Furosemide chemical structure
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Furosemide

Furosemide (INN) or frusemide (former BAN) is a loop diuretic used in the treatment of congestive heart failure and edema. It is most commonly marketed by Aventis Pharma under the brand name Lasix. It has also been used to prevent thoroughbred race horses from bleeding through the nose during races. more...

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Along with some other diuretics, furosemide is also included on the World Anti-Doping Agency's banned drug list due to its alleged use as a masking agent for other drugs.

Mechanism of action

Like other loop diuretics, furosemide acts by inhibiting the Na/K/Cl cotransporter in the ascending loop of Henle. It also has inhibitory activity on carbonic anhydrase.

Clinical use in humans

Furosemide, as a loop diuretic, is principally used in the following indications (Aventis, 1998):

  • Edema associated with heart failure, hepatic cirrhosis, renal impairment, nephrotic syndrome
  • Hypertension
  • Adjunct in cerebral/pulmonary oedema where rapid diuresis is required (IV injection)

It is also sometimes used in the management of severe hypercalcemia in combination with adequate rehydration (Rossi, 2004).

It is considered ototoxic. (PMID 15311369)

Use in horses

Apparently, sometime in the early 1970s, furosemide's ability to prevent or at least greatly reduce the incidence of bleeding by horses during races was discovered accidentally. Pursuant to the racing rules of most states, horses that bleed from the nostrils three times are permanently barred from racing (for their own protection). Clinical trials followed, and by decade's end, racing commissions in some states began legalizing its use on race horses. On September 1, 1995, New York became the last state in the United States to approve such use, after years of refusing to consider doing so. Some states allow its use for all racehorses; some allow it only for confirmed "bleeders." Its use for this purpose is still prohibited in many other countries, however.

Brand names

Some of the brand names under which furosemide is marketed include: Aisemide®; Beronald®; Desdemin®; Discoid®; Diural®; Diurapid®; Dryptal®; Durafurid®; Errolon®; Eutensin®; Frusetic®; Frusid®; Fulsix®; Fuluvamide®; Furesis®; Furo-Puren®; Furosedon®; Hydro-rapid®; Impugan®; Katlex®; Lasilix®; Lasix®; Lowpston®; Macasirool®; Mirfat®; Nicorol®; Odemase®; Oedemex®; Profemin®; Rosemide®; Rusyde®; Trofurit®; Urex®

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Thiamine deficiency in congestive heart failure patients receiving long term furosemide therapy
From Alternative Medicine Review, 3/1/04 by C. Zenuk

Zenuk C, Healey, J, Donnelly J, et al. Can J Clin Pharmacol 2003;10:184-188.

OBJECTIVE: To assess the presence of thiamine deficiency in congestive heart failure patients receiving furosemide therapy. DESIGN: Prospective, biochemical analysis of thiamine status was performed in outpatients and inpatients of the University of Ottawa Heart Institute. SUBJECTS: Thirty-two patients with congestive heart failure who received at least 40 mg/day of furosemide were included. Patients were then separated into two groups depending on whether the dose of furosemide was greater than or equal to 80 mg/day. METHODS: The primary measure was actual thiamine status as assessed by the erythrocyte transketolase enzyme activity and the degree of thiamine pyrophosphate effect. RESULTS: Biochemical evidence of severe thiamine deficiency was found in 98% (24 of 25) patients receiving at least 80 mg/day of furosemide and in 57% (four of seven) of patients taking 40 mg Furosemide daily, odds ratio (OR) 19.0 (1.13<OR<601.29). Thiamine status was not associated with any other clinical variables. CONCLUSIONS: These findings suggest that thiamine deficiency occurs in a substantial proportion of congestive heart failure patients being treated with furosemide.

COPYRIGHT 2004 Thorne Research Inc.
COPYRIGHT 2004 Gale Group

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