Furosemide Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Ascites

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Congestive Heart Failure

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Edema

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Hypertension

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Nonobstructive Oliguria

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Pulmonary Edema

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Renal Failure

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Renal Transplant

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Oliguria

Oral:
Initial: 20 to 80 mg per dose.
Maintenance: Increase in increments of 20 to 40 mg/dose every 6 to 8 hours to desired effect. The usual dosage interval is once or twice daily, with a maximum daily dose of 600 mg.

Intravenous/Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary.

Continuous IV infusion: 0.1 mg/kg as an initial bolus dose, followed by 0.1 mg/kg/hour doubled every 2 hours to a maximum of 0.4 mg/kg/hour.

Usual Adult Dose for Hypercalcemia

Oral: 10 to 40 mg 4 times a day.
IV: 20 to 100 mg every 1 to 2 hours over 1 to 2 minutes.

Usual Pediatric Dose for Edema

Neonatal:
Oral: Bioavailability is about 20%; doses of 1 mg/kg/dose 1 to 2 times/day have been used
IM or IV: Note: Significant absorption within Extracorporeal Membrane Oxygenation (ECMO ) circuit; avoid administration directly into circuit; high doses may be required for adequate diuretic effect.
Gestational age (GA) less than 31 weeks: 1 mg/kg/dose every 24 hours; accumulation and increased risk of toxicity may be observed with doses greater than 2 mg/kg or doses of 1 mg/kg given more frequently than every 24 hours.
GA greater than or equal to 31 weeks: 1 to 2 mg/kg/dose every 12 to 24 hours
Continuous IV infusion: 0.2 mg/kg/hour, increase in 0.1 mg/kg/hour increments every 12 to 24 hours to a maximum infusion rate of 0.4 mg/kg/hour
Pulmonary edema: Inhalation: 1 to 2 mg/kg/dose diluted in 2 mL NS as a single dose

Infants and Children:
Oral: 2 mg/kg once daily; if ineffective, may increase in increments of 1 to 2 mg/kg/dose every 6 to 8 hours; not to exceed 6 mg/kg/dose. In most cases, it is not necessary to exceed individual doses of 4 mg/kg or a dosing frequency of once or twice daily.
IM or IV: 1 to 2 mg/kg/dose every 6 to 12 hours
Continuous infusion: 0.05 mg/kg/hour; titrate dosage to clinical effect

Renal Dose Adjustments

If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, furosemide should be discontinued.

Liver Dose Adjustments

Patients with cirrhosis and ascites should be given smaller doses of furosemide due to the risk of altered electrolyte balance, which can lead to hepatic encephalopathy.

Dose Adjustments

Oral: If needed, repeat dose in 6 hours, after another 6 hours increase dose to 20 to 40 mg every 6 hours until an adequate diuresis.
IV: If needed, repeat dose in 2 hours, after another 2 hours increase dose by 20 to 40 mg until an adequate diuresis. This dose should then be given once or twice a day.

Precautions

Furosemide is extensively bound to plasma proteins, especially albumin; (91% to 99% in healthy individuals) and is predominantly excreted unchanged in the urine. The elderly may experience decreased protein binding of furosemide and decreased renal function necessitating dosage adjustments in this population.

Dialysis

Data not available

Other Comments

Doses greater than 200 mg are rarely needed for treatment of edema. Doses as high as 2 to 2.5 g/day or more have been used. For the treatment of hypertension, twice a day dosing is recommended.

Following cardiac surgery, a continuous infusion is as effective as intermittent boluses of furosemide. Total daily urine output and change in serum electrolyte levels were similar between the two methods of administration.

Serum potassium should be closely monitored during therapy with furosemide.

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