FUROSEMIDE TABLETS BP 40 MG - patient leaflet, side effects, dosage

Patient leaflet - FUROSEMIDE TABLETS BP 40 MG

FUROSEMIDE 20MG & 40MG TABLETS

Read all of this leaflet carefully before you starts taking this medicine because it contains important information for you.

Keep the leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you only. Do not pass it on to others. It may harm them even if their signs of illness are the same as yours.
If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
1. What Furosemide is and what it is used for
2. What you need to know before you take Furosemide
3. How to take Furosemide Tablets
4. Possible side effects
5. How to store Furosemide Tablets
6. Contents of the pack and other information

11WHAT FUROSEMIDE IS AND WHAT IT IS USED FOR

Furosemide is a member of a group of medicines called diuretics (also called water tablets).
It works by interfering with the filtration process of the kidneys to reduce the amount of sodium and water taken back into the bloodstream, thus increasing the volume of urine produced.
Furosemide is used to treat oedema (fluid retention) caused by heart failure, and certain liver and kidney disorders.
It is also used to manage a condition called oliguria, where the body produces an abnormally small amount of urine, due to kidney disease.

2]what you need to know before you take

FUROSEMIDE

DO NOT take this medicine and talk to your doctor if you:

have previously had an allergic reaction to Furosemide, other diuretics or sulphonamides (e.g. sulphamethoxazole trimethoprim, sulfadiazine, etc)
are allergic to any of the other ingredients of this tablets (See section 6)
are pregnant, planning to become pregnant or breast-feeding
have liver cirrhosis (tiredness, weakness, water retention, feeling or being sick, loss of weight or appetite, yellowing skin or eyes)
have severe kidney damage which has stopped them working properly and producing urine
have very low levels of potassium, sodium or other electrolytes in your blood (your doctor will be able to advice you)
have the rare condition called porphyria which can affect the skin and nervous system
are suffering from digitalis toxicity (harmful effects of the drug digoxin)
have been told that you have a low volume of fluid in the body or a low blood pressure
have Addison’s disease (low levels of corticosteroid hormones secreted)

Warnings and precautions

Take special care and check with your doctor or pharmacist before taking these tablets if you have:

low levels of protein in the blood (hypo- proteinaemia) as a result of kidney damage
liver congestion (slowed blood flow through the vessels) or other liver problems
diabetes, kidney problems
prostate trouble or difficulty passing urine
have an abnormal blood condition
or had gout (causes excess uric acid in the blood and painful inflammation of the joints, mainly in the feet and hands and especially in the big toe)
are about to undergo any blood or urine tests

Talk to your doctor or pharmacist before taking Furosemide Tablets: if you are elderly, if you are on other medications which can cause the drop of the blood pressure and if you have other medical conditions that are risks for the drop of blood pressure.

Other medicines and Furosemide tablets

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, especially:

medicines used to treat high blood pressure such as ACE inhibitors, alpha blockers, diuretics (e.g. methyldopa, captopril)
antibiotics (for infection) such as cephaloridine, cephalothin, gentamycin and neomycin
digoxin used to increase the force of the heart muscle, and medicines to correct abnormal heart beats, eg amiodarone
non-steroidal anti-inflammatory drugs (to relieve the pain or inflammation in the joints or to lower a high temperature) such as aspirin, piroxicam and ibuprofen
corticosteroids (such as prednisolone) for allergic or inflammatory conditions such as asthma or arthritis
medicines for diabetes, eg insulin
theophylline used to treat asthma
antihistamines, eg cetrizine
curare-type muscle relaxing drugs such as tubocurarine
lithium, a treatment for depression
medicines used to treat other heart condition (e.g. lignocaine, mexiletine and tocainide)
drugs to treat mental illness (e.g. pimozide, amisulpride)
amphotericin (to treat fungal infection)
chloral hydrate (to treat insomnia)
antidepressants (e.g. monoamino oxidase inhibitors MAOIs)
colestyramine or colestipol for high cholesterol
moxisylte for Raynaud’s syndrome
antiepileptics (e.g. phenytoin or carbamazepine)
drugs for ADHD (Attention Deficit Hyperactivity Disorder)
drugs treating cancer (e.g. cisplatin)
levodopa (for Parkinson’s disease)
oral contraceptives
alprostadil for erectile dysfunction
probenecid to prevent gout
laxative used over a long period of time
medicines or food containing liquorice

If you are already taking or receiving one of these medicines, speak to you doctor before you start furosemide tablets.

Pregnancy and breast-feeding

Tell your doctor before you are given this medicine if you are or think you may be pregnant or are planning to become pregnant, or are breast feeding. Furosemide should only be given in pregnancy and while breast feeding, if the doctor thinks that it is absolutely necessary.

Driving and using machines

Furosemide may cause some patients to be less alert which could interfere with the ability to drive or to operate machines. If you notice that you are not as alert as usual, do not drive or operate machinery and ask your doctor for advice.

Furosemide tablets contains lactose

This medicine contains lactose, if you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking this medicine.

3] how to take furosemide

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Swallow the tablets with a drink of water.

Adult

The initial dose is 40mg a day, reduced to 20mg daily or 40mg on alternate days, depending on how you respond.
If you suffer from chronic kidney trouble, your doctor may prescribe a starting dose of 250 mg of Furosemide per day. If necessary your doctor may increase this to 250mg every 4 to 6 hours up to a maximum of 1500mg per day.
If Furosemide tablets are prescribed for a child make sure that the tablets are taken as instructed by the doctor.
The dosage is worked out depending on the child’s weight.
A dose of 1–3mg for each kilogram of the child’s body weight should be given daily. Do not exceed 40 mg per day.

Elderly

Furosemide is generally cleared from the body more slowly in the elderly. If you are elderly, your doctor may decide to start with a low dose and increase the dose gradually according to your response.

If you take more tablets than you should

If you or anyone else has swallowed a lot of the tablets all together contact your nearest hospital casualty department or doctor immediately.

If you forget to take a dose

If you forget to take a dose, take it as soon as you remember, but do not take two doses together. Then go on as before.

If you have further questions on the use of this medicine, ask your doctor or pharmacist.

4]possible side effects

Like all medicines, furosemide tablets can cause sideeffects, although not everyone gets them.

If you experience any of the following tell your doctor immediately:

severe allergic reaction which may include a skin rash, itching, dermatitis, peeling skin, sensitivity to sunlight, difficulty breathing, swelling of face, mouth, lips or eyelids, unexplained high temperature (fever) and feeling faint
inflammation of blood vessels (vasculitis, which may cause rash, fever and joint or muscle pains) or kidney inflammation, this may change the number of times you may pass urine or you may see blood in your urine.
sore throat or repeated infections

Furosemide may cause other unwanted effects:

Very common (may affect more than 1 in 10 people):

dehydration, low blood pressure causing loss of concentration and slowed reactions, light-headedness, sensations of pressure in the head, headache, dizziness, drowsiness, weakness, changes in vision, dry mouth, dizziness when standing
altered balance of fluid or chemicals in the body (e.g. sodium, potassium, chlorine, calcium and magnesium) causing a dry mouth, weakness, tiredness or drowsiness, restlessness, fits, muscle pain fatigue or cramps, low blood pressure, difficulty passing water, fast or irregular heart rate and feeling and being sick

Common (may affect up to 1 in 10 people):

low blood volume (hypovolaemia)
increased creatinine and blood urea (seen in blood tests) Uncommon (may affect up to 1 in 100 people):
a reduction of the blood cells in the bone marrow causing tiredness, unexplained bruising and paleness
changes in the body seen in tests such as levels of cholesterol, glucose, uric acid
stomach upset, diarrhoea, abdominal pain
blurred vision or yellow vision
deafness (sometimes irreversible)
gout (causing a swollen painful joint or joints)
diabetes

Rare (may affect up to 1 in 1,000 people):

hearing difficulty or ringing in the ears
over-sensitivity to light, pins and needles
sudden constant pain in the upper part of your tummy (this may suggest inflammation of a gland called the pancreas)
abnormal liver function which may cause jaundice (yellowing of the skin or whites of the eyes)
psychiatric disorder causing delusions, hallucinations, disorganized speech
symptoms of shock such as changes in heart rate, breathlessness, cool clammy skin

Very rare (may affect up to 1 in 10,000 people):

muscular spasm

Not known (frequency cannot be estimated from the available data):

acute generalized exanthematous pustulosis (AGEP) (acute febrile drug eruption)
headache, dizziness, confusion, fainting and loss of consciousness (caused by symptomatic hypotension)

During the treatment with furosemide, the blood levels of some fats (cholesterol and triglyceride) may rise, but these usually return to normal within six months. Deposits calcium salts in the kidneys have been reported in premature babies following treatment with furosemide. Furosemide may occasionally alter the composition of your blood and your doctor may want to do some blood tests from time to time. If you are to undergo a blood test remember to tell the doctor of your treatment with Furosemide.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.

5Jhow to store furosemide

Do not use this medicine after the expiry which is stated on the label, carton after ‘EXP’. The expiry date refers to last date of that month.
Do not store above 25°C.
Keep the container tightly closed (for plastic bottles).
Store in the original container (for plastic bottles).
Keep blister in the outer carton (for blister packs).

Keep all medicines out of the sight and reach of children.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6]CONTENTS of the pack and other INFORMATION

What furosemide tablets contain

The active ingredient is 20mg or 40mg of Furosemide.

The other ingredients are

Furosemide tablets 20 mg:

Lactose monohydrate, magnesium stearate, sodium starch glycollate and maize starch.

Furosemide tablets 40 mg:

Lactose, talc, magnesium stearate, maize starch and colloidal silica.

What Furosemide tablets look like and contents of the pack:

Furosemide 20mg tablets:

White, circular tablets embossed ‘PV’ on one face and F/20 on the other.

Furosemide 40mg tablets:

White, circular tablets embossed ‘PV’ on one face and F/40 on the other