe renal dysfunction. These individuals may require high dosages that are associated with an increased risk of electrolyte abnormalities (hyponatremia, hypochloremic alkalosis, hypokalemia, hypomagnesemia, hypocalcemia) and ototoxicity (tinnitus, hearing loss). Therapy with loop diuretics should be administered cautiously in patients with significantly impaired renal function. Prolongation of the dosing intervals may be appropriate to prevent drug accumulation, and patient should be monitored closely for the signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Excessive diuresis should be avoided as it may induce dehydration and hypovolemia, which can result in abrupt reduction in glomerular filtration and renal blood flow. If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, or if renal function becomes progressively worse as indicated by rising BUN or serum creatinine levels, an interruption or discontinuation of therapy should be considered.

References

  1. Risler T, Schwab A, Kramer B, Braun N, Erley C "Comparative pharmacokinetics and pharmacodynamics of loop diuretics in renal failure." Cardiology 84 (1994): 155-61
  2. Tilstone WJ, Fine A "Furosemide kinetics in renal failure." Clin Pharmacol Ther 23 (1978): 644-50
  3. Marcantonio LA, Auld WH, Murdoch WR, Purohit R, Skellern GG, Howes CA "The pharmacokinetics and pharmacodynamics of the diuretic bumetanide in hepatic and renal disease." Br J Clin Pharmacol 15 (1983): 245-52
View all 28 references

Furosemide (Includes Lasix) ↔ Lupus Erythematosus

Moderate Potential Hazard, Moderate plausibility

Applies to: Lupus Erythematosus

The use of furosemide has been associated with exacerbation or activation of systemic lupus erythematosus. Therapy with furosemide should be administered cautiously in patients with a history of lupus.

References

  1. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.

Loop Diuretics (Includes Lasix) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus, Abnormal Glucose Tolerance

Loop diuretics may cause hyperglycemia, glycosuria, and alterations in glucose tolerance tests. Rarely, precipitation of diabetes mellitus has been reported. Therapy with loop diuretics should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during therapy, and their antidiabetic regimen adjusted accordingly.

References

  1. Domenet JG "Diabetogenic effect of oral diuretics." Br Med J 3 (1968): 188
  2. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  3. Dimitriadis G, Tegos C, Golfinopoulou L, Roboti C, Raptis S "Furosemide-induced hyperglycaemia - the implication of glycolytic kinases." Horm Metab Res 25 (1993): 557-9
View all 10 references

Loop Diuretics (Includes Lasix) ↔ Hyperuricemia

Moderate Potential Hazard, High plausibility

Applies to: Gout

Loop diuretics may decrease the rate of uric acid excretion. Hyperuricemia can occur but is usually asymptomatic and rarely leads to clinical gout except in patients with a history of gout or chronic renal failure. Therapy with loop diuretics should be administered cautiously in such patients.

References

  1. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
  3. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
View all 4 references

You should also know about...

Lasix (furosemide) drug Interactions

There are 698 drug interactions with Lasix (furosemide)

Lasix (furosemide) alcohol/food Interactions

There is 1 alcohol/food interaction with Lasix (furosemide)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2014 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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