GENERIC NAME: furosemide

BRAND NAME: Lasix

DRUG CLASS AND MECHANISM: Furosemide is a potent diuretic (water pill) that is used to eliminate
water and salt from the body. In the kidneys, salt (composed of sodium and chloride), water, and other
small molecules normally are filtered out of the blood and into the tubules of the kidney. The filtered fluid
ultimately becomes urine. Most of the sodium, chloride and water that is filtered out of the blood is
reabsorbed into the blood before the filtered fluid becomes urine and is eliminated from the body.
Furosemide works by blocking the absorption of sodium, chloride, and water from the filtered fluid in the
kidney tubules, causing a profound increase in the output of urine (diuresis). The onset of action after oral
administration is within one hour, and the diuresis lasts about 6-8 hours. The onset of action after injection
is five minutes and the duration of diuresis is two hours. The diuretic effect of furosemide can cause
depletion of sodium, chloride, body water and other minerals. Therefore, careful medical supervision is
necessary during treatment. The FDA approved furosemide in July 1982.

PREPARATIONS: Tablets: 20, 40, and 80mg. Oral solution: 10 mg/ml, 40 mg/5 ml. Injection: 10 mg/ml

STORAGE: Furosemide should be stored at room temperature in a light resistant container.

PRESCRIBED FOR: Furosemide is a powerful diuretic that is used to treat excessive accumulation of

fluid and/or swelling (edema) of the body caused byheart failure, cirrhosis, chronic kidney failure, and the
nephrotic syndrome. It is sometimes used alone or in conjunction with other blood pressure pills to
treat high blood pressure.

DOSING: The usual starting oral dose for treatment of edema in adults is 20-80 mg as a single dose. The
same dose or an increased dose may be administered 6-8 hours later. Doses may be increased 20-40
mg every 6-8 hours until the desired effect occurs. The effective dose may be administered once or twice
daily. Some patients may require 600 mg daily. The starting oral dose for children is 2 mg/kg. The starting
dose may be increased by 1-2 mg/kg every 6 hours until the desired effect is achieved. Doses greater
than 6 mg/kg are not recommended. The recommended dose for treating hypertension is 40 mg twice
daily.

DRUG INTERACTIONS: Administration of furosemide with aminoglycoside antibiotics (for example,

gentamicin) or [ethacrynic acid (Edecrin) - another diuretic] may cause hearing damage. Furosemide
competes with aspirin for elimination in the urine by the kidneys. Concomitant use of furosemide and
aspirin may, therefore, lead to high blood levels of aspirin and aspirin toxicity. Furosemide also may
reduce excretion of lithium (Eskalith, Lithobid) by the kidneys, causing increased blood levels of lithium
and possible side effects from lithium. Sucralfate(Carafate) reduces the action of furosemide by binding
furosemide in the intestine and preventing its absorption into the body. Ingestion of furosemide and
sucralfate should be separated by two hours.

PREGNANCY: There are no adequate studies of furosemide in pregnant women.

NURSING MOTHERS: Furosemide is secreted in breast milk. Nursing mothers should

avoid breastfeeding while taking furosemide.

SIDE EFFECTS: Common side effects of furosemide include low blood

pressure,dehydration and electrolyte depletion (for example, sodium, potassium). Less common side
effects include jaundice, ringing in the ears (tinnitus), sensitivity to light
 (photophobia), rash, pancreatitis, nausea, diarrhea, abdominal pain, anddizziness. Increased blood sugar
and uric acid levels also may occur.

What is the most important information I should know about furosemide (Lasix)?

Do not use this medication if you are unable to urinate.

Before using this medication, tell your doctor if you have kidney disease, liver
disease, gout, lupus, diabetes, or an allergy to sulfa drugs.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular
basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled appointments.

Furosemide will make you urinate more often and you may get dehydrated easily. Follow your doctor's
instructions about using potassium supplements or getting enough salt and potassium in your diet.

Avoid becoming dehydrated. Follow your doctor's instructions about the type and amount of liquids you
should drink while you are taking furosemide.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High
blood pressure often has no symptoms.

What should I discuss with my healthcare provider before taking furosemide (Lasix)?

Do not use this medication if you are unable to urinate.

Before using furosemide, tell your doctor if you have:

 kidney disease;
 liver disease;
 gout;
 lupus;
 diabetes; or
 an allergy to sulfa drugs.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take
furosemide.

FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby. Before
taking furosemide, tell your doctor if you are pregnant or plan to become pregnant during treatment.

Furosemide can pass into breast milk and may harm a nursing baby. Do not use this medication without
telling your doctor if you are breast-feeding a baby.

How should I take furosemide (Lasix)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts,
or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do
not have a dose-measuring device, ask your pharmacist for one.

Your doctor may occasionally change your dose to make sure you get the best results from this
medication.

Furosemide will make you urinate more often and you may get dehydrated easily. Follow your doctor's
instructions about using potassium supplements or getting enough salt and potassium in your diet.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular
basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled appointments.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High
blood pressure often has no symptoms.

Store this medication at room temperature away from heat, light, and moisture.

Furosemide liquid medicine should be used within 60 to 90 days after opening the bottle. Ask your
pharmacist how many days your medicine is good for. Throw away any unused liquid after that time has
passed.

What happens if I miss a dose (Lasix)?

Furosemide is sometimes used only once, so you may not be on a dosing schedule. If you are using the
medication regularly, take the missed dose as soon as you remember. If it is almost time for the next
dose, skip the missed dose and wait until your next regularly scheduled dose. Do not take extra medicine
to make up the missed dose.

What happens if I overdose (Lasix)?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose
symptoms may include ringing in your ears, loss of appetite, weakness, dizziness, confusion, feeling light-
headed, or fainting.

What should I avoid while taking furosemide (Lasix)?

Avoid becoming dehydrated. Follow your doctor's instructions about the type and amount of liquids you
should drink while you are taking furosemide.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Furosemide can make your
skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear
protective clothing if you must be out in the sun.

What other drugs will affect furosemide (Lasix)?

If you take sucralfate (Carafate), take it at least 2 hours before or after you take furosemide.

Before taking this medication, tell your doctor if you are using any of the following drugs:
 lithium;
 digoxin (Lanoxin);
 steroids (prednisone and others);
 ethacrynic acid (Edecrin);
 diet pills or cold medicine;
 other blood pressure medications;
 amikacin (Amikin), gentamicin (Garamycin), netilmicin (Netromycin), streptomycin, tobramycin
(Nebcin, Tobi);
 salicylates such as aspirin, Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others; or
 indomethacin.

This list is not complete and there may be other drugs that can interact with furosemide. Tell your doctor
about all the prescription and over-the-counter medications you use. This includes vitamins, minerals,
herbal products, and drugs prescribed by other doctors. Do not start using a new medication without
telling your doctor.

A loop diuretic used for the treatment of oedema associated with heart failure, liver disease with ascites
(accumulation of fluid in the abdominal cavity), or kidney disease. It is also used to treat hypertension that has not
responded to antihypertensive drugs. Furosemide is available, on prescription only, as tablets, a suspension, or a
solution for intravenous injection. See also co-amilofruse.

Side effects, precautions, and interactions with other drugs:

see loop diuretics.

Proprietary preparations:
Froop; Frusol; Lasix; Rusyde; Diumide-K Continus (combined with potassium chloride); Frumil (see co-
amilofruse); Frusene (combined with triamterene); Lasilactone (combined with spironolactone).
Ceftriaxone (INN) (  /ˌsɛftraɪˈæksoʊn/) is a third-generation cephalosporin antibiotic. Like other third-
generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-
negative bacteria. In most cases, it is considered to be equivalent to cefotaxime in terms of safety and
efficacy. Ceftriaxone sodium is marketed by Hoffman-La Roche under the trade name Rocephin.

eftriaxone is often used (in combination, but not direct, with macrolide and/or aminoglycoside antibiotics)

for the treatment of community-acquired or mild to moderate health care-associated pneumonia. It is also
a choice drug for treatment of bacterial meningitis. In pediatrics, it is commonly used in febrile infants
between 4 and 8 weeks of age who are admitted to the hospital to exclude sepsis. The dosage for acute
ear infection in the very young is 50 mg/kg IM, one dose only. It has also been used in the treatment
of Lyme disease, typhoid fever andgonorrhea.[citation needed]

Intravenous dosages may be adjusted for body mass in younger patients and is administered every 12–
24 hours, at a dose that depends on the type and severity of the infection.

For the treatment of gonorrhea, a single intramuscular injection is usually given. Treatment for chlamydia
infection is also recommended (usually with azithromycin) unless it is specifically ruled out.[1]

It must not be mixed or administered simultaneously (within 48 hours) with calcium-containing solutions or
products for patients younger than 28 days old,[2] even via different infusion lines (rare fatal cases of
calcium-ceftriaxone precipitates in lung and kidneys in neonates have been described).[3]

To reduce the pain of intramuscular injection, ceftriaxone may be reconstituted with 1% lidocaine.[4]

Ceftriaxone has also been investigated for efficacy in preventing relapse to cocaine addiction.[5

Before using ceftriaxone injection,

 tell your doctor and pharmacist if you are allergic to ceftriaxone injection, other cephalosporin or
penicillin antibiotics, or any other medications.
 tell your doctor and pharmacist what prescription and nonprescription medications, vitamins,
nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention
any intravenous medications or feedings that contain calcium such as total parenteral nutrition
(TPN, a liquid feeding that is given intravenously to people who cannot eat or digest food).
 tell your doctor if you have or have ever had problems with your digestive system, especially
colitis (inflammation of the large intestine), malnutrition (you do not eat or cannot digest the
nutrients needed for good health), or kidney or liver disease.
 tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you
become pregnant while using ceftriaxone injection, call your doctor.
ROCEPHIN® 
(ceftriaxone sodium) for Injection

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Rocephin and
other antibacterial drugs, Rocephin should be used only to treat or prevent infections that are proven or
strongly suspected to be caused by bacteria.