EXP: 1
DAY (RT).
Label: Do not Refrigerate.
Recommended routes: IM, IV-push, Continuous
infusion.
Doses up to 6 grams/day have been used in patients
with renal failure.
Dosing: 20 to 40 mg initially. Increase by 20 mg
increments q1 to 2 hours until response.
Continuous infusion: 20 to 160 mg/hr.
IV bolus: Usual doses (eg <80 mg) can be given
slowly over 1-2 minutes. If higher doses are
needed, a continuous infusion is
recommended-usually greater efficacy as well as
decreased risk of side effects.
DOSAGE AND ADMINISTRATION
Adults - Parenteral therapy with furosemide
injection should be used only in patients unable
to take oral medication or in emergency situations
and should be replaced with oral therapy as soon
as practical.
Edema
The usual initial dose of furosemide is 20 mg to
40 mg given as a single dose, injected
intramuscularly or intravenously. The intravenous
dose should be given slowly (1 to 2 minutes).
Ordinarily a prompt diuresis ensues. If needed,
another dose may be administered in the same
manner 2 hours later or the dose may be increased.
The dose may be raised by 20 mg and given not
sooner than 2 hours after the previous dose until
the desired diuretic effect has been obtained.
This individually determined single dose should
then be given once or twice daily.
Therapy should be individualized according to
patient response to gain maximal therapeutic
response and to determine the minimal dose needed
to maintain that response. Close medical
supervision is necessary. If
the physician elects to use high dose
parenteral therapy, add the furosemide to
either Sodium Chloride Injection, USP, 0.9%,
Lactated Ringer’s Injection, USP, or Dextrose
(5%) Injection, USP, after pH has been adjusted to
above 5.5, and administer as a controlled
intravenous infusion at a rate not greater than 4
mg/min. Furosemide injection is a buffered
alkaline solution with a pH of about 9 and drug
may precipitate at pH values below 7. Care must be
taken to ensure that the pH of the prepared
infusion solution is in the weakly alkaline to
neutral range. Acid solutions, including other
parenteral medications (e.g., labetalol,
ciprofloxacin, amrinone, milrinone) must not be
administered concurrently in the same infusion
because they may cause precipitation of the
furosemide. In addition, furosemide injection
should not be added to a running intravenous line
containing any of these acidic products.
Acute Pulmonary Edema
The usual initial dose of furosemide is 40 mg
injected slowly intravenously (over 1 to 2
minutes). If a satisfactory response does not
occur within 1 hour, the dose may be increased to
80 mg injected slowly intravenously (over 1 to 2
minutes).
If necessary, additional therapy (e.g., digitalis,
oxygen) may be administered concomitantly.
Pediatric Patients- Parenteral therapy
should be used only in patients unable to take
oral medication or in emergency situations and
should be replaced with oral therapy as soon as
practical.
The usual initial dose of furosemide injection
(intravenously or intramuscularly) in infants and
children is 1 mg/kg body weight and should be
given slowly under close medical supervision. If
the diuretic response to the initial dose is not
satisfactory, dosage may be increased by 1 mg/kg
not sooner than 2 hours after the previous dose,
until the desired diuretic effect has been
obtained. Doses greater than 6 mg/kg body weight
are not recommended.
Literature reports suggest that the maximum dose
for premature infants should not exceed 1
mg/kg/day. WARNINGS: Pediatric Use: In
premature neonates with respiratory distress
syndrome, diuretic treatment with furosemide in
the first few weeks of life may increase the risk
of persistent patent ductus arteriosus (PDA),
possibly through a prostaglandin-E-mediated
process.
Literature reports indicate that premature infants
with post-conceptual age (gestational plus
postnatal) less than 31 weeks receiving doses
exceeding 1 mg/kg/24 hours may develop plasma
levels which could be associated with potential
toxic effects including ototoxicity.
Hearing loss in neonates has been associated with
the use of furosemide injection
Furosemide injection should be inspected visually
for particulate matter and discoloration before
administration. Do not use if solution is
discolored.
HOW SUPPLIED
1275 - Carpuject® with Luer Lock - 10 mg/mL
- 2 mL
Box of 10
Store at 20 to 25°C (68 to 77°F). [See USP
Controlled Room Temperature.] Do not freeze.
Protect CARPUJECT from light. Do not remove
cartridges from package until time of use.
Do not use the injection if it is discolored or
contains a precipitate.
©Hospira 2004
EN-0529
HOSPIRA, INC., LAKE FOREST, IL 60045 USA
Stability
(Lexi)
Furosemide injection should be stored at
controlled room temperature and protected from
light
Exposure to light may cause discoloration; do not
use furosemide solutions if they have a yellow
color.
Refrigeration may result in precipitation or
crystallization, however, resolubilization at room
temperature or warming may be performed without
affecting the drug's stability.
Furosemide solutions are unstable in acidic media
but very stable in basic media.
I.V. infusion solution mixed in NS or D5W solution
is stable for 24 hours at room temperature. May
also be diluted for infusion 1-2 mg/mL (maximum:
10 mg/mL) over 10-15 minutes (following infusion
rate parameters).
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