given at a maximum rate of 4 mg/minute can be
repeated every 24 hourslCAUTIONSEffect may be prolonged in neonates.
hepatorenal syndrome.hypoproteinaemia may reduce
diuretic effect and increase risk of side-effects
lINTERACTIONS→Appendix 1 : loop diuretics
lPREGNANCYFurosemide should not be used to treat
gestational hypertension because of the maternal
hypovolaemia associated with this condition.
lBREAST FEEDINGAmount too small to be harmful. May
inhibit lactation.
lDIRECTIONS FOR ADMINISTRATION
▶With intravenous useForintravenous injection, give over
5 – 10 minutes at a usual rate of 100 micrograms/kg/minute
(not exceeding 500 micrograms/kg/minute), max.
4 mg/minute; lower rate of infusion may be necessary in
renal impairment. Forintravenous infusion, dilute with
Sodium Chloride 0. 9 % to a concentration of 1 – 2 mg/mL.
Glucose solutions unsuitable (infusion pH must be above
5. 5 ).
▶With oral useFor administration bymouth, tablets can be
crushed and mixed with water or injection solution diluted
and given by mouth. Risk of ototoxicity may be reduced by
giving high oral doses in 2 or more divided doses.
lPRESCRIBING AND DISPENSING INFORMATION
▶With oral useSome liquid preparations contain alcohol,
caution especially in neonates.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Tablet
▶Furosemide (Non-proprietary)
Furosemide 20 mgFurosemide 20 mg tablets| 28 tabletP
£ 1. 02 DT = £ 0. 37
Furosemide 40 mgFurosemide 40 mg tablets| 28 tabletP
£ 1. 03 DT = £ 0. 33 | 1000 tabletP£ 11. 79 – £ 28. 21
Furosemide 500 mgFurosemide 500 mg tablets| 28 tabletP
£ 70. 00 DT = £ 38. 58
▶Diuresal(Ennogen Pharma Ltd)
Furosemide 500 mgDiuresal 500 mg tablets| 28 tabletPsDT
=£ 38. 58
Solution for injection
▶Furosemide (Non-proprietary)
Furosemide 10 mg per 1 mlFurosemide 250 mg/ 25 ml solution for
injection ampoules| 10 ampouleP£ 25. 00 – £ 40. 00
Furosemide 50 mg/ 5 ml solution for injection ampoules|
10 ampouleP£ 2. 38 – £ 7. 60
Furosemide 20 mg/ 2 ml solution for injection ampoules|
10 ampouleP£ 4. 58 DT = £ 3. 28
Oral solution
EXCIPIENTS:May contain Alcohol
▶Furosemide (Non-proprietary)
Furosemide 4 mg per 1 mlFurosemide 20 mg/ 5 ml oral solution
sugar free sugar-free| 150 mlP£ 14. 81 DT = £ 14. 81
Furosemide 8 mg per 1 mlFurosemide 40 mg/ 5 ml oral solution
sugar free sugar-free| 150 mlP£ 19. 57 DT = £ 19. 57
Furosemide 10 mg per 1 mlFurosemide 50 mg/ 5 ml oral solution
sugar free sugar-free| 150 mlP£ 20. 21 DT = £ 20. 21
▶Frusol(Rosemont Pharmaceuticals Ltd)
Furosemide 4 mg per 1 mlFrusol 20 mg/ 5 ml oral solution sugar-free
| 150 mlP£ 12. 07 DT = £ 14. 81
Furosemide 8 mg per 1 mlFrusol 40 mg/ 5 ml oral solution sugar-free
| 150 mlP£ 15. 58 DT = £ 19. 57
Furosemide 10 mg per 1 mlFrusol 50 mg/ 5 ml oral solution sugar-
free| 150 mlP£ 16. 84 DT = £ 20. 21
DIURETICS›OSMOTIC DIURETICS
Mannitol
lINDICATIONS AND DOSE
Cerebral oedema
▶BY INTRAVENOUS INFUSION
▶Child 1 month–11 years: 0. 25 – 1. 5 g/kg, repeated if
necessary, to be administered over 30 – 60 minutes,
dose may be repeated 1 – 2 times after 4 – 8 hours
▶Child 12–17 years: 0. 25 – 2 g/kg, repeated if necessary, to
be administered over 30 - 60 minutes, dose may be
repeated 1 – 2 times after 4 – 8 hours
Peripheral oedema and ascites
▶BY INTRAVENOUS INFUSION
▶Child: 1 – 2 g/kg, to be given over 2 – 6 hourslUNLICENSED USENot licensed for use in children under
12 years.
lCONTRA-INDICATIONSAnuria.intracranial bleeding
(except during craniotomy).severe cardiac failure.severe
dehydration.severe pulmonary oedema
lCAUTIONSExtravasation causes inflammation and
thrombophlebitis
lSIDE-EFFECTS
▶Common or very commonCough.headache.vomiting
▶UncommonDizziness.fever.malaise.nausea.pain.skin
reactions
▶Frequency not knownArrhythmia.asthenia.azotaemia.
chest pain.chills.coma.compartment syndrome.
confusion.congestive heart failure.dry mouth.
electrolyte imbalance.fluid imbalance.hyperhidrosis.
hypersensitivity.hypertension.lethargy.metabolic
acidosis.muscle complaints.musculoskeletal stiffness.
nephrotic syndrome.neurotoxicity.peripheral oedema.
pulmonary oedema.rebound intracranial pressure
increase.renal impairment.rhinitis.seizure.thirst.
urinary disorders.vision blurred
lPREGNANCYManufacturer advises avoid unless
essential—no information available.
lBREAST FEEDINGManufacturer advises avoid unless
essential—no information available.
lRENAL IMPAIRMENTUse with caution in severe
impairment.
lPRE-TREATMENT SCREENINGAssess cardiac function
before treatment.
lMONITORING REQUIREMENTSMonitorfluid and electrolyte
balance, serum osmolality, and cardiac, pulmonary and
renal function.
lDIRECTIONS FOR ADMINISTRATIONExamine infusion for
crystals. If crystals present, dissolve by warming infusion
fluid (allow to cool to body temperature before
administration).
For mannitol 20 %, an in-linefilter is recommended
( 15 -micronfilters have been used).lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: infusion, solution for infusion
Infusion
▶Mannitol (Non-proprietary)
Mannitol 100 mg per 1 mlMannitol 50 g/ 500 ml ( 10 %) infusion Viaflo
bags| 1 bagPs
Mannitol 50 g/ 500 ml ( 10 %) infusion Viaflex bags| 1 bagPs
Polyfusor K mannitol 10 % infusion 500 ml bottles| 1 bottleP
£ 4. 92
Mannitol 150 mg per 1 mlMannitol 75 g/ 500 ml ( 15 %) infusion Viaflo
bags| 20 bagPs
Mannitol 200 mg per 1 mlPolyfusor M mannitol 20 % infusion
500 ml bottles| 1 bottleP£ 6. 46
Mannitol 100 g/ 500 ml ( 20 %) infusion Viaflex bags| 1 bagPsBNFC 2018 – 2019 Oedema 141
Cardiovascular system2