Furosemide bufus injections 10 mg/ml 2 ml – [10 ampoules]

Furosemide is a fast-acting diuretic, which is a derivative of sulfonamide. Furosemide blocks the transport system of sodium, potassium, chlorine ions in the thick segment of the ascending knee of the Genle loop, due to which its saluretic

action depends on the entry of the drug into the lumen of the renal tubules (due to the mechanism of anion transport).

Diuretic action of Furosemide Bufus is associated with inhibition of sodium chloride reabsorption in this part of the loop

Genle. Secondary effects in relation to the increase in sodium excretion are an increase in the amount of urine excreted (due to osmotically bound water) and increased potassium secretion in the distal part of the renal tubule. At the same time, excretion of calcium and magnesium ions increases. When repeated administration of Furosemide bufus, its diuretic activity is not reduced, since as the drug interrupts the tubulo-collicular feedback in Macula densa (a tubular structure closely associated with the juxtaglomerular complex).

Furosemide causes dose-dependent stimulation of the renin-angiotensin-aldosterone system. In heart failure, furosemide rapidly reduces preload (due to vein dilation), reduces pulmonary artery pressure and left ventricular filling pressure. This rapidly developing effect appears to be mediated through the effects of prostaglandins and therefore a condition for its development is the absence of disturbances in prostaglandin synthesis, in addition to which sufficient preservation of renal function is also required to realize this effect.

Furosemide has a hypotensive effect, which is due to increased sodium excretion, decreased circulating blood volume and reduced vascular smooth muscle response to vasoconstrictor effects (due to the natriuretic effect, furosemide reduces the vascular response to catecholamines, whose concentration in patients with arterial hypertension is increased).

A dose-dependent increase in diuresis and natriuresis is observed with furosemide bufus at a dose of 10 mg to 100 mg (healthy volunteers). After intravenous administration of 20 mg of Furosemide bufus, the diuretic effect develops in 15 minutes and lasts about 3 hours.

– Edematous syndrome in chronic heart failure (if diuretic therapy is necessary);

– Edematous syndrome in acute heart failure;

– Edematous syndrome in chronic renal failure;

– Acute renal failure, including pregnancy and burns (to maintain fluid excretion);

– Edematous syndrome in nephrotic syndrome (if diuretic therapy is necessary);

– edema syndrome in liver disease (if necessary in addition to treatment with aldosterone antagonists);

– hypertensive crisis (as a supportive measure);

– maintenance of forced diuresis in cases of poisoning.

– Hypersensitivity to furosemide, or to any of the components of the drug; patients with allergy to sulfonamides (sulfonamide antimicrobials or sulfonylurea preparations) may develop a “cross” allergy to furosemide;

– renal failure with anuria (if there is no reaction to furosemide administration);

– hepatic precoma and coma associated with hepatic encephalopathy;

– Severe hypokalemia;

– Severe hyponatremia;

– hypovolemia (with or without arterial hypotension) or dehydration;

– Severe urinary outflow disorders of any etiology (including unilateral urinary tract involvement);

– pregnancy and breastfeeding.

General recommendations

When prescribing Furosemide Bufus, it is recommended to use the lowest dose, sufficient to achieve the desired therapeutic effect.

The dose is adjusted individually.

Furosemide Bufus is administered intravenously and, in exceptional cases, intramuscularly (when intravenous injection or ingestion is not possible). Intramuscular administration of the drug is not suitable for the treatment of acute conditions such as pulmonary edema.

Intravenous administration of Furosemide Bufus is used only when its intravenous administration is impossible or when there is a violation of absorption of the drug in small intestine or when it is necessary to obtain the maximum rapid effect. When administering Furosemide bufus intravenously it is always recommended to switch to oral administration as soon as possible.

The drug should be administered slowly when administered intravenously. The rate of intravenous administration should not exceed 4 mg/min. In patients with severe renal impairment (with serum creatinine concentration ≥ 5 mg/dL), it is recommended that the rate of intravenous administration of Furosemide bufus should not exceed 2.5 mg/min. To achieve optimal efficacy and suppression of counter-regulation (activation of renin-angiotensin and antinatriuretic neurohumoral regulatory links), prolonged intravenous infusion of Furosemide bufus is preferable to repeated intravenous bolus administration. If after one or more bolus intravenous infusions for acute conditions there is no continuous intravenous infusion available, it is preferable to low doses with short intervals between injections (approximately 4 hours) are preferable to intravenous bolus administration of higher doses with longer intervals between injections.

Parenteral solution has a pH of about 9 and has no buffering properties. At pH lower than 7 the active substance may precipitate, therefore when diluting Furosemide bufus it is necessary to aspire to pH of the resulting solution ranges from neutral to slightly alkaline. For dilution can be used 0.9% sodium chloride solution. Diluted Furosemide Bufus solution should be used as soon as possible after preparation.

Recommended maximum daily dose for intravenous administration in adults is 1500 mg and in children 20 mg.

Duration of treatment is determined by the physician individually depending on indications.

Special recommendations on the dosage regimen in children

In children the dose should be reduced according to body weight. Recommended dose for parenteral administration is 1 mg/kg/body weight/day, but not more than 20 mg/day.

Specific recommendations for dosing regimen in adults

Edematous syndrome in liver disease

Furosemide bufus is prescribed in addition to treatment with aldosterone antagonists in case of their insufficient effectiveness. Careful dosage selection is required to prevent complications such as orthostatic circulatory dysregulation, water-electrolyte balance disorders or acid-base state, so that fluid loss occurs gradually (at the beginning of treatment fluid loss up to about 0.5 kg of body weight per day is possible). If intravenous administration is necessary, the initial dose for intravenous administration is 20-40 mg.

Edema syndrome in chronic renal failure

The natriuretic response to Furosemide Bufus depends on several factors, including the severity of renal failure and blood sodium content, so the effect of the dose cannot be accurately predicted. In patients with chronic renal failure, careful selection of the dose is required, by gradually increasing it so that fluid loss occurs gradually (at the beginning of treatment, fluid loss up to approximately 2 liters/day may occur, which can be up to 280 mmol Na+ per day). In patients on hemodialysis, the maintenance dose is usually 250-1500 mg/day orally.

When administered intravenously, the dose of Furosemide Bufus can be determined as follows: treatment begins with intravenous drip infusion at a rate of 0.1 mg/min and then gradually increases the infusion rate every 30 minutes depending on the therapeutic effect.

Acute renal failure (for maintenance of fluid excretion)

Hypovolemia, arterial hypotension and significant disorders of water-electrolyte and acid-base balance should be eliminated before starting treatment with Furosemide bufus.

The recommended initial intravenous dose is 40 mg. If after its administration the necessary diuretic effect is not achieved, Furosemide Bufus may be administered as a continuous intravenous infusion, starting from the infusion rate of 50-100 mg/h.