Neonatal Drug Therapy Manual

Furosemide

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Lasix
Classification: 
Diuretic
Original Date: 
March 1993
Revised Date: 
January 2018
Indications: 
  • Pulmonary edema/congestive heart failure
  • As adjunctive therapy for BPD
Administration: 
  • IV direct: over 5 minutes (maximum: 1 mg/kg/dose)
  • IV intermittent infusion: over 15 - 30 minutes
  • IV continuous infusion
  • PO
Dosage: 
  • IV:
    • IV direct / IV intermittent infusion:
      • 1 - 2 mg/kg/dose Q12 - 24H
      • ** Follow above administration directives for IV administration**
    • IV continuous infusion: (rarely used)
      • 0.05 mg/kg/hr ; titrate dose to clinical effect
  • PO:
    • 1 - 2 mg/kg/dose Q12 - 24H
Side Effects: 
  • CVS: hypotension, cardiac arrhythmias (rare)
  • Endocrine and metabolic: hyperglycemia, hypocalcemia, hypokalemia, hyponatremia, hypomagnesemia, metabolic alkalosis
  • Otic: potentially ototoxic, especially with concomitant aminoglycosides
  • Renal: hypercalciuria, interstitial nephritis, nephrocalcinosis

 

Parameters to Monitor: 
  • Serum electrolytes, serum creatinine
  • Weight, urine output
  • BP
  • HR
Reconstitution and Stability: 

CHEO:

IV direct/ IV intermittent infusion/ IV continuous infusion

  • Furosemide 10 mg/mL
    • Take 1 mL (10 mg) and add to 9 mL of 0.9% NaCl
    • Final concentration: 1 mg/mL

TOH:

IV direct/ IV intermittent infusion

  • Furosemide 10 mg/mL
    • Take 1 mL (10 mg) and add to 9 mL of 0.9% NaCl
    • Final concentration: 1 mg/mL

Continuous infusion

  • Furosemide 10 mg/mL
    • Take 1 mL (10 mg) and add to 19 mL of D5W
    • Final concentration: 0.5 mg/mL
Compatibility: 

- Solutions Compatible: D5W, D10W, 0.9 % NaCl, dextrose-saline combinations

- Y-site Compatible: calcium gluconate, epinephrine, fentanyl, heparin, KCl up to 40 mmol/L, morphine, SMOF, TPN

Incompatible: dobutamine, dopamine, fluconazole, gentamicin, midazolam, morphine, vancomycin

Notes: 
  • Do not use if IV solution is yellow
References: 

-American Society of Health-System Pharmacists.  Handbook on Injectable Drugs. 19th Edition. Bethesda: American Society of Health-System Pharmacists; 2017

 

 

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