Furosemide
Acute decompensated heart failure, Volume overload, Pulmonary edema, Edema from cirrhosis or nephrotic syndrome
Indications
- Acute decompensated heart failure
- Volume overload
- Pulmonary edema
- Edema from cirrhosis or nephrotic syndrome
Adult dosing
- iv bolus: dose: 40; unit: mg; route: IV; interval: q6-12h; may double if no response; fixed: true; drip: dose: 5; maxDose: 40; unit: mg/hr; route: IV; weightBased: false; titrationTarget: Titrate to urine output >0.5 mL/kg/hr
Pediatric dosing
- iv: dose: 1; unit: mg/kg; maxDose: 40; route: IV; interval: q6-12h; weightBased: true
Contraindications
- Anuria
- Hepatic coma
- Severe electrolyte depletion
Clinical pearls
- IV dose = 2x oral dose (50% oral bioavailability)
- Diuretic-naive: start 20-40mg IV; home dose: give 1-2.5x home oral dose as IV
- Drip is more effective than intermittent bolus for severe CHF (DOSE trial)
- Monitor K, Mg, Na — replace aggressively
Source and review
- AHA/ACC HF Guidelines 2022. Last reviewed: 2024-11-01