Furosemide adverse reactions

Ethacrynic acid Adverse reactions may include anorexia, pain, Gl bleeding, severe neutropenia, agranulocytosis, fever, chills, confusion, fatigue, malaise, sense of fullness in the ears, blurred vision, tinnitus, hearing loss (irreversible), rash. Furosemide Adverse reactions may include anorexia, cramping, constipation, blurred vision, hearing loss, restlessness, fever, anemia, purpura, thrombocytopenia, agranulocytosis, photosensitivity, urticaria, pruritus, thrombophlebitis, muscle spasm, weakness. 

Of the following, which adverse reaction is not associated with furosemide ... 

Tuzel IH. Comparison of adverse reactions to bumetanide and furosemide. J Clin Pharmacol 198121(11-12 Pt 2) 615-19. 

Naranjo CA, Busto U, Cassis L. Furosemide-induced adverse reactions during hospitalization. Am J Hosp Pharm 1978 35(7) 794-8. 

Earl G, Davenport J, Narula J. Furosemide challenge in patients with heart failure and adverse reactions to sulfa-containing diuretics. Ann Intern Med 2003 138(4) 358-9. 

Williams GM, latropoulos MJ, Djordjevic MV et al (1993) The triphenylethylaie dmg tamoxifen is a strong liver carcinogen in the rat. Carcinogenesis 14 315—317 Williams DP, Kitteringham NR, Naisbitt DJ et al (2002) Are chemically reactive metabolites responsible for adverse reactions to drags Curr Drag Metab 3 351-366 Williams DP, Antoine DJ, Butler PJ et al (2007) The metabolism and toxicity of furosemide in the Wistar rat and CD-I mouse a chemical and biochemical definition of the toxicophore. J Pharmacol Exp Ther 322 1208-1220... 

Ten female patients aged 66 to 90 years were given clomethiazole edisilate syrup SOO mg each evening and 250 mg each morning as a sedative, with furosemide 20 to 80 mg. No significant changes in the serum levels or effects of clomethiazole or furosemide were detected, and no other significant adverse reactions were seen. ... 

A study in 4 healthy subjects found that indometacin 150 mg daily given with triamterene 200 mg daily over a 3-day period reduced the creatinine clearance in 2 subjects by 62% and 72%, respectively. Renal function returned to normal after a month. Indometacin alone caused an average 10% fall in creatinine clearance, but triamterene alone caused no consistent change in renal function. No adverse reactions were seen in 18 other subjects treated in the same way with indometacin and furosemide, hydrochlorothiazide or spironolactone. Five patients are reported to have rapidly developed acute renal failure after receiving indometacin and triamterene, either concurrently or sequentially. " ... 

There are another 4 case reports of individual patients who experienced serious lithium toxicity or other adverse reactions when given lithium and furosemide. " One of the patients was also on a salt-restricted diet, which has also been implicated in episodes of lithium toxicity, see Lithium + Sodium compounds, p.l 128. In contrast, 6 patients who had been stabilised on lithium for over 6 years had no significant changes in their serum-lithium levels over a 12-week period while taking furosemide 20 to 80 mg daily. Other studies in healthy subjects also found no significant changes in lithium levels when furosemide 40 or 80 mg daily was given. "... 

Furosemide LESS-DILI concern Adverse reactions NEG FLAG NEG... 

An 18-year-old woman with Mycoplasma pneumoniae infection complicated by pulmonary hyfpertension, cryoglobulinemia, and rhabdomyolysis developed hyperthermia, a tachycardia, and dermal blisters. Therapy at the time of onset included a continuous infusion of furosemide. Furosemide and other medications were withdrawn and within 2 days the adverse reactions resolved. She was then rechallenged with two doses of furosemide... 

Electrolyte balance In a study on the effects of cirrhosis and moderate ascites without renal failure on the risk of hyperkalemia, 100 patients were randomized to sequential treatment with potassium canrenoate followed by furosemide or combined treatment from the start [24 ]. The first group received potassium canrenoate 200 mg/day which was then increased to 400 mg/day. Non-responders were then treated with potassium canrenoate 400 mg/day and furosemide in an initial dose of 50 mg/day which could then be increased to 150 mg/ day. The second group was treated initially with both potassium canrenoate 200 mg/ day and furosemide 50 mg/day, increasing to 400 and 150 mg/day respectively. Hyperkalemia was more frequent in the first group (18% versus 4%). In particular, 72% of patients who developed adverse reactions in the first group did so during monotherapy with potassium canrenoate. 

Furosemide is quickly and almost completely excreted by kidney unmetabolized. The usual oral dose is 20-120 mg, but much larger doses (for example 1000 mg) have been used in renal insufficiency. It is very effective after intravenous injection, and doses of 500 mg and more can be used in emergencies (renal insufficiency, pulmonary edema). The majority of adverse effects occur with the use of high doses, 95% of the reactions being dose dependent (1). 

The phototoxic diuretic drug furosemide 6, a 5-(aminosulfonyl)-4-chloro-2-[(2-furanylmethyl)-amino] benzoic acid, is photolabile under aerobic and anaerobic conditions. Previous studies have established that furosemide causes adverse photosensitizing effects in vivo and has a high in vitro photosensitizing capability. In this context, it is capable of initiating both energy transfer and free radical reactions. Irradiation of a methanol solution of 6 produces under an oxygen atmosphere photoproducts... 

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