Page 129 - 2026 SMOG

FUROSEMIDE (LASIX)
Class/Mechanism of Action
• Antihypertensive; Loop Diuretic
Inhibits reabsorption of sodium and chloride in the kidney, causing increased loss of water,
sodium, chloride, magnesium, and calcium in the urine. When given IV, it also causes rapid
venous dilation—symptomatic improvement of acute pulmonary edema approximately
15–20min.
Indications
• Labeled Indications
˚ Management of edema associated with heart failure, cirrhosis of the liver (i.e., ascites), or
kidney disease (including nephrotic syndrome); acute pulmonary edema
Contraindications
• Hypersensitivity to furosemide or any component of the formulation
• Anuria (no pre-hospital utility in hypovolemic shock)
Adverse Reactions/Precautions
• Can cause profound diuresis with resulting shock and electrolyte depletion. Monitor closely!
˚ May cause: Hypovolemia, hypotension, hyponatremia, hypokalemia
• May potentiate the effect of additional antihypertensives
• May lead to Acute Kidney Injury due to fluid loss
• Ototoxicity: associated with hearing loss and tinnitus; generally reversible
• Pregnancy: Category C
• Lactation: Use caution; large doses suppress volume and lactation
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Acute Pulmonary Edema Edema (Heart Failure)
• IV • IV/IM
˚ 40mg over 1–2min. If the response is not ˚ Initial: 1mg/kg as a single dose
adequate within 1hr, may increase the
If necessary, increase dose by up to
dose to 80mg ˚ 1mg/kg and give greater than 2hr after
Edema (Heart Failure) the previous dose, repeating until desired
• IV/IM response is achieved, to a maximum dose
˚ Initial: 20–40mg once, then titrate prn of 6mg/kg.
to an effective dose. If the initial dose
does not result in diuresis, double the
individual dose (rather than administering
the same dose more frequently) until
diuresis occurs.
• Continuous IV Infusion
˚ Initial: 5mg/hr; if diuretic response is
not adequate, repeat IV bolus dose and
increase continuous infusion to 10mg/hr;
continue to bolus and titrate infusion prn
up to 40mg/hr

2026 Standard Medical Operating Guidelines (SMOG) • 121