Skip to Content


Generic Name: Furosemide
Class: Loop Diuretics
- Loop Diuretics
- Diuretics, Loop
VA Class: CV702
CAS Number: 54-31-9

Medically reviewed by Last updated on Apr 15, 2019.


  • Furosemide is a potent diuretic that given in excessive amounts may induce a profound diuresis with water and electrolyte depletion.133 e Careful medical supervision is required; dosage selection and titration should be adjusted to the individual patient’s needs.133 e (See Dosage and Administration.)


A sulfonamide, loop-type diuretic and antihypertensive agent.133 e

Uses for Lasix


Management of edema associated with heart failure, hepatic cirrhosis, and renal disease (e.g., nephrotic syndrome).133 e

Considered a diuretic of choice for most patients with heart failure.524

Most experts state that all patients with symptomatic heart failure who have evidence for, or a history of, fluid retention generally should receive diuretic therapy in conjunction with moderate sodium restriction, an agent to inhibit the renin-angiotensin-aldosterone (RAA) system (e.g., ACE inhibitor, angiotensin II receptor antagonist, angiotensin receptor-neprilysin inhibitor [ARNI]), a β-adrenergic blocking agent (β-blocker), and in selected patients, an aldosterone antagonist.524 713 800

IV management of acute pulmonary edema (in combination with oxygen and a cardiac glycoside).150


Management of hypertension, alone or in combination with other classes of antihypertensive agents.133 1200

Not considered a preferred agent for initial management of hypertension according to current evidence-based hypertension guidelines; other agents (i.e., ACE inhibitors, angiotensin II receptor antagonists, calcium-channel blockers, thiazide diuretics) are preferred for initial management.501 502 503 504 1200

Some experts state that loop diuretics (e.g., bumetanide, furosemide, torsemide) are preferred over thiazides in patients with moderate to severe chronic kidney disease (CKD)502 504 1200 or symptomatic heart failure.524 1200

Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).501 502 503 504 515 1200 1201

A 2017 ACC/AHA multidisciplinary hypertension guideline classifies BP in adults into 4 categories: normal, elevated, stage 1 hypertension, and stage 2 hypertension.1200 (See Table 1.)

Source: Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13-115.

Individuals with SBP and DBP in 2 different categories (e.g., elevated SBP and normal DBP) should be designated as being in the higher BP category (i.e., elevated BP).

Table 1. ACC/AHA BP Classification in Adults1200


SBP (mm Hg)

DBP (mm Hg)









Hypertension, Stage 1




Hypertension, Stage 2




The goal of hypertension management and prevention is to achieve and maintain optimal control of BP.1200 However, the BP thresholds used to define hypertension, the optimum BP threshold at which to initiate antihypertensive drug therapy, and the ideal target BP values remain controversial.501 503 504 505 506 507 508 515 523 526 530 1200 1201 1207 1209 1222 1223 1229

The 2017 ACC/AHA hypertension guideline generally recommends a target BP goal (i.e., BP to achieve with drug therapy and/or nonpharmacologic intervention) of <130/80 mm Hg in all adults regardless of comorbidities or level of atherosclerotic cardiovascular disease (ASCVD) risk.1200 In addition, an SBP goal of <130 mm Hg generally is recommended for noninstitutionalized ambulatory patients ≥65 years of age with an average SBP of ≥130 mm Hg.1200 These BP goals are based upon clinical studies demonstrating continuing reduction of cardiovascular risk at progressively lower levels of SBP.1200 1202 1210

Other hypertension guidelines generally have based target BP goals on age and comorbidities.501 504 536 Guidelines such as those issued by the JNC 8 expert panel generally have targeted a BP goal of <140/90 mm Hg regardless of cardiovascular risk, and have used higher BP thresholds and target BPs in elderly patients501 504 536 compared with those recommended by the 2017 ACC/AHA hypertension guideline.1200

Some clinicians continue to support previous target BPs such as those recommended by JNC 8 due to concerns about the lack of generalizability of data from some clinical trials (e.g., SPRINT study) used to support the 2017 ACC/AHA hypertension guideline and potential harms (e.g., adverse drug effects, costs of therapy) versus benefits of BP lowering in patients at lower risk of cardiovascular disease.1222 1223 1224 1229

Consider potential benefits of hypertension management and drug cost, adverse effects, and risks associated with the use of multiple antihypertensive drugs when deciding a patient's BP treatment goal.1200 1220 1229

For decisions regarding when to initiate drug therapy (BP threshold), the 2017 ACC/AHA hypertension guideline incorporates underlying cardiovascular risk factors.1200 1207 ASCVD risk assessment is recommended by ACC/AHA for all adults with hypertension.1200

ACC/AHA currently recommend initiation of antihypertensive drug therapy in addition to lifestyle/behavioral modifications at an SBP ≥140 mm Hg or DBP ≥90 mm Hg in adults who have no history of cardiovascular disease (i.e., primary prevention) and a low ASCVD risk (10-year risk <10%).1200

For secondary prevention in adults with known cardiovascular disease or for primary prevention in those at higher risk for ASCVD (10-year risk ≥10%), ACC/AHA recommend initiation of antihypertensive drug therapy at an average SBP ≥130 mm Hg or an average DBP ≥80 mm Hg.1200

Adults with hypertension and diabetes mellitus, CKD, or age ≥65 years are assumed to be at high risk for cardiovascular disease; ACC/AHA state that such patients should have antihypertensive drug therapy initiated at a BP ≥130/80 mm Hg.1200 Individualize drug therapy in patients with hypertension and underlying cardiovascular or other risk factors.502 1200

In stage 1 hypertension, experts state that it is reasonable to initiate drug therapy using the stepped-care approach in which one drug is initiated and titrated and other drugs are added sequentially to achieve the target BP.1200 Initiation of antihypertensive therapy with 2 first-line agents from different pharmacologic classes recommended in adults with stage 2 hypertension and average BP >20/10 mm Hg above BP goal.1200

Lasix Dosage and Administration



  • Careful etiologic diagnosis should precede the use of any diuretic.e

  • Hospitalization of the patient during initiation of therapy is advisable, especially for patients with hepatic cirrhosis and ascites or chronic renal failure.133 e

  • In prolonged diuretic therapy, intermittent use of the drug (e.g., on 2–4 consecutive days each week) may be advisable.e

  • For the management of fluid retention (e.g., edema) associated with heart failure, experts state that diuretics should be administered at a dosage sufficient to achieve optimal volume status and relieve congestion without inducing an excessively rapid reduction in intravascular volume, which could result in hypotension, renal dysfunction, or both.524

Monitoring and BP Treatment Goals

  • Monitor BP regularly (i.e., monthly) during therapy and adjust dosage of the antihypertensive drug until BP controlled.1200

  • If added to regimen of a patient receiving another antihypertensive agent, reduce dosage of preexisting therapy by ≥50% initially to avoid severe hypotension; additional dosage adjustment may be required.133

  • If unacceptable adverse effects occur, discontinue drug and initiate another antihypertensive agent from a different pharmacologic class.1216

  • Assess patient's renal function and electrolytes 2–4 weeks after initiation of diuretic therapy.1200

  • If adequate BP response not achieved with a single antihypertensive agent, either increase dosage of single drug or add a second drug with demonstrated benefit and preferably a complementary mechanism of action (e.g., ACE inhibitor, angiotensin II receptor antagonist, calcium-channel blocker).1200 1216 Many patients will require ≥2 drugs from different pharmacologic classes to achieve BP goal; if goal BP still not achieved with 2 antihypertensive agents, add a third drug.1200 1216 1220


Administer orally, IV, or IM.133 150

Oral Administration

Administer orally once (preferably in the morning)e or twice daily .133

For ease of administration and maximum dosage flexibility in children, consider use of oral solution preparation.151

IV Administration

For solution and drug compatibility information, see Compatibility under Stability.

IV administration may be used in emergency clinical circumstances when a rapid onset of diuresis is desired, or in patients unable to take oral medication or those with impaired GI absorption; replace with oral therapy as soon as possible.133 150 e

Consider the potential risks, when using large parenteral doses; monitor patient closely.105 107


For IV infusion, dilute in 5% dextrose, 0.9% sodium chloride, or lactated Ringer’s injection and adjust pH to >5.5.150 e

Rate of Administration

For direct IV injection, administer slowly over a period of 1–2 minutes.150 e

If high-dose parenteral furosemide therapy is necessary, the manufacturer recommends that the drug be administered as a controlled infusion at a rate not exceeding 4 mg/minute in adults.150 e


Individualize dosage according to patient’s requirements and response; titrate dosage to gain maximum therapeutic effect while using the lowest possible effective dosage.e (See Boxed Warning.)

Pediatric Patients


2 mg/kg administered as a single dose.103 104 105 107 108 133 If necessary, increase in increments of 1 or 2 mg/kg every 6–8 hours103 104 105 107 108 to a maximum of 6 mg/kg.103 133 Generally not necessary to exceed individual doses of 4 mg/kg or a dosing frequency of once or twice daily.104 Use minimum effective dosage for maintenance therapy.133

IV or IM

1 mg/kg administered as a single IM or IV injection.103 104 105 106 107 108 150 If necessary for resistant forms of edema, the initial dose may be increased by 1 mg/kg103 104 105 108 no more often than every 2 hours until the desired effect has been obtained or up to a maximum dosage of 6 mg/kg.103 Adequate response usually is obtained with individual parenteral doses of 1 mg/kg.104 105 107 108

Acute Pulmonary Edema
IV or IM

1 mg/kg administered as a single IM or IV injection.103 104 105 106 107 108 150 If necessary for resistant forms of edema, the initial dose may be increased by 1 mg/kg103 104 105 108 no more often than every 2 hours until the desired effect has been obtained or up to a maximum dosage of 6 mg/kg.103 Adequate response generally obtained with 1 mg/kg.104 105 107 108


Initially, 0.5–2 mg/kg given once or twice daily.149 Increase as necessary up to a maximum of 6 mg/kg daily.149



20–80 mg given as a single dose, preferably in the morning.133 e If needed, repeat same dose 6–8 hours later or increase dose by 20- to 40-mg increments and give no sooner than 6–8 hours after last dose until desired diuretic response (including weight loss) is obtained.133 e May titrate carefully up to 600 mg daily in severe cases.133

The effective dose may be given once or twice daily thereafter, or, in some cases, by intermittent administration on 2–4 consecutive days each week.133 e Dosage may be reduced for maintenance therapy.e

For management of fluid retention (e.g., edema) associated with heart failure, some experts recommend initiating furosemide at a low dosage (e.g., 20–40 mg once or twice daily) and increasing dosage (maximum 600 mg daily) until urine output increases and weight decreases, generally by 0.5–1 kg daily.524

IV or IM

20–40 mg given as a single IM or IV injection.150 e If needed, repeat same dose 2 hours later or increase dose by 20-mg increments and give no sooner than every 2 hours until the desired diuretic response is obtained.150 Effective dosages may then be given once or twice daily.150

Acute Pulmonary Edema

40 mg given as a single IV injection.150 If needed, an 80-mg dose may be given 1 hour after the initial dose.150


40 mg twice daily.133 If desired BP not attained, consider adding other antihypertensive agents.133

Some experts state that usual dosage range is 20–80 mg daily in 2 divided doses.1200

Prescribing Limits

Pediatric Patients


Maximum of 6 mg/kg.103 133

IV or IM

Maximum of 6 mg/kg in infants and children; do not exceed 1 mg/kg daily in premature infants.150


Maximum 6 mg/kg daily.149



Maximum of 600 mg daily.133 524

Special Populations

Renal Impairment

Higher doses may be required for patients with acute or chronic renal failure.e

Cautions for Lasix


  • Anuria.133

  • Known hypersensitivity to furosemide or any ingredient in the formulation.133



Hepatic Effects

Sudden alterations of electrolyte balance in patients with cirrhosis may precipitate hepatic coma; use with caution in patients with hepatic cirrhosis and ascites.133

Do not initiate therapy in patients with hepatic coma or electrolyte depletion until the basic condition is improved.133 Therapy in such patients is best initiated in the hospital with careful monitoring of clinical status and electrolyte balance.133

Renal Effects

If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, discontinue the drug.133 150

Sensitivity Reactions


Anaphylaxis (e.g., urticaria, angioedema, hypotension) within 5 minutes after IV administration reported.102

Systemic Lupus Erythematosus

Possible exacerbation or activation of systemic lupus erythematosus.133 150

Sulfonamide Sensitivity

Patients sensitive to sulfonamides may show allergic reactions to furosemide.e


Photosensitivity may occur.133

Major Toxicities


Risk of tinnitus, reversible or permanent hearing impairment increased following IV or IM administration, especially at high dosages,133 e after too-rapid administration,133 in patients with severely impaired renal function, and/or in patients receiving other ototoxic drugs (e.g., aminoglycosides).133 e (See Specific Drugs under Interactions.)

If high-dose IV therapy is indicated, administer by slow IV infusion (e.g., at a rate not exceeding 4 mg/minute in adults).133 150

General Precautions

Fluid, Electrolyte, and Cardiovascular Effects

Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in elderly patients.133 (See Boxed Warning.)

Risk of orthostatic hypotension, especially with brisk diuresis.133 150 151 May be aggravated by concomitant use with alcohol, barbiturates, or narcotics.133 151 e

Risk of hypokalemia, especially with brisk diuresis, inadequate oral electrolyte intake, when cirrhosis is present, or during concomitant use of corticosteroids or ACTH.133 150 Concomitant therapy with digitalis may exaggerate metabolic effects of hypokalemia, especially myocardial effects.133 150

Observe carefully for manifestations of fluid and electrolyte depletion (e.g., dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, nausea, vomiting).133

Endocrine Effects

Possible increased blood glucose and alterations in glucose tolerance tests (with abnormalities of the fasting and 2-hour postprandial sugar); precipitation of diabetes mellitus rarely reported.133 150 Monitor urine and blood glucose concentrations periodically in patients with diabetes and those suspected of latent diabetes.e

Possible hyperuricemia and precipitation of gout;133 150 use with caution in patients with a history of gout or elevated serum uric acid concentrations.e

Patient Monitoring

Monitor regularly for the possible occurrence of blood dyscrasias, liver or kidney damage, or other idiosyncratic reactions.133 150

Serum electrolytes (particularly potassium), CO2, Scr, and BUN should be determined frequently during the first few months of therapy and periodically thereafter.133 150

Elective Surgery

Discontinue therapy 1 week (oral furosemide) or 2 days (parenteral furosemide) before elective surgery.e

Specific Populations


Category C.133


Distributed into milk.133 Use with caution.133

Pediatric Use

Risk of persistent patent ductus arteriosus (PDA) may be increased in premature neonates with respiratory distress syndrome (RDS) who receive furosemide during the first weeks of life.103 e

Do not exceed dosage of 1 mg/kg per 24 hours in premature neonates with <31 weeks’ postconception age (gestational age at birth plus postnatal age); risk of potentially toxic furosemide plasma concentrations with higher dosages.150

Renal calcification reported in severely premature infants treated with IV furosemide for edema due to PDA and hyaline membrane disease; concomitant chlorothiazide therapy may decrease hypercalciuria and dissolve some calculi.150

Hearing loss reported in neonates; possibly secondary to renal immaturity.103 125 126 150

Oral solutions contain sorbitol; high dosages may cause diarrhea in children.e

Hepatic Impairment

Use with caution.133 e

Renal Impairment

Use with caution.133 e

Common Adverse Effects

Orthostatic hypotension, dizziness, electrolyte imbalance (hyponatremia, hypokalemia, hypochloremia) tinnitus, photosensitivity.133 e

Interactions for Lasix

Specific Drugs





May aggravate orthostatic hypotension133 151 e

Anticonvulsants (e.g., phenytoin sodium, phenobarbital)

Possible reduced diuretic effecte

Antidiabetic agents (e.g., insulin, oral agents)

Possible antagonism of hypoglycemic effect as result of hypokalemia133

Observe for possible decreased diabetic control; correct potassium deficit and/or adjust dosage of antidiabetic agente

Antihypertensive agents

Additive antihypertensive effect; orthostatic hypotension may occur133

Reduce dosage of both drugse

Concomitant therapy generally used to therapeutic advantagee


May aggravate orthostatic hypotension133 151 e

Cardiac glycosides (e.g., digoxin)

Possible electrolyte disturbances (e.g., hypokalemia, hypomagnesemia), increased risk of digitalis toxicity, and/or fatal cardiac arrhythmias e

Monitor electrolytes; correct hypokalemia e

Chloral hydrate (no longer commercially available in the US)

Possible reaction characterized by diaphoresis, flushes, hypertension, and uneasiness in patients with acute MI and heart failuree

Consider alternate hypnotic drug (e.g., a benzodiazepine) in patients who require IV furosemidee

Diuretics, loop (e.g., bumetanide, ethacrynic acid, torsemide)

Share similar diuretic mechanisms e

No therapeutic rationale for concomitant usee

Diuretics, potassium- sparing (e.g., amiloride, spironolactone, triamterene)

Possible reduction in potassium loss 133

May be used to therapeutic advantage133

Diuretics, thiazides

Additive diuretic effecte

Use reduced dosage of furosemide when added to existing diuretic regimene

Drugs that cause potassium loss (e.g., corticosteroids, corticotropin, amphotericin B)

Additive hypokalemic effects133 e

Monitor electrolytes; correct hypokalemia 133 e


Possible decreased diuretic and natriuretic effect133

Monitor closely to determine if desired diuretic and/or hypotensive effect is obtained133


Reduced renal clearance of lithium and increased risk of lithium toxicity 133

Avoid concomitant use;133 e if concomitant therapy is necessary, monitor for lithium toxicitye


May aggravate orthostatic hypotension133 151 e

Neuromuscular blocking agents, nondepolarizing (e.g., atracurium besylate, tubocurarine chloride)

Potential for prolonged neuromuscular blockadee


Decreased arterial responsive to norepinephrine133

Norepinephrine may still be used effectively133


Possible weight gain and increased Scr, serum potassium concentrations, and BUN (NSAIAs)133

Ototoxic drugs (e.g., aminoglycoside antibiotics)

Possible additive ototoxic effect, especially in patients with impaired renal function133

Avoid concomitant use except in life-threatening situations133

Salicylates (e.g., aspirin)

Possible transient reductions in Clcr in patient with chronic renal insufficiencye

Monitor for toxicity133


May potentiate action of succinylcholine133


Possible reduced natriuretic and antihypertensive effects133

Do not administer simultaneously; separate administration by ≥2 hours133

Observe closely for desired diuretic and/or antihypertensive effect133

Uricosuric drugs (probenecid, sulfinpyrazone)

Possible antagonism of uricosuric effectse

Monitor serum uric acid concentrationse

Lasix Pharmacokinetics



Mean oral bioavailability of furosemide from commercially available tablets and oral solution is 64% and 60%, respectively.133

Commercially available tablets and oral solution are bioequivalent.133


Following oral administration, onset of diuresis occurs within 30 minutes to 1 hour; maximal effect after 1–2 hours.133 e

Following IV administration, diuresis occurs within 5 minutes and peaks within 20–60 minutes.150 e

Onset of diuresis after IM administration occurs somewhat later than after IV administration.150

Maximum hypotensive effect may not be apparent until after several days of therapy.e


Diuretic effect persists 6–8 hours following oral administration and approximately 2 hours following IV administration.133 150 e


Food does not appear to affect diuretic effect.e

Special Populations

In patients with severely impaired renal function, the diuretic response may be prolonged.e



Crosses the placenta and is distributed into milk.e

Plasma Protein Binding

Approximately 95% bound to plasma proteins (mainly albumin) in both normal and azotemic patients.133 e



Metabolized in the liver to the defurfurylated derivative, 4-chloro-5-sulfamoylanthranilic acid.e

Elimination Route

Rapidly excreted in urine by glomerular filtration and by secretion from the proximal tubule.e

Approximately 50% of an oral dose and 80% of an IV or IM dose are excreted in urine within 24 hours; 69–97% of these amounts is excreted in the first 4 hours.150 e The remainder of the drug is eliminated by nonrenal mechanisms including degradation in the liver and excretion of unchanged drug in the feces.e


Biphasic;e terminal half-life is approximately 2 hours.133

Special Populations

Hepatic or renal impairment prolongs the elimination half-life of the drug.e

In patients with marked renal impairment without liver disease, nonrenal clearance is increased to the extent that up to 98% of the drug is cleared within 24 hours.e

Not removed by hemodialysis.133




Solution or Tablets

Tight, light resistant containers at 15–30°C.133 151



15–30°C; protect from light.150 Discard unused portion.150


For information on systemic interactions resulting from concomitant use, see Interactions.


Do not mix with strongly acidic solutions (i.e., pH < 5.5), such as those containing ascorbic acid, amrinone, ciprofloxacin, labetalol, tetracycline, milrinone, epinephrine, or norepinephrine, because furosemide may be precipitated.150 e

Solution Compatibilitya


Alcohol 5% and dextrose 5%

Amino acids 4.25%, dextrose 25%

Dextrose 5% in Ringer’s injection, lactated

Dextrose 5% in sodium chloride 0.9%

Dextrose 5, 10, or 20% in water

Invert sugar 10% in Electrolyte #1

Mannitol 20%

Ringer’s injection, lactated

Sodium chloride 0.9%

Sodium lactate 1/6 M


Fructose 10% in water

Invert sugar 10% in Electrolyte #2

Drug Compatibility
Admixture Compatibilitya


Amikacin sulfate


Ampicillin sodium

Atropine sulfate


Calcium gluconate

Cefuroxime sodium

Cimetidine HCl

Dexamethasone sodium phosphate

Diamorphine HCl


Epinephrine HCl

Heparin sodium

Hydrocortisone sodium succinate

Isosorbide dinitrate

Kanamycin sulfate

Lidocaine HCl

Midazolam HCl


Morphine sulfate


Penicillin G

Potassium chloride

Ranitidine HCl

Scopolamine butylbromide

Sodium bicarbonate



Tobramycin sulfate


Buprenorphine HCl

Chlorpromazine HCl


Dobutamine HCl

Erythromycin lactobionate

Isoproterenol HCl

Meperidine HCl

Metoclopramide HCl


Prochlorperazine edisylate

Promethazine HCl


Amiodarone HCl

Gentamicin sulfate

Hydrocortisone sodium succinate

Verapamil HCl

Y-Site Compatibilitya


Allopurinol sodium


Amikacin sulfate

Amphotericin B cholesteryl sulfate complex



Bleomycin sulfate

Cefepime HCl






Dexmedetomidine HCl


Doxorubicin HCl liposome injection

Epinephrine HCl

Etoposide phosphate

Fentanyl citrate

Fludarabine phosphate


Foscarnet sodium

Granisetron HCl

Heparin sodium

Hetastarch in lactated electrolyte injection (Hextend)

Hydrocortisone sodium succinate

Hydromorphone HCl

Indomethacin sodium trihydrate

Kanamycin sulfate

Leucovorin calcium



Melphalan HCl


Methotrexate sodium



Norepinephrine bitartrate


Piperacillin sodium–tazobactam sodium

Potassium chloride


Ranitidine HCl

Remifentanil HCl


Sodium nitroprusside


Tirofiban HCl




Tobramycin sulfate

Vitamin B complex with C




Chlorpromazine HCl



Diltiazem HCl


Esmolol HCl

Fenoldopam mesylate




Gemcitabine HCl

Gentamicin sulfate

Hydralazine HCl

Idarubicin HCl


Metoclopramide HCl

Midazolam HCl

Milrinone lactate

Nicardipine HCl

Ondansetron HCl

Quinidine gluconate

Thiopental sodium

Vecuronium bromide

Vinblastine sulfate

Vincristine sulfate

Vinorelbine tartrate


Amiodarone HCl

Dobutamine HCl

Dopamine HCl

Doxorubicin HCl


Labetalol HCl

Meperidine HCl

Morphine sulfate


  • Inhibits primarily the absorption of sodium and chloride not only in the proximal and distal tubules but also in the ascending limb of the loop of Henle.133 e Does not inhibit carbonic anhydrase and is not an aldosterone antagonist.e

  • Mechanism of hypotensive effect not definitively determined but presumed to result from decreased plasma volume.e

  • Induces greater diuresis and electrolyte loss than with thiazides or most other diuretics except ethacrynic acid.e

  • Possesses some renal vasodilator effect; renal vascular resistance decreases and renal blood flow increases following administration.e

Advice to Patients

  • Risks associated with excessive fluid loss or electrolyte imbalance.133

  • Potential for postural hypotension; importance of rising slowly from a seated position.133

  • Importance of discussing dietary measures and supplementation to prevent or correct hypokalemia.133

  • Importance of informing patients with diabetes mellitus that blood glucose and urine glucose concentrations may increase.133 e

  • Importance of informing patients of possible photosensitivity.133 e

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs (e.g., appetite suppressants, cold remedies) as well as any concomitant illnesses.133 e

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.133 e

  • Importance of informing patients of other important precautionary information.133 e (See Cautions.)


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name



Dosage Forms


Brand Names




40 mg/5 mL*

Furosemide Solution

10 mg/mL*

Furosemide Solution


20 mg*

Furosemide Tablets



40 mg*

Furosemide Tablets

Lasix (scored)


80 mg*

Furosemide Tablets





10 mg/mL*

Furosemide Injection

AHFS DI Essentials™. © Copyright 2020, Selected Revisions April 15, 2019. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.


Only references cited for selected revisions after 1984 are available electronically.

102. Hansbrough JR, Wedner HJ, Chaplin DD et al. Anaphylaxis to intravenous furosemide. J Allergy Clin Immunol. 1987; 80:538-41.

103. Hoechst-Roussel. Lasix (furosemide) injection, oral solution, and tablets prescribing information (dated 1994 Oct). In: Physicians’ desk reference. 50th ed. Montvale NJ: Medical Economics Company Inc; 1996:1240-2.

104. Engle MA, Lewy JE, Lewy PR et al. The use of furosemide in the treatment of edema in infants and children. Pediatrics. 1978; 62:811-8.

105. Baliga R, Lewy JE. Pathogenesis and treatment of edema. Pediatr Clin North Am. 1987; 34:639-48.

106. Repetto HA, Lewy JE, Braudo JL et al. The renal functional response to furosemide in children with acute glomerulonephritis. J Pediatr. 1972; 80:660-6.

107. Lewy JE. Diuretics in infancy. Controversies Nephrol. 1981; 27:33-44.

108. Lewy JE, Moel DI. Pathogenesis and management of edema in the newborn. Clin Perinatol. 1975; 2:117-23.

110. Lardinois CK, Neuman SL. The effects of antihypertensive agents on serum lipids and lipoproteins. Arch Intern Med. 1988; 148:1280-8.

111. Holland OB, Pool PE. Metabolic changes with antihypertensive therapy of the salt-sensitive patient. Am J Cardiol. 1988; 61:53-9H.

112. Weinberger MH. Diuretics and their side effects: dilemma in the treatment of hypertension. Hypertension. 1988; 11(Suppl II):II-16-20.

113. Ames R. Effects of diuretic drugs on the lipid profile. Drugs. 1988; 36(Suppl 2):33-40.

114. Lasser NL, Grandits G, Caggiula AW et al. Effects of antihypertensive therapy on plasma lipids and lipoproteins in the Multiple Risk Factor Intervention Trial. Am J Med. 1984; 76(Suppl 2A):52-66.

115. Bloomgarden ZT, Ginsberg-Fellner F, Rayfield EJ et al. Elevated hemoglobin A1c and low-density lipoprotein cholesterol levels in thiazide-treated diabetic patients. Am J Med. 1984; 77:823-7.

116. Gluck Z, Baumgartner G, Weidmann P et al. Increased ratio between serum beta- and alpha-lipoproteins during diuretic therapy: an adverse effect? Clin Sci Mol Med Suppl. 1978; 4:325-8s.

117. Ames RP, Hill P. Antihypertensive therapy and the risk of coronary heart disease. J Cardiovasc Pharmacol. 1982; 4(Suppl 2):S206-12.

118. Ames RP, Hill P. Improvement of glucose tolerance and lowering of glycohemoglobin and serum lipid concentrations after discontinuance of antihypertensive drug treatment. Circulation. 1982; 65:899-904.

119. Perola P, Lehto H, Lammintausta R et al. Metabolic effects of furosemide and the combination of furosemide and triamterene. Curr Ther Res. 1985; 37:545-53.

120. Weinberger MH. Antihypertensive therapy and lipids: evidence, mechanisms, and implications. Arch Intern Med. 1985; 145:1102-5.

121. Gerlag PGG, van Meijel JJM. High-dose furosemide in the treatment of refractory congestive heart failure. Arch Intern Med. 1988; 148:286-91.

122. Weidmann P, Gerber A. Effects of treatment with diuretics on serum proteins. J Cardiovasc Pharmacol. 1984; 6(Suppl 1):S260-8.

123. Weidmann P, Gerber A, Mordasini R. Effects of antihypertensive therapy on serum lipoproteins. Hypertension. 1983; 5(5 part 2):III-120-3.

125. Tuck S, Morselli P, Broquaire M et al. Plasma and urinary kinetics of furosemide in newborn infants. J Pediatr. 1983; 103:481-5.

126. Mirochnick MH, Miceli JJ, Kramer PA et al. Furosemide pharmacokinetics in very low birth weight infants. J Pediatr. 1988; 112:653-7.

128. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80.

129. Psaty BM, Smith NL, Siscovich DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA. 1997; 277:739-45.

130. Whelton PK, Appel LJ, Espeland MA et al. for the TONE Collaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46.

131. Anon. Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Part II. Management of heart failure: approaches to the prevention of heart failure. Am J Cardiol. 1999; 83:9-38A.

132. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA. 1988; 259:539-44.

133. Aventis Pharmaceuticals. Lasix (furosemide) tablets prescribing information. Bridgewater, NJ; 2004 Jan.

134. Sherman LG, Liang CS, Baumgardner S et al. Piretanide, a potent diuretic with potassium-sparing properties, for the treatment of congestive heart failure. Clin Pharmacol Ther. 1986; 40:587-94.

135. Patterson JH, Adams KF Jr, Applefeld MM et al. Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Pharmacotherapy. 1994; 14:514-21.

136. Wilson JR, Reichek N, Dunkman WB et al. Effect of diuresis on the performance of the failing left ventricle in man. Am J Med. 1981;70:234-9.

137. Parker JO. The effects of oral ibopamine in patients with mild heart failure—a double blind placebo controlled comparison to furosemide. Int J Cardiol. 1993; 40:221-7.

138. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4.

139. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20.

140. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61.

141. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site.

142. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-42.

143. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97.

146. The Guidelines Subcommittee of the WHO/ISH Mild Hypertension Liaison Committee. 1999 guidelines for the management of hypertension. J Hypertension. 1999; 17:392-403.

149. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(Suppl 2):555-76.

150. American Pharmaceutical Partners, Inc. Furosemide Injection, USP prescribing information. Schaumburg, IL; 2002 Apr.

151. Roxane Laboratories, Inc. Furosemide tablets and oral solution prescribing information. Columbus, OH; 2003 Aug.

501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20.

502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357.

503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85.

504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26.

505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503.

506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4.

507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6.

508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8.

515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88.

523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.

524. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240-327.

526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; 45:2160-2236.

530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8.

536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.

713. Gupta D, Georgiopoulou VV, Kalogeropoulos AP et al. Dietary sodium intake in heart failure. Circulation. 2012; 126:479-85.

714. Hospira. Dopamine hydrochloride prescribing information. Lake Forest, IL; 2014 Mar.

715. Hospira. Dopamine hydrochloride and 5% dextrose injection prescribing information. Lake Forest, IL; 2014 May.

716. Cicci JD, Reed BN, McNeely EB et al. Acute decompensated heart failure: evolving literature and implications for future practice. Pharmacotherapy. 2014; 34:373-88.

717. Triposkiadis FK, Butler J, Karayannis G et al. Efficacy and safety of high dose versus low dose furosemide with or without dopamine infusion: the Dopamine in Acute Decompensated Heart Failure II (DAD-HF II) trial. Int J Cardiol. 2014;172(1):115-21.

718. Torres-Courchoud I, Chen HH. Is there still a role for low-dose dopamine use in acute heart failure?. Curr Opin Crit Care. 2014; 20:467-71.

719. Houston BA, Kalathiya RJ, Kim DA et al. Volume Overload in Heart Failure: An Evidence-Based Review of Strategies for Treatment and Prevention. Mayo Clin Proc. 2015; 90:1247-61.

720. Chen HH, Anstrom KJ, Givertz MM et al. Low-dose dopamine or low-dose nesiritide in acute heart failure with renal dysfunction: the ROSE acute heart failure randomized trial. JAMA. 2013; 310:2533-43.

723. Hummel SL, Konerman MC. Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt?. JACC Heart Fail. 2016; 4:36-8.

724. Yancy CW. The Uncertainty of Sodium Restriction in Heart Failure: We Can Do Better Than This. JACC Heart Fail. 2016; 4:39-41.

800. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016; :.

1200. Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; 71:el13-e115.

1201. Bakris G, Sorrentino M. Redefining hypertension - assessing the new blood-pressure guidelines. N Engl J Med. 2018; 378:497-499.

1202. Carey RM, Whelton PK, 2017 ACC/AHA Hypertension Guideline Writing Committee. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American College of Cardiology/American Heart Association hypertension guideline. Ann Intern Med. 2018; 168:351-358.

1207. Burnier M, Oparil S, Narkiewicz K et al. New 2017 American Heart Association and American College of Cardiology guideline for hypertension in the adults: major paradigm shifts, but will they help to fight against the hypertension disease burden?. Blood Press. 2018; 27:62-65.

1209. Qaseem A, Wilt TJ, Rich R et al. Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2017; 166:430-437.

1210. SPRINT Research Group, Wright JT, Williamson JD et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015; 373:2103-16.

1216. Taler SJ. Initial treatment of hypertension. N Engl J Med. 2018; 378:636-644.

1220. Cifu AS, Davis AM. Prevention, detection, evaluation, and management of high blood pressure in adults. JAMA. 2017; 318:2132-2134.

1222. Bell KJL, Doust J, Glasziou P. Incremental benefits and harms of the 2017 American College of Cardiology/American Heart Association high blood pressure guideline. JAMA Intern Med. 2018; 178:755-7.

1223. LeFevre M. ACC/AHA hypertension guideline: what is new? what do we do?. Am Fam Physician. 2018; 97(6):372-3.

1224. Brett AS. New hypertension guideline is released. From NEJM Journal Watch website. Accessed 2018 Jun 18.

1229. Ioannidis JPA. Diagnosis and treatment of hypertension in the 2017 ACC/AHA guidelines and in the real world. JAMA. 2018; 319(2):115-6.

a. Trissel LA. Handbook on Injectable Drugs. Bethesda, MD: American Society of Health-System Pharmacists.

e. AHFS Drug Information. McEvoy GK, ed. Furosemide. American Society of Health-System Pharmacists.

Related questions