英文药名: Lasix(Furosemide Oral Solution)

中文药名: 速尿（呋塞米口服液）

药品名称

【别名】呋喃苯胺酸; 呋塞米; 腹安酸; 利尿磺胺; 利尿灵; 速尿; 速尿灵
【外文名】Furosemide, Frusemide, LASIX, Diural, Furanlral, Seguril, Urex
药理作用

1、利尿：作用强大、迅速而短暂。
(1)个体差异明显，应注意剂量个体化。
(2)利尿作用不受酸碱平衡失调及电解质紊乱的影响。
(3)易引起低血钾、低盐综合征及低氯性碱中毒。低血钾最常见
(4)还促进Ca2＋、Mg2＋排出，而抑制尿酸排出。
2、扩张血管：
(1)能扩张肾血管，增加肾血流量，改变肾皮质内血流分布；
(2)还能扩张小静脉，减少回心血量，减轻心脏负荷，降低左室充盈压，减轻肺水肿。
扩血管机制可能与本药促进前列腺素酶合成，抑制其分解有关。
适应症

临床上用于治疗心脏性水肿、肾性水肿、肝硬变腹水、功能障碍或血管障碍所引起的周围性水肿，并可促使上部尿道结石的排出。其利尿作用迅速、强大，多用于其他利尿药无效的严重病人。由于水、电解质丢失明显等原因，故不宜常规使用。静脉给药（２０～８０ｍｇ）可治疗肺水肿和脑水肿。药物中毒时可用以加速毒物的排泄。
用法用量

1.肌注或静注：每次２０ｍｇ，隔日１次，必要时亦可１日１～２次。１日量视需要可增至１２０ｍｇ。静注必须缓慢，不宜与其他药物混合注射。儿童用量酌减。
2.口服：开始时每日４０ｍｇ，以后根据需要可增至每日８０～１２０ｍｇ。当每日剂量超过４０ｍｇ时，可以每４小时１次分服。儿童口服量开始按每千克体重１～２ｍｇ，再视情况酌增。 长期（７～１０日）用药后利尿作用消失，故需长期应用者，宜采取间竭疗法：给药１～３日，停药２～４日。
任何疑问，请遵医嘱！
不良反应

1、水与电解质紊乱，常为过度利尿所引起，表现为低血容量、低血钾、低血钠、低氯性碱血症，长期应用还可引起低血镁。
2、耳毒性，表现为耳鸣、听力减退或暂时性耳聋，呈剂量依赖性。耳毒性的发生机制可能与药物引起内耳淋巴液电解质成分改变有关。肾功能不全或同时使用其他耳毒性药物，如并用氨基糖苷类抗生素时较易发生耳毒性。
3、高尿酸血症，袢利尿药可能造成高尿酸血症，并引发痛风。
4、其他，可有恶心、呕吐、大剂量时尚可出现胃肠出血。
注意事项

1.可能出现轻微恶心、腹泻、药疹、瘙痒、视力模糊等不良反应，有时可发生起立性眩晕、乏力、疲倦、肌肉痉挛、口渴，少数病人有白细胞减少，个别病人出现血小板减少，多形性红斑、直立性低血压。长期应用可致胃及十二指肠溃疡。
2.由于能减少尿酸排出，故多次应用后能产生尿酸过多症，个别病人长期应用可产生急性痛风。
3.糖尿病病人应用后可使血糖增高；尽管其升血糖远较噻嗪类利尿药弱，但与降血糖药合并应用时，仍有使血糖增高的可能。
4.由于利尿作用迅速、强大，因而要注意掌握开始剂量，防止过度利尿，引起脱水和电解质失衡。
5.肝炎病人服用后，因电解质（特别是钾离子）过度丢失，易产生肝昏迷。
6.长期大量用药时，应注意检查血中电解质浓度。顽固性水肿病人特别容易出现低钾症状，在同时使用洋地黄或排钾的甾体激素时，更应注意补充钾盐。
7.在脱水的同时，可出现可逆性血尿素氮水平升高。如果肌酐水平升高不显著和肾功能无损害时，可继续使用本品。
8.使用第１个月，要定期检查血清电解质、二氧化碳和血中尿素氮水平。与其他利尿药一样，当治疗进展中的肾脏疾患而有血清尿素氮值增加和少尿现象发生时，应立即停止用药。
9.能增强降压药的作用，故合并用药时，降压药的用量应适当减少。
10.因结构上本品是与氯噻嗪结构相似的一类磺胺型化合物，能降低动脉对升压胺（如去甲肾上腺素）的反应，并能增加筒箭毒碱的肌松驰及麻痹作用，故手术前１周应停用。
11.低钾血症、超量服用洋地黄、肝昏迷病人禁用。晚期肝硬变病人慎用。
12.大剂量静注过快时，可出现听力减退或暂时性耳聋。与氨基糖甙类抗生素配伍应用，更易引起听力减退。
规格

呋塞米口服液: 10mg/ml X 120ml。
注射液：每支２０ｍｇ（２ｍｌ）。
片剂：每片20mg,40mg,80mg,500mg。

Uses

Lasix is a loop diuretic (water pill) that prevents your body from absorbing too much salt, allowing the salt to instead be passed in your urine.

Lasix treats fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure (hypertension).

Lasix may also be used for other purposes not listed in this medication guide.
How to take
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.

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

Lasix 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 Lasix 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 Lasix even if you feel fine. High blood pressure often has no symptoms.

Side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Lasix and call your doctor at once if you have any of these serious side effects:

dry mouth, thirst, nausea, vomiting
feeling weak, drowsy, restless, or light-headed
fast or uneven heartbeat
muscle pain or weakness
urinating less than usual or not at all
easy bruising or bleeding, unusual weakness
a red, blistering, peeling skin rash
hearing loss; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
diarrhea, constipation, or stomach pain
headache
numbness, burning, pain, or tingly feeling
dizziness; or
blurred vision.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Precaution

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

Before taking Lasix, 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 Lasix. 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.

Drug interactions

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.

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 may add to or potentiate the therapeutic effect of other antihypertensive drugs.

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.

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.

Missed dose

Lasix 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.

Storage

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