Does Lasix (furosemide) cause side effects?
Lasix (furosemide) is a potent diuretic (water pill) used to treat excess accumulation of fluid or swelling of the body (edema) caused by cirrhosis, chronic kidney failure, heart failure, and kidney disease. Furosemide is also used in conjunction with other blood pressure medications to treat high blood pressure (hypertension). Common side effects of furosemide include low blood pressure, dehydration, electrolyte depletion, yellowing of skin and eyes (jaundice), ringing in the ears (tinnitus), sensitivity to light, rash, pancreatitis, nausea, diarrhea, abdominal pain, dizziness, increased blood sugar, and increased uric acid levels.
Serious side effects of furosemide include severe anaphylactic shock, necrotizing angiitis, interstitial nephritis, hearing loss, anemia, low white blood cells, low blood platelets, eosinophilia, Steven-Johnson syndrome, heart reactions like orthostatic hypotension (fainting or dizziness when standing up), and an increase in triglyceride and cholesterol levels.
Drug interactions of furosemide include aminoglycoside antibiotics, ethacrynic acid, aspirin, lithium, sucralfate, other antihypertensive drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), cisplatin, cyclosporine, methotrexate, phenytoin, antibiotics, heart medications, laxatives, and steroids. Furosemide should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Furosemide is secreted in breast milk. Nursing mothers should avoid breastfeeding while taking furosemide.
What are the important side effects of Lasix (furosemide)?
Common side effects of Lasix (furosemide) are:
- electrolyte depletion (for example, sodium, potassium).
Other important side effects include:
- jaundice,
- ringing in the ears (tinnitus),
- sensitivity to light (photophobia),
- rash,
- pancreatitis,
- nausea,
- diarrhea,
- abdominal pain, and
- dizziness.
Increased blood sugar and uric acid levels also may occur.
Profound diuresis with water and electrolyte depletion can occur if Lasix is given in excess amounts. Other side effects and adverse effects of this medicine include:
- Gut (gastrointestinal or GI) reactions like pancreatitis, jaundice, anorexia, cramping, diarrhea, constipation, nausea, and vomiting
- Systemic hypersensitivity reactions like severe anaphylactic shock, necrotizing angiitis, and interstitial nephritis
- Central nervous system (CNS) reactions like vertigo, headaches, blurred vision, tinnitus, and hearing loss
- Blood reactions like anemia, leukopenia, thrombocytopenia, and eosinophilia
- Hypersensitive skin reactions like rash, itching, hives, photosensitivity, exfoliative dermatitis, and Steven-Johnson syndrome
- Heart reactions like orthostatic hypotension (fainting or dizziness when standing up) and an increase in triglyceride and cholesterol levels
Other reactions include:
QUESTION
The only purpose of the kidneys is to filter blood.
See Answer
Lasix (furosemide) side effects list for healthcare professionals
Adverse reactions are categorized below by organ system
and listed by decreasing severity.
Gastrointestinal System Reactions
- hepatic encephalopathy in patients with hepatocellular
insufficiency - pancreatitis
- jaundice (intrahepatic cholestatic jaundice)
- increased liver enzymes
- anorexia
- oral and gastric irritation
- cramping
- diarrhea
- constipation
- nausea
- vomiting
Systemic Hypersensitivity Reactions
- Severe anaphylactic or anaphylactoid reactions (e.g. with
shock) - systemic vasculitis
- interstitial nephritis
- necrotizing angiitis
Central Nervous System Reactions
Hematologic Reactions
- aplastic anemia
- thrombocytopenia
- agranulocytosis
- hemolytic anemia
- leukopenia
- anemia
- eosinophilia
Dermatologic-Hypersensitivity Reactions
- toxic epidermal necrolysis
- Stevens-Johnson Syndrome
- erythema multiforme
- drug rash with eosinophilia and systemic symptoms
- acute generalized exanthematous pustulosis
- exfoliative dermatitis
- bullous pemphigoid
- purpura
- photosensitivity
- rash
- pruritis
- urticaria
Cardiovascular Reaction
- Orthostatic hypotension may occur and be aggravated by
alcohol, barbiturates or narcotics. - Increase in cholesterol and triglyceride serum levels
Other Reactions
- hyperglycemia
- glycosuria
- hyperuricemia
- muscle spasm
- Weakness
- restlessness
- urinary bladder spasm
- thrombophlebitis
- fever
Whenever adverse reactions are moderate or severe, Lasix
dosage should be reduced or therapy withdrawn.
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What drugs interact with Lasix (furosemide)?
Lasix may increase the ototoxic potential of
aminoglycoside antibiotics, especially in the presence of impaired renal
function. Except in life-threatening situations, avoid this combination.
Lasix should not be used concomitantly with ethacrynic
acid because of the possibility of ototoxicity. Patients receiving high doses
of salicylates concomitantly with Lasix, as in rheumatic disease, may
experience salicylate toxicity at lower doses because of competitive renal
excretory sites.
There is a risk of ototoxic effects if cisplatin and
Lasix are given concomitantly. In addition, nephrotoxicity of nephrotoxic drugs
such as cisplatin may be enhanced if Lasix is not given in lower doses and with
positive fluid balance when used to achieve forced diuresis during cisplatin
treatment.
Lasix has a tendency to antagonize the skeletal muscle
relaxing effect of tubocurarine and may potentiate the action of
succinylcholine.
Lithium generally should not be given with diuretics
because they reduce lithium’s renal clearance and add a high risk of lithium
toxicity.
Lasix combined with angiotensin converting enzyme
inhibitors or angiotensin II receptor blockers may lead to severe hypotension
and deterioration in renal function, including renal failure. An interruption
or reduction in the dosage of Lasix, angiotensin converting enzyme inhibitors,
or angiotensin receptor blockers may be necessary.
Potentiation occurs with ganglionic or peripheral
adrenergic blocking drugs.
Lasix may decrease arterial responsiveness to
norepinephrine. However, norepinephrine may still be used effectively.
Simultaneous administration of sucralfate and Lasix
tablets may reduce the natriuretic and antihypertensive effects of Lasix.
Patients receiving both drugs should be observed closely to determine if the
desired diuretic and/or antihypertensive effect of Lasix is achieved. The
intake of Lasix and sucralfate should be separated by at least two hours.
In isolated cases, intravenous administration of Lasix
within 24 hours of taking chloral hydrate may lead to flushing, sweating
attacks, restlessness, nausea, increase in blood pressure, and tachycardia. Use
of Lasix concomitantly with chloral hydrate is therefore not recommended.
Phenytoin interferes directly with renal action of Lasix.
There is evidence that treatment with phenytoin leads to decrease intestinal
absorption of Lasix, and consequently to lower peak serum furosemide
concentrations.
Methotrexate and other drugs that, like Lasix, undergo
significant renal tubular secretion may reduce the effect of Lasix. Conversely,
Lasix may decrease renal elimination of other drugs that undergo tubular
secretion. High-dose treatment of both Lasix and these other drugs may result
in elevated serum levels of these drugs and may potentiate their toxicity as
well as the toxicity of Lasix.
Lasix can increase the risk of cephalosporin-induced
nephrotoxicity even in the setting of minor or transient renal impairment.
Concomitant use of cyclosporine and Lasix is associated
with increased risk of gouty arthritis secondary to Lasix-induced hyperurecemia
and cyclosporine impairment of renal urate excretion.
High doses ( > 80 mg) of furosemide may inhibit the
binding of thyroid hormones to carrier proteins and result in transient
increase in free thyroid hormones, followed by an overall decrease in total thyroid
hormone levels.
One study in six subjects demonstrated that the
combination of furosemide and acetylsalicylic acid temporarily reduced
creatinine clearance in patients with chronic renal insufficiency. There are
case reports of patients who developed increased BUN, serum creatinine and
serum potassium levels, and weight gain when furosemide was used in conjunction
with NSAIDs.
Literature reports indicate that coadministration of
indomethacin may reduce the natriuretic and antihypertensive effects of Lasix
(furosemide) in some patients by inhibiting prostaglandin synthesis.
Indomethacin may also affect plasma renin levels, aldosterone excretion, and
renin profile evaluation. Patients receiving both indomethacin and Lasix should
be observed closely to determine if the desired diuretic and/or
antihypertensive effect of Lasix is achieved.