Furosemide

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Furosemide chemical structure
Furosemide
Systematic (IUPAC) name
5-(aminosulfonyl)-4-chloro-2-
[(2-furanylmethyl)amino]benzoic acid
Identifiers
CAS number 54-31-9
ATC code C03CA01
PubChem 162482
DrugBank APRD00608
Chemical data
Formula C12H11N2ClO5S 
Mol. weight 330.745 g/mol
Pharmacokinetic data
Bioavailability 43-69%
Metabolism hepatic and renal glucuronidation
Half life up to 100 minutes
Excretion renal 66%, biliary 33%
Therapeutic considerations
Pregnancy cat.

C(AU) C(US)

Legal status

Prescription only

Routes Oral, IV, IM

Furosemide (INN) or frusemide (former BAN) is a loop diuretic used in the treatment of congestive heart failure and edema. It is most commonly marketed by sanofi-aventis under the brand name Lasix. It has also been used to prevent thoroughbred race horses from bleeding through the nose during races.

Along with some other diuretics, furosemide is also included on the World Anti-Doping Agency's banned drug list due to its alleged use as a masking agent for other drugs.

Contents

[edit] Mechanism of action

Main article: Loop diuretic

Like other loop diuretics, furosemide acts by inhibiting the Na-K-2Cl symporter in the thick ascending loop of Henle. It also has inhibitory activity on carbonic anhydrase.

[edit] Clinical use in humans

Furosemide, as a loop diuretic, is principally used in the following indications (Aventis, 1998):

It is also sometimes used in the management of severe hypercalcemia in combination with adequate rehydration (Rossi, 2004).

Although disputed,[1] it is considered ototoxic: "usually with large parenteral doses and rapid administration and in renal impairment"[2]

[edit] Drug Interactions

Furosemide has potential interactions with the following medications:[1]

[edit] Use in horses

Apparently, sometime in the early 1970s, furosemide's ability to prevent or at least greatly reduce the incidence of bleeding by horses during races was discovered accidentally. Pursuant to the racing rules of most states, horses that bleed from the nostrils three times are permanently barred from racing (for their own protection). Clinical trials followed, and by decade's end, racing commissions in some states began legalizing its use on race horses. On September 1, 1995, New York became the last state in the United States to approve such use, after years of refusing to consider doing so. Some states allow its use for all racehorses; some allow it only for confirmed "bleeders." Its use for this purpose is still prohibited in many other countries, however.

[edit] Brand names

Some of the brand names under which furosemide is marketed include: Aisemide®, Beronald®, Desdemin®, Discoid®, Diural®, Diurapid®, Dryptal®, Durafurid®, Errolon®, Eutensin®, Frusetic®, Frusid®, Fulsix®, Fuluvamide®, Furesis®, Furo-Puren®, Furosedon®, Hydro-rapid®, Impugan®, Katlex®, Lasilix®, Lasix®, Lodix®, Lowpston®, Macasirool®, Mirfat®, Nicorol®, Odemase®, Oedemex®, Profemin®, Rosemide®, Rusyde®, Salix®, Trofurit®, Urex®

Founded around 1964.

[edit] References

[edit] Footnotes

  1. ^ Rais-Bahrami K, Majd M, Veszelovszky E, Short B (2004). "Use of furosemide and hearing loss in neonatal intensive care survivors.". Am J Perinatol 21 (6): 329-32. PMID 15311369.
  2. ^ BNF 45 March 2003

[edit] External links


Antihypertensives (C02) and diuretics (C03) edit
Antiadrenergic agents (including alpha):

Clonidine, Doxazosin, Guanethidine, Guanfacine, Lofexidine, Mecamylamine, Methyldopa, Moxonidine, Prazosin, Rescinnamine, Reserpine

Vasodilators:

Diazoxide, Hydralazine, Minoxidil, Nitroprusside, Phentolamine

Other antihypertensives:

Bosentan, Ketanserin

Low ceiling diuretics:

Bendroflumethiazide, Chlorothiazide, Chlortalidone, Hydrochlorothiazide, Indapamide, Quinethazone, Mersalyl, Metolazone, Theobromine

High ceiling diuretics:

Bumetanide, Furosemide, Torasemide

Potassium-sparing diuretics:

Amiloride, Eplerenone, Spironolactone, Triamterene

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