Health Guide
Drug Guide

Diuretic, loop (Oral route, injection route, intravenous route)

Brand Names:

Dosage Forms:

Uses of This Medicine:

Loop diuretics are given to help reduce the amount of water in the body. They work by acting on the kidneys to increase the flow of urine.

Furosemide and torsemide are also used to treat high blood pressure (hypertension) in those patients who are not helped by other medicines or in those patients who have kidney problems.

Loop diuretics may also be used for other conditions as determined by your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, loop diuretics are used in certain patients with the following medical conditions:

Before Using This Medicine:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Although there is no specific information comparing the use of loop diuretics in children with use in any other age group, these medicines are not expected to cause different side effects in children than they do in adults.

Older adults

Dizziness, lightheadedness, or signs of too much potassium loss may be more likely to occur in the elderly, who are more sensitive to the effects of this medicine. Elderly patients may also be more likely to develop blood clots.

Pregnancy

Studies have not been done in pregnant women. However, studies in animals have shown this medicine to cause harmful effects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

In general, diuretics are not useful for normal swelling of feet and hands that occurs during pregnancy. Diuretics should not be taken during pregnancy unless recommended by your doctor.

Breast-feeding

These medicines have not been reported to cause problems in nursing babies. Furosemide passes into breast milk; it is not known whether bumetanide, ethacrynic acid, or torsemide passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking a diuretic and who wish to breast-feed should discuss this with their doctor.

Other medicines

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Proper Use of This Medicine:

This medicine may cause you to have an unusual feeling of tiredness when you begin to take it. You may also notice an increase in the amount of urine or in your frequency of urination. After you have taken the medicine for a while, these effects should lessen. In general, to keep the increase in urine from affecting your sleep:

However, it is best to plan your dose or doses according to a schedule that will least affect your personal activities and sleep. Ask your health care professional to help you plan the best time to take this medicine.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

For patients taking the oral liquid form of furosemide:

For patients taking this medicine for high blood pressure:

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

If this medicine upsets your stomach, it may be taken with meals or milk. If stomach upset (nausea, vomiting, or stomach pain) continues or gets worse, or if you suddenly get severe diarrhea, check with your doctor.

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly.

This medicine may cause a loss of potassium from your body.

To prevent the loss of too much water and potassium, tell your doctor if you become sick, especially with severe or continuing nausea and vomiting or diarrhea.

Before having any kind of surgery (including dental surgery) or emergency treatment, make sure the medical doctor or dentist in charge knows that you are taking this medicine.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. This is more likely to occur in the morning. Getting up slowly may help. When you get up from lying down, sit on the edge of the bed with your feet dangling for 1 or 2 minutes. Then stand up slowly. If the problem continues or gets worse, check with your doctor.

The dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are taking this medicine, be careful to limit the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for long periods of time.

For diabetic patients:

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

For patients taking furosemide:

If you have a severe reaction from the sun, check with your doctor.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common
ECG abnormality with torsemide only
Rare
Black, tarry stools
blood in urine or stools
cough or hoarseness
fever or chills
joint pain
lower back or side pain
painful or difficult urination
pinpoint red spots on skin
ringing or buzzing in ears or any loss of hearing more common with ethacrynic acid
skin rash or hives
stomach pain (severe) with nausea and vomiting
unusual bleeding or bruising
yellow eyes or skin
yellow vision for furosemide only
Signs and symptoms of too much potassium loss
Dryness of mouth
increased thirst
irregular heartbeat
mood or mental changes
muscle cramps or pain
nausea or vomiting
unusual tiredness or weakness
weak pulse

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Dizziness or lightheadedness when getting up from a lying or sitting position
excessive urination with torsemide only
Less common
Acid or sour stomach with torsemide only
belching with torsemide only
blurred vision
chest pain with bumetanide and torsemide only
confusion with ethacrynic acid only
cough increase with torsemide only
diarrhea more common with ethacrynic acid
difficulty having a bowel movement (stool) with torsemide only
difficulty in moving with torsemide only
headache
heartburn with torsemide only
increased sensitivity of skin to sunlight with furosemide only
indigestion with torsemide only
lack or loss of strength with torsemide only
loss of appetite more common with ethacrynic acid
muscle aching or stiffness with torsemide only
nervousness with ethacrynic acid and torsemide only
premature ejaculation or difficulty in keeping an erection with bumetanide only
redness or pain at place of injection
runny nose with torsemide only
sneezing with torsemide only
sore throat with torsemide only
stomach cramps or pain
stomach discomfort or upset with torsemide only
stuffy nose with torsemide only
swollen joints with torsemide only

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Last Updated: 6/12/2013

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