top of page

Furosemide Pharmacology

Pharmacology

Clinical Particulars

Furosemide, a sulfamoyl-anthranilic acid derivative, is a rapid-onset high-ceiling loop diuretic in all mammalian species. Furosemide demonstrates a broad spectrum of pharmacologic activity, but its principal action is a potent, fast-acting, short-duration, high-ceiling loop diuretic. It mainly works by inhibiting electrolyte reabsorption from the kidneys and enhancing water excretion from the body.  In small animal medicine, it is regarded by most as the first-line loop diuretic for managing cardiac disease. However, there are a variety of other potential applications.

Pharmacodynamics

Pharmacokinetics

Mechanism of Action

Furosemide works directly on the cells of the proximal and distal tubules of the nephron loop of Henle, reducing the absorption of electrolytes by blocking the sodium-potassium-chloride transporter, decreasing the reabsorption of sodium and chloride, as well as calcium, magnesium, and hydrogen ions and increasing potassium excretion in the distal tubules (Abbott & Kovacic, 2008; Booth, 2011; Carone et al., 2016; Chetboul et al., 2017; Cohen et al., 1976; DiBartola, 2011; Ettinger, 2024 & 2017; Harada et al., 2015; Hori et al., 2010; Lee et al., 1986; Maddison, 2008; Pichette et al., 1999; Plumb, 2024; PubChem, 2024; Sayer et al., 2009; Shankar and Brater, 2003; Uechi et al., 2003; Watson, 2011). Furosemide concentration within tubular filtrate, not blood, determines the diuretic effect  (Koyner et al., 2015).


  1. Furosemide reduces the absorption of electrolytes by blocking the sodium-potassium-chloride transporter,

  2. Furosemide decreases the reabsorption of sodium and chloride, as well as calcium, magnesium, and hydrogen ions.

  3. Furosemide increases potassium excretion in the distal tubules.

Summary of Applications

There are a variety of potential applications; Furosemide demonstrates a broad spectrum of pharmacologic activity.

Cardiology (Mammalian)

  • Acute Cardiac Disease | Acute Heart Failure (AHF): In humans and most mammalian species, initial AHF therapy typically includes the administration of parenteral furosemide, oxygen, and sedation (FOS) or furosemide, oxygen, nitroglycerine, and sedation (FONS). In patients with AHF and signs of hypo-perfusion, Clinicians should avoid diuretic administration until adequate perfusion is attained (Abbott & Kovacic, 2008; Afari et al., 2019; Chitty, 2015; Convey et al., 2024; DeFrancesco, 2013; Fitzgerald et al., 2018; Giorgi et al., 2022; Keene et al., 2019; Koster et al., 2023; Matsue et al., 2017; Ohad et al., 2018; Ponikowski et al., 2016; Roche-Catholy et al., 2021; Schnellbacher et al., 2012; Wang & Gottlieb, 2008). Detailed information, where available, is given in species-specific dosing monographs.

  • Chronic Cardiac Disease; CHF (Congestive Heart Failure): Furosemide is widely used as a loop diuretic to reduce pulmonary oedema in CHF (Adin et al., 2020; Ames et al., 2013; Ferasin & Marcora, 2007; Häggström et al., 2013, 2008; Lombard et al., 2006; Yata et al., 2019). It is the core diuretic recommended in ACVIM MMVD consensus protocols (Keene et al., 2019). CHF use in other species is also extensive (Watson, 2011). Detailed information, where available, is given in species-specific dosing monographs.

  • Feline HCM: Intravenous administration of furosemide, either as multiple boluses or a constant rate infusion, is recommended for CHF and pulmonary oedema. Thoracocentesis should be performed when respiratory distress results from pleural effusion. Intravenous fluid treatment is contraindicated in cats with clinically evident congestion, oedema or effusion and can exacerbate signs of CHF even if diuretics are administered concurrently. Ideally, measuring blood chemistries can be considered before treatment if samples can be obtained without compromising patient safety. However, diuretic treatment is recommended for acute heart failure regardless of azotemia. Cats with pulmonary oedema (stage C) must be treated with a loop diuretic – either furosemide or torsemide (torasemide). The route of administration and dosage depends on the nature and severity of clinical signs at presentation, radiographic changes, and response to initial therapy.  (Ferasin et al., 2003; Hause, 1984; Kittleson and Côté, 2021; Lee et al., 2023; Luis Fuentes et al., 2020; Ohad et al., 2018; Rush et al., 2002; Schober et al., 2021).

  • Anti-Hypertensive Agent: Furosemide has a vasodilatory effect that precedes diuresis and may confer its immediate benefit in patients with volume overload. However, in a recent systematic review, the evidence for clinical benefit was graded as modest (Abbott & Kovacic, 2008; Musini et al., 2015)

Nephrology (Mammalian)

  • Acute Kidney Injury (AKI): In humans and other mammalian species, furosemide, alongside suitable IVFT and electrolyte management, reduces the severity of hyperkalaemia, acidosis, and fluid overload in mild AKI through increased urine output (UOP). However, furosemide helps maintain urinary production but does not impact patients' survival or renal recovery rate. Instead, it may reduce the severity and duration of morbidity in recovering patients.  Some studies have shown the adverse effects of prophylactic loop diuretic administration in patients predisposed to AKI, despite theoretical reasons to use furosemide to prevent AKI. Therefore, no specific protocols are presently recommended (Escudero et al., 2022; Giorgi et al., 2022; Guan et al., 2023; Heyman et al., 1994; Ho and Power, 2010; Keir & Kellum, 2015; Li et al., 2023; Pruchnicki & Dasta, 2002; Shilliday et al., 1997; Su et al., 2024; Zhao et al., 2020). Use should be discontinued if there is any increase in a patient’s azotemic condition. Furosemide is often given as an IV bolus in cats and dogs with mild AKI. If an increased UOP is observed, the dose may be repeated every 6-12 hours if needed, or furosemide may be given as a CRI. The CRI's function is to maintain sufficient serum concentrations to allow continuous accumulation within the tubular filtrate. Dogs and cats who fail to respond to a furosemide bolus are unlikely to respond to a CRI, as they likely have adequate serum concentrations for several hours following bolus administration (Ettinger, 2024).  There may be differences in outcomes of patients with different AKI aetiologies and furosemide, alongside suitable IVFT, and suitable electrolyte management has been recommended in a variety of presentations, including AKI associated with sepsis (De Vriese, 2003; Keir and Kellum, 2015; Li et al., 2023),  AKI associated with acute lung injury (Escudero et al., 2022; Giorgi et al., 2022; Grams et al., 2011; Guan et al., 2023; Keir & Kellum, 2015; Li et al., 2023; Su et al., 2024; To et al., 2023; Zhao et al., 2020), AKI associated with Grape/Raisin and similar nephrotoxins (Downs et al., n.d.; Mazzaferro et al., 2004; Yoon et al., 2011).

  • Glomerular Disease: Furosemide is considered a first-choice drug in nephrotic syndrome dogs with pulmonary oedema or hyperkalemia, and spironolactone for dogs with pleural or abdominal effusion. The goal of diuretic treatment is a slow, progressive decrease in the oedema to a clinically acceptable condition (IRIS Canine GN Study Group et al., 2013).

Neurology (Mammalian)

  • Anti-Convulsant (AED): Furosemide has shown potential as an adjunct to antiseizure therapy in epilepsy, status epilepticus, and acute ischemic damage related to seizures. How this may benefit veterinary patients with seizure and cardiac comorbidities is yet to be investigated  (Abbott & Kovacic, 2008; Hochman, 2012; PubChem, 2024; Uwera et al., 2015; Zaccara et al., 2020).

Respiratory Medicine (Mammalian)

  • Bronchospasm: Furosemide can be nebulised or inhaled to relieve dyspnea in patients with bronchospasm. Furosemide is a known bronchodilator in horses, humans, rats and guinea pigs (Abbott & Kovacic, 2008; Boyden et al., 2015; Broadstone et al., 1991; Foresi et al., 1992; Maddison, 2008; Saba et al., 2020; Stevens et al., 2012; Sudo et al., 2000). Bronchodilatory effects in cats and dogs are unknown. It also has potential synergistic benefits if nebulised with additional bronchodilators; these effects may benefit veterinary patients of many species with asthma, chronic bronchitis, lower airway diseases and pulmonary oedema secondary to left heart failure. (Abbott and Kovacic, 2008; Boyden et al., 2015; Foresi et al., 1992; Kallet, 2007; Newton et al., 2008; Saba et al., 2020; Shimoyama and Shimoyama, 2002; Sudo et al., 2000).

Oncology (Mammalian)

  • Cyclophosphamide Therapy: IV administration of furosemide concurrently with cyclophosphamide decreased the incidence of cyclophosphamide-associated sterile hemorrhagic cystitis (SHC) (Chan et al., 2016; Charney et al., 2003).

Electrolyte Management (Mammalian)

  • Acute Hypercalcemia: Loop-active agents inhibit calcium reabsorption in the thick ascending limb of Henle's loop and have, therefore, proved helpful in treating acute hypercalcemic crises in dogs hypercalcemia by maximising sodium excretion, thereby inhibiting sodium reabsorption and promoting calciuresis. Calciuresis is induced using a combination of furosemide with 0.9% saline administration, so furosemide is an adjunct to other therapies described for hypercalcemia. In the medium and long term, the cause of hypercalcaemia requires more appropriate management (Abbott & Kovacic, 2008; Bushinsky et al., 1986; Carrick & Costner, 2018; Chakhtoura & El-Hajj Fuleihan, 2021; Malangone & Campen, 2015; Peterson & Fluegeman, 2013; Watson, 2011).

  • Hyperkalemia: Furosemide administration results in elevated levels of sodium, chloride, and water delivered to the distal collecting ducts, resulting in enhanced renal secretion of potassium and hydrogen. Potassium excretion increases with dose. Serum potassium levels can be lowered acutely using intravenous insulin and glucose, nebulised beta2 agonists, or both. Intravenous calcium effectively reverses electrocardiographic changes and reduces the risk of arrhythmias but does not lower serum potassium. Sodium polystyrene therapy, sometimes with intravenous furosemide and saline, is used in humans to decrease total body potassium levels (Abbott & Kovacic, 2008; Hollander-Rodriguez and Calvert, 2006).

Fluid Retention: Ascites, Oedema  and Effusions

In most small animal species, furosemide has been used as part of fluid retention mitigation protocols for managing cardiac, pulmonary, hepatic and renal oedema, peripheral oedema due to mechanical obstruction, venous insufficiency, hypertension, intracranial trauma, udder oedema, uremia, hypercalcemia, hypertension, inflammatory effusions and neoplastic effusions. (Watson, 2011).

Pulmonary Oedema (Mammalian)

  • Furosemide administration is a popular treatment option for pulmonary oedema. Furosemide significantly reduces de novo oedema formation by reducing pulmonary capillary pressure and blood volume, influencing the balance between oedema clearance and production. Some reviews suggest this effect can be of value even when diuresis does not occur (Agudelo et al., 2021; Caudal et al., 2018; Chetboul et al., 2017; Dumont et al., 2023; Herrería-Bustillo et al., 2022; Nemi et al., 2023; Paik et al., 2016; Pelligand et al., 2020).

Ascites (Mammalian)

  • Portal Hypertension and Ascites: Treatment goals should remove enough volume to improve patient comfort (reducing abdominal pressure), renal perfusion, and cardiac output, allowing an ongoing response to diuretic therapy. Once ascitic effusion is mobilised, diuretics can often be used intermittently with concurrent dietary sodium restriction to control ascitic accumulation.

  • Ascites Associated With Cardiac Disease: Furosemide or Spironolactone administration are popular treatment options for ascites associated with cardiac disease. Diuretic therapy is initiated after therapeutic abdominocentesis to prevent or reduce the rate of recurrent fluid accumulation. Ideally, clinicians should evaluate serum electrolytes, renal values, and systemic blood pressure before and after starting these therapies.

  • Ascites Associated With Glomerular Disease: Furosemide administration is a popular treatment option for ascites associated with glomerular nephritis and hypoproteinaemia in most mammalian veterinary species (IRIS Canine GN Study Group et al., 2013).

  • Ascites Associated With Neoplastic Effusions: These are traditionally treated using centesis aspiration and drainage, but loop diuretics may occasionally be employed after initial drainage. The evidence for benefit in the management of neoplastic effusions is weak or absent.

  • Ascites Associated With Inflammatory Effusions: Diuretics may be beneficial if fluid accumulation is acute and severe. Additional treatment modalities, such as therapeutic centesis and anti-inflammatory agents, alongside management of any underlying cause, are expected. Patients who undergo significant pleural manipulation during spinal deformity surgery may decrease the incidence of clinically symptomatic pleural effusion requiring thoracocentesis (Vora and Crawford, 2011).

Intracranial Hypertension (Mammalian)

  • Mannitol is the usual treatment option for increased intracranial pressure (ICP). In animals where mannitol fails to control ICP, or if mannitol is contraindicated because of cardiac or electrolyte abnormalities or ongoing intracranial haemorrhage is suspected, furosemide may be given. The administration of furosemide simultaneously with mannitol or hypertonic saline has reportedly been synergistic in reducing ICP; however, the additional risk of hypovolemia leaves these still to be regarded as unsuitable treatments.  (Ettinger, 2024, 2017; Silverstein and Hopper, 2009; Todd, 2013; Todd et al., 2006; Wang et al., 2013).

Pharmacodynamics

Administration

  • Traditional: Intramuscular (IM), intravenous (IV), and oral use are common in veterinary patients (SPC data 2024).

  • Alternatives: Nebulisation, intracoelomic (IC), or subcutaneous (SC), but such use may result in unpredictable efficacy, time of onset and duration of action (Watson 2011).

Absorption

  • Following oral administration, furosemide absorption from the gastrointestinal tract is variable and unpredictable. Bioavailability from both oral and injectable administration ranges from 10% to 90%, and,  in all species, it may be necessary to try several doses before the most effective one is found (PubChem, 2024).

Distribution

  • The volume of distribution following intravenous administration of 40 mg furosemide was 0.181 L/kg in healthy subjects and 0.140 L/kg in patients with heart failure. Furosemide is rapidly excreted in urine without a cumulative effect  (Ueichi et all 2003; PubChem, 2024).

Biotransformation

  • Renal: The kidney is the primary site of action, metabolism, and excretion of furosemide. Approximately 50% of the furosemide load is excreted unchanged in the urine, and the rest is metabolised into glucuronide in the kidney (Abbott and Kovacic, 2008; Booth, 2011; PubChem, 2024; Watson, 2011)

Elimination

Renal: The kidneys are responsible for 85% of total furosemide clearance, where about 43% of the drug undergoes renal excretion. More furosemide is excreted in urine following the IV injection than after the tablet or oral solution (Abbott and Kovacic, 2008;


Metabolism and Excretion

  • Renal: The kidneys are responsible for 85% of total furosemide clearance, where about 43% of the drug undergoes renal excretion. More furosemide is excreted in urine following the I.V. injection than after the tablet or oral solution. Approximately 50% of the furosemide load is excreted unchanged in urine, and the rest is metabolised into glucuronide in the kidney.

Pharmacokinetics

Precautions

Adverse Effects

Reported furosemide side effects include altered drug metabolism and interactions, electrolyte depletion, ototoxicity, mucociliary impairment, endocrine and exocrine pancreatic effects, delayed wound healing, sulfonamide toxicity, and thyroid binding interference (Abbott and Kovacic, 2008).


  • Azotaemia: Temporary elevations in BUN and creatinine may occur.

  • Compromised Cardiac Output: Reduced cardiac output can occur in animals with severe pulmonary disease, hypertrophic cardiomyopathy, pericardial or myocardial disorders, cardiac tamponade and severe hypertension (SPC data).

  • Dehydration: Due to the diuretic action of furosemide, hemoconcentration and impairment of circulation may occur.

  • Delayed wound healing: No significant publications connect furosemide with delayed wound healing in a clinical setting. However, a potential connection is implied (Abbott and Kovacic, 2008).

  • Efficacy Reduction: Increased drinking water intake may impair therapeutic efficacy may be impaired. If the animal's condition permits, water intake should be restricted to physiologically normal levels during treatment (Abbott and Kovacic, 2008).

  • Electrolyte Depletion: Electrolyte deficiency (including hypokalemia & hyponatremia) and dehydration may occur with prolonged treatment. (Abbott and Kovacic, 2008; Booth, 2011; Carone et al., 2016; DiBartola, 2011; Giorgi et al., 2022; Keir and Kellum, 2015; Langston, 2008; Maddison, 2008; McClellan et al., 2006; Watson, 2011).

  • Mucociliary impairment: Whilst unlikely to influence the outcomes of veterinary patients, Furosemide impairs mucociliary clearance in human patients under mechanical ventilation (Abbott and Kovacic, 2008; Goto et al., 2010; Kondo et al., 2002).

  • Ototoxicity: Furosemide has the potential for ototoxicity, potentiated through concurrent administration of aminoglycosides or bolus instead of CRI administration. Hearing loss associated with furosemide use is often temporary, but permanent deafness is more common with concurrent acute or chronic renal failure or administration of other ototoxic drugs. (Abbott and Kovacic, 2008; Brown, 1981; Ding et al., 2016; Göttl et al., 1985; Hori et al., 2010; Oishi et al., 2012; PubChem, 2024; Rybak, 1982; Rybak et al., 1991; Watson, 2011)

  • Pancreatic Perfusion: Minor changes in pancreatic perfusion have been identified in canine patients receiving furosemide. While the clinical significance of this is unclear, some case reports associate furosemide therapy with the onset of pancreatitis (Abbott and Kovacic, 2008; Ghatak et al., 2017; Holland and Williamson, 1984; Li and Zheng, 2023; Wallach et al., 1983).

  • Pancreatitis: Some case reports associate furosemide therapy with the onset of pancreatitis (Ghatak et al., 2017; Holland and Williamson, 1984; Wallach et al., 1983)

  • Sulfonamide Hypersensitivity: Dose-dependent adverse reactions to sulfonamides include non-regenerative anaemia, hematuria, and inhibition of thyroid hormone synthesis. The sulfa moiety is found in numerous drugs (e.g., antimicrobials, NSAIDs [deracoxib], diuretics [furosemide], drugs for colitis [sulfasalazine], and carbonic anhydrase-inhibiting antiglaucoma drugs [dichlorphenamide]) (Trepanier, 2004; Abbott and Kovacic, 2008).

  • Thyroid binding interference: Thyroid function tests must be interpreted cautiously in patients receiving either short—or long-term furosemide (Abbott and Kovacic, 2008).

Contraindications

  • Anuria And Renal Outflow Obstruction: Loop diuretics cannot function without GFR or urine output (Carone et al., 2016).

  • Circulatory Compromise: Avoid loop diuretics in hypovolaemia, hypotension and dehydration (SPC data).

  • Electrolyte Disturbances: Avoid using loop diuretics in hyperglycemia, hyperuricemia, hypocalcemia, hypokalemia, hypomagnesemia, hyponatremia, and metabolic alkalosis (Carone et al., 2016).

  • Hypersensitivity: Avoid use in cases of hypersensitivity to furosemide, sulfonamides, or excipients. The sulfa moiety found in numerous drugs (e.g., antimicrobials, NSAIDs [deracoxib], diuretics [furosemide], drugs for colitis [sulfasalazine], carbonic anhydrase inhibiting antiglaucoma drugs [dichlorphenamide]) precludes their use in pets known to be sensitised to sulfa antimicrobials (Trepanier, 2004; Abbott and Kovacic, 2008; SPC data).

  • Hypovolaemia, Hypotension Or Dehydration: Furosemide should be used cautiously in patients with pre-existing electrolyte or water balance abnormalities, impaired hepatic function, progressive renal disease, or diabetes mellitus. Patients with conditions that may lead to electrolyte or water balance abnormalities (e.g., vomiting or diarrhoea) should be monitored carefully (SPC data).

  • Interactive Medications: Monitoring plasma potassium levels is advisable during prolonged combined therapy treatment with Cardiac Glycosides. Potassium supplements may be necessary. Allergic reactions have been associated with the use of Sulphonamides. Do not use them concurrently with Aminoglycoside antimicrobials or Cephalosporin antimicrobials.

  • Nephropathy: Do not use in animals with acute glomerular nephritis, renal failure with anuria, or electrolyte deficiency disease.

  • Nephrotoxins: Do not use concurrently with Aminoglycoside or Cephalosporin antimicrobials (SPC data).

  • Pancreatitis: A risk-benefit analysis should be undertaken. Alterations in pancreatic perfusion have been identified in canine patients receiving furosemide, and some case reports associate furosemide therapy with the onset of pancreatitis (Ghatak et al., 2017; Holland and Williamson, 1984; Wallach et al., 1983).

  • Uncontrolled Water Access: Increased drinking water intake may impair therapeutic efficacy (SPC data).

Reproductive Safety

  • Pregnancy: Furosemide crosses the placenta. Embryotoxic effects (foetal urinary tract malformation) were seen in trials with laboratory animals at maternally non-toxic doses. Furosemide has been reported to delay ductus arteriosus closure and dilate constricted ductus arteriosus in neonatal rats through disruption of prostaglandin production. Clinicians should consider the risks versus benefits when using furosemide in a pregnant animal, as there is conflicting information about its safety (van der Zande et al., 2024; Wang et al., 2018; SPC data).

  • Lactation:  Avoid Use. Furosemide is excreted in milk and may affect nursing offspring. Little information is available on using furosemide during breastfeeding, and intense diuresis from high doses might decrease lactation. An alternate drug may be preferred, especially while nursing a newborn or preterm infant. Low doses of furosemide do not suppress lactation. There is unknown potential for ototoxicity in neonates (Cominos et al., 1976; LactMed, 2006).

  • Male Fertility: Avoid Use. The effects are unknown  (SPC data).

  • Female Fertility: Avoid Use. The effects are unknown (SPC data).

  • Neonates: Avoid Use. There is unknown potential for ototoxicity in neonates (Cominos et al., 1976; LactMed, 2006).

Potentially Significant Interactions

  • Aminoglycosides:  Increased risk of nephrotoxicity [kidney injury] and ototoxicity [deafness) (Carone et al., 2016; Plumb, 2024).

  • Amikacin: Increased risk of nephrotoxicity [kidney injury] and ototoxicity [deafness) (Carone et al., 2016; Fujimura et al., 1992; Smith and Ps, 1983; Zadrozniak et al., 2019).

  • Azathioprine: In dogs, furosemide alters thiopurine methyltransferase levels in red blood cells, which may vary the metabolism of thiopurine medications such as azathioprine (Abbott and Kovacic, 2008; Kidd et al., 2004).

  • Aspirin: Aspirin therapy inhibits furosemide-induced acute venodilation and counteracts antihypertensive benefits in CHF (Abbott and Kovacic, 2008; Jhund et al., 2001).

  • Digoxin: There is an increased risk of digoxin intoxication, and furosemide-induced hypokalaemia can increase the risk of cardiac arrhythmia. The combined use of digoxin and diuretics should be avoided (Carone et al., 2016; Patel et al., 2022; Tsutsumi et al., 1979).

  • Methadone: Furosemide-induced hypokalaemia can increase the risk of cardiac arrhythmia and hypotension. Monitor heart rate, rhythm, blood pressure, and clinical status (Carone et al., 2016; Plumb, 2024).

  • NSAIDs: Administration of non-steroidal COX-1 and COX-2 inhibitors (Carprofen, Deracoxib, Firoxoxib, Flunixin, Grapiprant, Ketoprofen, Ketorolac, Mavacoxib, Meloxicam,  Piroxicam, Robenacoxi,  Tolfenamic Acid )decreases the furosemide diuretic response. Nephrotoxicity increases (Abbott and Kovacic, 2008; Carone et al., 2016; Moore et al., 2015; Plumb, 2024; Trepanier, 2005; Watson, 2011)..

  • ACEi: The interaction between furosemide and an ACE inhibitor is considered a synergistic pharmacodynamic interaction, where the ACE inhibitor is a vasodilator, and furosemide, as a diuretic, will reduce cardiac preload volume. However, the risk of hypotension and nephrotoxicity is also increased(Becker et al., 1989; Effendi et al., 2023; McLay et al., 1993; Pirintr et al., 2023; Toussaint et al., 1989).

Additional interactions identified in the literature

  • Anti-Arrhythmic Medications (including Amiodarone and Sotalol): Increased risk of cardiac toxicity because of Furosemide-induced hypokalaemia. Antagonism of effects of Lidocaine, Tocainide or Mexiletine possible.

  • Anti-Diabetic Medications: Antagonism of hypoglycaemic effects.

  • Anti-Hypertensive Medications: Enhanced hypotensive effect possible with all types. Concurrent use with ACE inhibitors or Angiotensin II receptor antagonists can result in marked falls in blood pressure; Furosemide should be stopped or the dose reduced before starting an ACE inhibitor or Angiotensin II receptor antagonists. Increased risk of first-dose hypotension with post-synaptic alpha-blockers (e.g. Prazosin). Enhanced hypotensive effect with Phenothiazines.

  • Antihistamines: Hypokalaemia with increased risk of cardiac toxicity.

  • Antimicrobials: Increased risk of ototoxicity with Aminoglycosides, Polymixins or Vancomycin. Increased risk of nephrotoxicity with Aminoglycosides or Cefaloridine. Increased risk of hyponatraemia with Trimethoprim.

  • Anxiolytics and Hypnotics: Enhanced hypotensive effect of some agents.

  • Cardiac Glycosides: Increased risk of cardiac toxicity (because of Furosemide-induced hypokalaemia and electrolyte disturbances, including hypomagnesaemia).

  • Corticosteroids: Increased risk of hypokalaemia, sodium retention and possible antagonism of diuretic effect.

  • Cytotoxics: Increased risk of nephrotoxicity and ototoxicity with platinum compounds/Cisplatin.

  • NSAIDs: Increased risk of nephrotoxicity (especially with pre-existing hypovolaemia/dehydration. Indometacin and Ketorolac may antagonise the effects of Furosemide.

  • Oestrogens: Diuretic effect antagonised.

  • Other diuretics: Possible severe additive effect. Increased risk of hypokalaemia with Thiazide diuretics. Contraindicated concurrently with some potassium-sparing diuretic products (e.g. Amiloride/ Spironolactone) - increased risk of hyperkalaemia.

  • Potassium Salts: Contraindicated due to significant risk of hyperkalaemia.

  • Salicylates: Effects potentiated by Furosemide. Salicylic toxicity is increased.

  • Sympathomimetics: Increased risk of hypokalaemia with high doses of beta2 sympathomimetics.

  • Tetracyclines: Increased risk of azotaemia.

  • Torsades de pointes: Increased risk of cardiac toxicity when used alongside drugs that prolong Q-T interval because of Furosemide-induced hypokalaemia and other electrolyte disturbances.

  • Vasodilators: Enhanced hypotensive effect is possible, e.g., with Hydralazine.

Overdose

  • Acute: Dehydration, electrolyte imbalances, and water imbalances. These may present as depressed mentation, akinesia, seizures, and cardiovascular collapse.

  • Chronic: Typically, electrolyte derangements such as hypokalemia are seen.

Precautions

Availability

Formulations

  • Injection: 50 mg/ml Solution for Injection

  • Tablets: 10 mg, 20 mg, 40 mg tablets

  • Oral Liquids: 20 mg/5 ml Oral Solution and 10mg/ml Oral Solution

UK SPCs

  1. Dimazon 50 mg/ml Solution for Injection [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/current/search-results (accessed 12.28.23).

  2. Frusedale 40 mg Oral Tablets [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A003210 (accessed 12.28.23).

  3. Frusemide 40 mg Tablets [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A005945 (accessed 12.28.23).

  4. Furosemide 10mg/ml Oral Solution - Summary of Product Characteristics (SmPC) - (emc) [WWW Document], n.d. URL https://www.medicines.org.uk/emc/product/2460/smpc#gref (accessed 12.29.23).

  5. Furosemide 20 mg/5 ml Oral Solution - Summary of Product Characteristics (SmPC) - (emc) [WWW Document], n.d. URL https://www.medicines.org.uk/emc/product/4576/smpc#gref (accessed 12.29.23).

  6. Furosemide Tablets BP (Vet) 20 mg [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/current/search-results (accessed 12.28.23).

  7. Furosemide Tablets BP (Vet) 40 mg [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A003335 (accessed 12.28.23).

  8. Furosivet 20 mg Tablets for Dogs and Cats [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A010184 (accessed 12.28.23).

  9. Furosoral 10 mg Tablets for Cats and Dogs [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A009114 (accessed 12.28.23).

  10. Furosoral 40 mg Tablets for Cats and Dogs [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A009115 (accessed 12.28.23).

  11. Libeo 40 mg Chewable Tablets for Dogs [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A008670 (accessed 12.28.23).

Availability

Identifiers

  • Systematic Name:  IUPAC Name 4-chloro-2-(furan-2-ylmethylamino)-5-sulfamoylbenzoic acid (PubChem, 2024).

  • Formula: C12H11ClN2O5S (PubChem, 2024).

  • Pharmacotherapeutic Group(s): Cardiovascular Medicines; High-ceiling Loop Diuretic.

  • ATC Code(s): C03CA01

  • ATC Vet Code(s): QC03CA01

Identifiers

Evidence Base

Pharmacology Bibliography

  1. Abbott, L.M., Kovacic, J., 2008. The pharmacologic spectrum of furosemide. Journal of Veterinary Emergency and Critical Care 18, 26–39. https://doi.org/10.1111/j.1476-4431.2007.00267.x

  2. Adin, D., Atkins, C., Papich, M., DeFrancesco, T., Griffiths, E., Penteado, M., Kurtz, K., Klein, A., 2017. Furosemide continuous rate infusion diluted with 5% dextrose in water or hypertonic saline in normal adult dogs: a pilot study. Journal of Veterinary Cardiology 19, 44–56. https://doi.org/10.1016/j.jvc.2016.09.004

  3. Adin, D.B., Hill, R.C., Scott, K.C., 2003a. Short-term compatibility of furosemide with crystalloid solutions. J Vet Intern Med 17, 724–726. https://doi.org/10.1111/j.1939-1676.2003.tb02508.x

  4. Adin, D.B., Taylor, A.W., Hill, R.C., Scott, K.C., Martin, F.G., 2003b. Intermittent Bolus Injection versus Continuous Infusion of Furosemide in Normal Adult Greyhound Dogs. Journal of Veterinary Internal Medicine 17, 632–636. https://doi.org/10.1111/j.1939-1676.2003.tb02493.x

  5. Afari, M.E., Aoun, J., Khare, S., Tsao, L., 2019. Subcutaneous furosemide for the treatment of heart failure: a state-of-the art review. Heart Fail Rev 24, 309–313. https://doi.org/10.1007/s10741-018-9760-6

  6. Agudelo, C.F., Jekl, V., Hauptman, K., Crha, M., Kocaturk, M., 2021. A case of a complete atrioventricular canal defect in a ferret. BMC Vet Res 17, 45. https://doi.org/10.1186/s12917-020-02736-2

  7. Artru, A.A., Powers, K.M., 1997. Furosemide decreases cerebrospinal fluid formation during desflurane anesthesia in rabbits. J Neurosurg Anesthesiol 9, 166–174. https://doi.org/10.1097/00008506-199704000-00012

  8. Bays, T.B., 2020. Geriatric Care of Rabbits, Guinea Pigs, and Chinchillas. Veterinary Clinics of North America: Exotic Animal Practice, Geriatrics 23, 567–593. https://doi.org/10.1016/j.cvex.2020.05.006

  9. Berg, K.J., Loew, D., 1977. Inhibition of furosemide-induced natriuresis by acetylsalicylic acid in dogs. Scandinavian Journal of Clinical and Laboratory Investigation 37, 125–131. https://doi.org/10.3109/00365517709156066

  10. Booth, D., 2011. Small Animal Clinical Pharmacology and Therapeutics - 2nd Edition [WWW Document]. URL https://shop.elsevier.com/books/small-animal-clinical-pharmacology-and-therapeutics/boothe/978-0-7216-0555-5 (accessed 1.24.24).

  11. Boyden, J.Y., Connor, S.R., Otolorin, L., Nathan, S.D., Fine, P.G., Davis, M.S., Muir, J.C., 2015. Nebulized medications for the treatment of dyspnea: a literature review. J Aerosol Med Pulm Drug Deliv 28, 1–19. https://doi.org/10.1089/jamp.2014.1136

  12. Branch, R.A., 1983. Role of binding in distribution of furosemide: where is nonrenal clearance? Fed Proc 42, 1699–1702.

  13. Broadstone, R.V., Robinson, N.E., Gray, P.R., Woods, P.S.A., Derksen, F.J., 1991. Effects of furosemide on ponies with recurrent airway obstruction. Pulmonary Pharmacology 4, 203–208. https://doi.org/10.1016/0952-0600(91)90012-R

  14. Brown, R.D., 1981. Comparative Acute Cochlear Toxicity of Intravenous Bumetanide and Furosemide in the Purebred Beagle. The Journal of Clinical Pharmacology 21, 620–627. https://doi.org/10.1002/j.1552-4604.1981.tb05674.x

  15. Brozmanova, A., Jochem, J., Javorka, K., Zila, I., Zwirska-Korczala, K., 2006. Diuretic-induced dehydration/hypovolemia inhibits thermal panting in rabbits. Respiratory Physiology & Neurobiology 150, 99–102. https://doi.org/10.1016/j.resp.2005.10.008

  16. Bushinsky, D.A., Favus, M.J., Langman, C.B., Coe, F.L., 1986. Mechanism of chronic hypercalciuria with furosemide: increased calcium absorption. Am J Physiol 251, F17-24. https://doi.org/10.1152/ajprenal.1986.251.1.F17

  17. Cantarovich, F., Rangoonwala, B., Lorenz, H., Verho, M., Esnault, V.L.M., 2004. High-dose furosemide for established ARF: A prospective, randomized, double-blind, placebo-controlled, multicenter trial. American Journal of Kidney Diseases 44, 402–409. https://doi.org/10.1053/j.ajkd.2004.05.021

  18. Carone, L., Oxberry, S.G., Twycross, R., Charlesworth, S., Mihalyo, M., Wilcock, A., 2016. Furosemide. Journal of Pain and Symptom Management 52, 144–150. https://doi.org/10.1016/j.jpainsymman.2016.05.004

  19. Carrick, A.I., Costner, H.B., 2018. Rapid Fire: Hypercalcemia. Emerg Med Clin North Am 36, 549–555. https://doi.org/10.1016/j.emc.2018.04.008

  20. Caudal, V., Whitty, J., Snead, E.C.R., Starrak, G.S., 2018. Noncardiogenic pulmonary edema associated with ozone exposure in three kittens. J Am Vet Med Assoc 253, 1328–1333. https://doi.org/10.2460/javma.253.10.1328

  21. Chakhtoura, M., El-Hajj Fuleihan, G., 2021. Treatment of Hypercalcemia of Malignancy. Endocrinol Metab Clin North Am 50, 781–792. https://doi.org/10.1016/j.ecl.2021.08.002

  22. Chan, C.M., Frimberger, A.E., Moore, A.S., 2016. Incidence of sterile hemorrhagic cystitis in tumor-bearing dogs concurrently treated with oral metronomic cyclophosphamide chemotherapy and furosemide: 55 cases (2009–2015). Journal of the American Veterinary Medical Association 249, 1408–1414. https://doi.org/10.2460/javma.249.12.1408

  23. Charney, S.C., Bergman, P.J., Hohenhaus, A.E., McKnight, J.A., 2003. Risk factors for sterile hemorrhagic cystitis in dogs with lymphoma receiving cyclophosphamide with or without concurrent administration of furosemide: 216 cases (1990-1996). J Am Vet Med Assoc 222, 1388–1393. https://doi.org/10.2460/javma.2003.222.1388

  24. Chetboul, V., Pouchelon, J.-L., Menard, J., Blanc, J., Desquilbet, L., Petit, A., Rougier, S., Lucats, L., Woehrle, F., TEST study investigators, 2017. Short-Term Efficacy and Safety of Torasemide and Furosemide in 366 Dogs with Degenerative Mitral Valve Disease: The TEST Study. J Vet Intern Med 31, 1629–1642. https://doi.org/10.1111/jvim.14841

  25. Chitty, J., 2015. Cardiovascular disease in rabbits. Companion Animal 20, 74–78. https://doi.org/10.12968/coan.2015.20.2.74

  26. Cohen, M.R., Hinsch, E., Vergona, R., Ryan, J., Kolis, S.J., Schwartz, M.A., 1976. A comparative diuretic and tissue distribution study of bumetanide and furosemide in the dog. J Pharmacol Exp Ther 197, 697–702.

  27. Cominos, D.C., van der Walt, A., van Rooyen, A.J., 1976. Suppression of postpartum lactation with furosemide. S Afr Med J 50, 251–252.

  28. Convey, V., Huh, T., Achilles, E.J., Massey, L.K., McKaba, V.F., Loughran, K.A., Kraus, M.S., Gelzer, A.R., Crooks, A.V., Oyama, M.A., 2024. Urine sodium concentration after intravenous furosemide in dogs with acute congestive heart failure and correlation with treatment efficacy. J Vet Intern Med 38, 71–80. https://doi.org/10.1111/jvim.16955

  29. Cook, D.J., Tudball, C.F., 2001. Potentiators and bolus intravenous furosemide. Lancet 358, 1373–1374. https://doi.org/10.1016/S0140-6736(01)06443-1

  30. Davis, A., Day, R.O., Begg, E.J., 1986. Interactions between non-steroidal anti-inflammatory drugs and antihypertensives and diuretics. Aust N Z J Med 16, 537–546. https://doi.org/10.1111/j.1445-5994.1986.tb02031.x

  31. De Vriese, A.S., 2003. Prevention and treatment of acute renal failure in sepsis. J Am Soc Nephrol 14, 792–805. https://doi.org/10.1097/01.asn.0000055652.37763.f7

  32. DeFrancesco, T.C., 2013. Management of Cardiac Emergencies in Small Animals. Veterinary Clinics of North America: Small Animal Practice 43, 817–842. https://doi.org/10.1016/j.cvsm.2013.03.012

  33. DiBartola, 2011. Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice.

  34. Ding, D., Liu, H., Qi, W., Jiang, H., Li, Y., Wu, X., Sun, H., Gross, K., Salvi, R., 2016. Ototoxic effects and mechanisms of loop diuretics. J Otol 11, 145–156. https://doi.org/10.1016/j.joto.2016.10.001

  35. Dobromylskyj, M.J., Little, C.J., 2021. Necropsy findings in a cat with diabetes mellitus and heart failure. JFMS Open Rep 7, 20551169211055383. https://doi.org/10.1177/20551169211055383

  36. Downs, J., Zoltowska, A., Hackney, T., Gardner, D.S., Ashmore, A., Brennan, M.L., n.d. Scoping review exploring the evidence base on Vitis vinifera toxicity in dogs after ingestion: Clinical effects, treatments and types of V. vinifera. Veterinary Record n/a, e4536. https://doi.org/10.1002/vetr.4536

  37. Dumont, R., Touzet, C., Gomes, E., Le Boedec, K., 2023. Treatment of recurrent hunting-associated respiratory distress episodes in 2 dogs. J Vet Intern Med 37, 2514–2519. https://doi.org/10.1111/jvim.16665

  38. Escudero, V.J., Mercadal, J., Molina-Andújar, A., Piñeiro, G.J., Cucchiari, D., Jacas, A., Carramiñana, A., Poch, E., 2022. New Insights Into Diuretic Use to Treat Congestion in the ICU: Beyond Furosemide. Front Nephrol 2, 879766. https://doi.org/10.3389/fneph.2022.879766

  39. Ettinger, S.J., 2024. Textbook of veterinary internal medicine: 9th Edition. Diseases of the dog and the cat and  (Côté, E) Elsevier Enhanced Digital Version, 2024-02-08.  VitalBook file. Elsevier, St. Louis, Missouri.

  40. Ettinger, S.J., 2017. Textbook of veterinary internal medicine: 8th Edition Diseases of the dog and the cat and Elsevier Enhanced Digital Version.  Available from: vbk://9780323462129, Eighth edition. ed. Elsevier, St. Louis, Missouri.

  41. Filler, G., 2001. Acute renal failure in children: aetiology and management. Paediatr Drugs 3, 783–792. https://doi.org/10.2165/00128072-200103110-00001

  42. Fisk, A., Londoño, L., Carrera-Justiz, S., Buckley, G., 2019. Cochleotoxicity and acute kidney injury secondary to parenteral gentamicin administration in a dog. Can Vet J 60, 976–980.

  43. Fitzgerald, B.C., Dias, S., Martorell, J., 2018. Cardiovascular Drugs in Avian, Small Mammal, and Reptile Medicine. Veterinary Clinics of North America: Exotic Animal Practice, Therapeutics 21, 399–442. https://doi.org/10.1016/j.cvex.2018.01.015

  44. Foresi, A., Pelucchi, A., Mastropasqua, B., Cavigioli, G., Carlesi, R.M., Marazzini, L., 1992. Effect of Inhaled Furosemide and Torasemide on Bronchial Response to Ultrasonically Nebulized Distilled Water in Asthmatic Subjects. Am Rev Respir Dis 146, 364–368. https://doi.org/10.1164/ajrccm/146.2.364

  45. Gavaghan, B.J., Kittleson, M.D., McAloose, D., 1999. Persistent atrial standstill in a cat. Aust Vet J 77, 574–579. https://doi.org/10.1111/j.1751-0813.1999.tb13192.x

  46. Ghatak, R., Masso, L., Kapadia, D., Kulairi, Z.I., 2017. Medication as a Cause of Acute Pancreatitis. Am J Case Rep 18, 839–841. https://doi.org/10.12659/ajcr.903327

  47. Giorgi, M.E., Mochel, J.P., Yuan, L., Adin, D.B., Ward, J.L., 2022. Retrospective evaluation of risk factors for development of kidney injury after parenteral furosemide treatment of left-sided congestive heart failure in dogs. J Vet Intern Med 36, 2042–2052. https://doi.org/10.1111/jvim.16571

  48. Goto, D.M., Torres, G.M., Seguro, A.C., Saldiva, P.H.N., Lorenzi-Filho, G., Nakagawa, N.K., 2010. Furosemide impairs nasal mucociliary clearance in humans. Respiratory Physiology & Neurobiology 170, 246–252. https://doi.org/10.1016/j.resp.2010.01.013

  49. Göttl, K.H., Roesch, A., Klinke, R., 1985. Quantitative evaluation of ototoxic side effects of furosemide, piretanide, bumetanide, azosemide and ozolinone in the cat--a new approach to the problem of ototoxicity. Naunyn Schmiedebergs Arch Pharmacol 331, 275–282. https://doi.org/10.1007/BF00634249

  50. Grams, M.E., Estrella, M.M., Coresh, J., Brower, R.G., Liu, K.D., for the National Heart, L., 2011. Fluid Balance, Diuretic Use, and Mortality in Acute Kidney Injury. Clinical Journal of the American Society of Nephrology 6, 966. https://doi.org/10.2215/CJN.08781010

  51. Guan, C., Li, C., Xu, L., Che, L., Wang, Y., Yang, C., Zhang, N., Liu, Z., Zhao, L., Zhou, B., Man, X., Luan, H., Xu, Y., 2023. Hospitalized patients received furosemide undergoing acute kidney injury: the risk and prediction tool. Eur J Med Res 28, 312. https://doi.org/10.1186/s40001-023-01306-0

  52. Harada, K., Ukai, Y., Kanakubo, K., Yamano, S., Lee, J., Kurosawa, T.A., Uechi, M., 2015. Comparison of the diuretic effect of furosemide by different methods of administration in healthy dogs. Journal of Veterinary Emergency and Critical Care 25, 364–371. https://doi.org/10.1111/vec.12301

  53. Hause, W.R., 1984. Management of acute illness in cats. Mod Vet Pract 65, 461–465.

  54. Herrería-Bustillo, V.J., Adamantos, S., Lamb, C.R., García-Arce, M., Thomas, E., Saiz-Álvarez, M.R., Cook, S., Cortellini, S., 2022. Retrospective evaluation of negative-pressure pulmonary edema in dogs (2006-2018): 35 cases. J Vet Emerg Crit Care (San Antonio) 32, 397–404. https://doi.org/10.1111/vec.13166

  55. Heyman, S.N., Rosen, S., Epstein, F.H., Spokes, K., Brezis, M.L., 1994. Loop diuretics reduce hypoxic damage to proximal tubules of the isolated perfused rat kidney. Kidney Int 45, 981–985. https://doi.org/10.1038/ki.1994.132

  56. Ho, K.M., Power, B.M., 2010. Benefits and risks of furosemide in acute kidney injury. Anaesthesia 65, 283–293. https://doi.org/10.1111/j.1365-2044.2009.06228.x

  57. Hochman, D.W., 2012. The extracellular space and epileptic activity in the adult brain: explaining the antiepileptic effects of furosemide and bumetanide. Epilepsia 53 Suppl 1, 18–25. https://doi.org/10.1111/j.1528-1167.2012.03471.x

  58. Holland, S.D., Williamson, H.E., 1984. Acute effects of high ceiling diuretics on pancreatic blood flow and function. J Pharmacol Exp Ther 229, 440–446.

  59. Hollander-Rodriguez, J.C., Calvert, J.F., 2006. Hyperkalemia. Am Fam Physician 73, 283–290.

  60. Hori, Y., Ohshima, N., Kanai, K., Hoshi, F., Itoh, N., Higuchi, S., 2010. Differences in the Duration of Diuretic Effects and Impact on the Renin-Angiotensin-Aldosterone System of Furosemide in Healthy Dogs. J. Vet. Med. Sci. 72, 13–18. https://doi.org/10.1292/jvms.09-0259

  61. Hori, Y., Takusagawa, F., Ikadai, H., Uechi, M., Hoshi, F., Higuchi, S., 2007. Effects of oral administration of furosemide and torsemide in healthy dogs. Am J Vet Res 68, 1058–1063. https://doi.org/10.2460/ajvr.68.10.1058

  62. Huynh, M., Boyeaux, A., Pignon, C., 2016. Assessment and Care of the Critically Ill Rabbit. Veterinary Clinics of North America: Exotic Animal Practice, Emergency and Critical Care 19, 379–409. https://doi.org/10.1016/j.cvex.2016.01.011

  63. Imai, M., 1977. Effect of bumetanide and furosemide on the thick ascending limb of Henle’s loop of rabbits and rats perfused in vitro. European Journal of Pharmacology 41, 409–416. https://doi.org/10.1016/0014-2999(77)90261-8

  64. Jekl, V., 2021. Respiratory Disorders in Rabbits. Veterinary Clinics of North America: Exotic Animal Practice 24, 459–482. https://doi.org/10.1016/j.cvex.2021.01.006

  65. Jhund, P.S., Davie, A.P., McMurray, J.J., 2001. Aspirin inhibits the acute venodilator response to furosemide in patients with chronic heart failure. J Am Coll Cardiol 37, 1234–1238. https://doi.org/10.1016/s0735-1097(01)01169-x

  66. Joubert, L., Radouco-Thomas, C., 1968. A study in human pharmacology: evaluation of four diuretics and a placebo. Can Med Assoc J 99, 57–63.

  67. Kallet, R.H., 2007. The role of inhaled opioids and furosemide for the treatment of dyspnea. Respir Care 52, 900–910.

  68. Keene, B.W., Atkins, C.E., Bonagura, J.D., Fox, P.R., Häggström, J., Fuentes, V.L., Oyama, M.A., Rush, J.E., Stepien, R., Uechi, M., 2019. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med 33, 1127–1140. https://doi.org/10.1111/jvim.15488

  69. Keir, I., Kellum, J.A., 2015. Acute kidney injury in severe sepsis: Pathophysiology, diagnosis, and treatment recommendations. Journal of Veterinary Emergency and Critical Care 25, 200–209. https://doi.org/10.1111/vec.12297

  70. Kidd, L.B., Salavaggione, O.E., Szumlanski, C.L., Miller, J.L., Weinshilboum, R.M., Trepanier, L., 2004. Thiopurine methyltransferase activity in red blood cells of dogs. J Vet Intern Med 18, 214–218. https://doi.org/10.1892/0891-6640(2004)18<214:tmairb>2.0.co;2

  71. Kondo, C.S., Macchionne, M., Nakagawa, N.K., de Carvalho, C.R.R., King, M., Saldiva, P.H.N., Lorenzi-Filho, G., 2002. Effects of intravenous furosemide on mucociliary transport and rheological properties of patients under mechanical ventilation. Crit Care 6, 81–87.

  72. Koster, L., Vogel, J., Springer, C.M., Hecht, S., 2023. Radiographic lung congestion scores in dogs with acute congestive heart failure caused by myxomatous mitral valve disease. J Vet Intern Med 37, 1983–1991. https://doi.org/10.1111/jvim.16850

  73. Koyner, J.L., Davison, D.L., Brasha-Mitchell, E., Chalikonda, D.M., Arthur, J.M., Shaw, A.D., Tumlin, J.A., Trevino, S.A., Bennett, M.R., Kimmel, P.L., Seneff, M.G., Chawla, L.S., 2015. Furosemide Stress Test and Biomarkers for the Prediction of AKI Severity. J Am Soc Nephrol 26, 2023–2031. https://doi.org/10.1681/ASN.2014060535

  74. LactMed, 2006. Furosemide, in: Drugs and Lactation Database (LactMed®). National Institute of Child Health and Human Development, Bethesda (MD).

  75. Langston, C., 2008. Managing Fluid and Electrolyte Disorders in Renal Failure. Veterinary Clinics of North America: Small Animal Practice, Advances in Fluid, Electrolyte, and Acid-Base Disorders 38, 677–697. https://doi.org/10.1016/j.cvsm.2008.01.007

  76. Lavallee, S.L., Iwamoto, L.M., Claybaugh, J.R., Dressel, M.V., Sato, A.K., Nakamura, K.T., 1997. Furosemide-induced airway relaxation in guinea pigs: relation to Na-K-2Cl cotransporter function. American Journal of Physiology-Lung Cellular and Molecular Physiology 273, L211–L216. https://doi.org/10.1152/ajplung.1997.273.1.L211

  77. Lee, H., Lee, D., Park, J., Yun, T., Koo, Y., Chae, Y., Kang, B.-T., Yang, M.-P., Kim, H., 2023. Heart failure in a cat due to hypertrophic cardiomyopathy phenotype caused by chronic uncontrolled hyperthyroidism. Acta Vet Hung 71, 96–100. https://doi.org/10.1556/004.2023.00815

  78. Lee, M.G., Li, T., Chiou, W.L., 1986. Effect of intravenous infusion time on the pharmacokinetics and pharmacodynamics of the same total dose of furosemide. Biopharmaceutics & Drug Disposition 7, 537–547. https://doi.org/10.1002/bdd.2510070603

  79. Li, C., Ren, Q., Li, X., Han, H., Xie, K., Wang, G., 2023. Association between furosemide administration and clinical outcomes in patients with sepsis-associated acute kidney injury receiving renal replacement therapy: a retrospective observational cohort study based on MIMIC-IV database. BMJ Open 13, e074046. https://doi.org/10.1136/bmjopen-2023-074046

  80. Li, Z.K., Zheng, P., 2023. Acute pancreatitis caused by tigecycline and furosemide combination treatment and hypofibrinogenemia caused by tigecycline: A case report. Int J Clin Pharmacol Ther 61, 466–470. https://doi.org/10.5414/CP204337

  81. Luis Fuentes, V., Abbott, J., Chetboul, V., Côté, E., Fox, P.R., Häggström, J., Kittleson, M.D., Schober, K., Stern, J.A., 2020. ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med 34, 1062–1077. https://doi.org/10.1111/jvim.15745

  82. Maddison, G., 2008. Small Animal Clinical Pharmacology E-Book: 2nd edition | Edited by Jill E. Maddison | ISBN: 9780702037252 [WWW Document]. Elsevier Asia Bookstore. URL https://www.asia.elsevierhealth.com/small-animal-clinical-pharmacology-e-book-9780702037252.html (accessed 1.23.24).

  83. Malangone, S., Campen, C.J., 2015. Hypercalcemia of Malignancy. J Adv Pract Oncol 6, 586–592.

  84. Matsuda, K., Mitsuo, H., Nishijima, T., Uchiyama, H., Nita, T., Matsunaga, S., Fujimoto, N., Ushijima, T., Ando, Y., Kan-o, M., Shinohara, G., Kimura, S., Sonoda, H., Shiose, A., 2024. Acute Dapagliflozin Administration Ameliorates Cardiac Surgery-Associated Acute Kidney Injury in a Rabbit Model. Circulation Journal 88, 1488–1498. https://doi.org/10.1253/circj.CJ-23-0864

  85. Matsue, Y., Damman, K., Voors, A.A., Kagiyama, N., Yamaguchi, T., Kuroda, S., Okumura, T., Kida, K., Mizuno, A., Oishi, S., Inuzuka, Y., Akiyama, E., Matsukawa, R., Kato, K., Suzuki, S., Naruke, T., Yoshioka, K., Miyoshi, T., Baba, Y., Yamamoto, M., Murai, K., Mizutani, K., Yoshida, K., Kitai, T., 2017. Time-to-Furosemide Treatment and Mortality in Patients Hospitalized With Acute Heart Failure. Journal of the American College of Cardiology 69, 3042–3051. https://doi.org/10.1016/j.jacc.2017.04.042

  86. Mazzaferro, E.M., Eubig, P.A., Hackett, T.B., Legare, M., Miller, C., Wingfield, W. e., Wise, L., 2004. Acute renal failure associated with raisin or grape ingestion in 4 dogs. Journal of Veterinary Emergency and Critical Care 14, 203–212. https://doi.org/10.1111/j.1534-6935.2004.00114.x

  87. Mazzoldi, C., Aspidi, F., Romito, G., 2023. Dermatologic adverse effect of subcutaneous furosemide administration in a cat. Open Vet J 13, 1027–1031. https://doi.org/10.5455/OVJ.2023.v13.i8.9

  88. McClellan, J.M., Goldstein, R.E., Erb, H.N., Dykes, N.L., Cowgill, L.D., 2006. Effects of administration of fluids and diuretics on glomerular filtration rate, renal blood flow, and urine output in healthy awake cats. Am J Vet Res 67, 715–722. https://doi.org/10.2460/ajvr.67.4.715

  89. Milovanov, I.S., Nikolaev, A.I., Trofimova, E.I., Dzgoeva, F.U., 1995. [Acute kidney failure in patients with glomerulonephritis related to the use of furosemide]. Klin Med (Mosk) 73, 90–93.

  90. Moore, N., Pollack, C., Butkerait, P., 2015. Adverse drug reactions and drug–drug interactions with over-the-counter NSAIDs. Ther Clin Risk Manag 11, 1061–1075. https://doi.org/10.2147/TCRM.S79135

  91. Müller, K., Mancinelli, E., 2022. Cardiology in Rabbits and Rodents–Common Cardiac Diseases, Therapeutic Options, and Limitations. Veterinary Clinics of North America: Exotic Animal Practice 25, 525–540. https://doi.org/10.1016/j.cvex.2022.01.006

  92. Musini, V.M., Rezapour, P., Wright, J.M., Bassett, K., Jauca, C.D., 2015. Blood pressure‐lowering efficacy of loop diuretics for primary hypertension. Cochrane Database Syst Rev 2015, CD003825. https://doi.org/10.1002/14651858.CD003825.pub4

  93. Nemi, J.R., Hopper, K., Epstein, S.E., 2023. Retrospective evaluation of noncardiogenic pulmonary edema in dogs and cats (2000-2021): 31 cases. J Vet Emerg Crit Care (San Antonio) 33, 354–359. https://doi.org/10.1111/vec.13290

  94. Newton, P.J., Davidson, P.M., Macdonald, P., Ollerton, R., Krum, H., 2008. Nebulized furosemide for the management of dyspnea: does the evidence support its use? J Pain Symptom Manage 36, 424–441. https://doi.org/10.1016/j.jpainsymman.2007.10.017

  95. Ochoa, P.G., Arribas, M.T.V., Mena, J.M., Pérez, M.G., 2006. Cutaneous adverse reaction to furosemide treatment: new clinical findings. Can Vet J 47, 576–578.

  96. Ohad, D.G., Segev, Y., Kelmer, E., Aroch, I., Bdolah-Abram, T., Segev, G., Klainbart, S., 2018. Constant rate infusion vs. intermittent bolus administration of IV furosemide in 100 pets with acute left-sided congestive heart failure: A retrospective study. Vet J 238, 70–75. https://doi.org/10.1016/j.tvjl.2018.07.001

  97. Oishi, N., Talaska, A.E., Schacht, J., 2012. Ototoxicity in dogs and cats. Vet Clin North Am Small Anim Pract 42, 1259–1271. https://doi.org/10.1016/j.cvsm.2012.08.005

  98. Ozawa, S., Guzman, D.S.-M., Keel, K., Gunther-Harrington, C., 2021. Clinical and pathological findings in rabbits with cardiovascular disease: 59 cases (2001–2018). Journal of the American Veterinary Medical Association 259, 764–776. https://doi.org/10.2460/javma.259.7.764

  99. Paik, J., Kang, J.-H., Chang, D., Yang, M.-P., 2016. Cardiogenic Pulmonary Edema in a Dog Following Initiation of Therapy for Concurrent Hypoadrenocorticism and Hypothyroidism. J Am Anim Hosp Assoc 52, 378–384. https://doi.org/10.5326/JAAHA-MS-6225

  100. Palmero, A., 2023. Respiratory distress in a domestic rabbit (Oryctolagus cuniculus). Emerging Animal Species 6, 100022. https://doi.org/10.1016/j.eas.2023.100022

  101. Pariaut, R., 2009. Cardiovascular Physiology and Diseases of the Rabbit. Veterinary Clinics of North America: Exotic Animal Practice 12, 135–144. https://doi.org/10.1016/j.cvex.2008.08.004

  102. Patel, R., Patel, P., Patel, N., Gangwani, J., Patel, D., 2022. Case report on the interaction between furosemide and digoxin that caused digoxin toxicity. Journal of Drug Delivery and Therapeutics 12, 9–12. https://doi.org/10.22270/jddt.v12i5-S.5717

  103. Pelligand, L., Guillot, E., Geneteau, A., Guyonnet, J., Magnier, R., Elliott, J., Peyrou, M., Jacobs, M., 2020. Population Pharmacokinetics and Pharmacodynamics Modeling of Torasemide and Furosemide After Oral Repeated Administration in Healthy Dogs. Front Vet Sci 7, 151. https://doi.org/10.3389/fvets.2020.00151

  104. Peterson, M.E., Fluegeman, K., 2013. Cholecalciferol. Top Companion Anim Med 28, 24–27. https://doi.org/10.1053/j.tcam.2013.03.006

  105. Phillips, L., Schaer, M., 1988. Idiopathic pleural effusion in a dog. J Am Vet Med Assoc 192, 788–790.

  106. Pichette, V., du Souich, P., 1996. Role of the kidneys in the metabolism of furosemide: its inhibition by probenecid. J Am Soc Nephrol 7, 345–349. https://doi.org/10.1681/ASN.V72345

  107. Pichette, V., Geadah, D., du Souich, P., 1996. The influence of moderate hypoalbuminaemia on the renal metabolism and dynamics of furosemide in the rabbit. Br J Pharmacol 119, 885–890. https://doi.org/10.1111/j.1476-5381.1996.tb15755.x

  108. Pichette, V., Geadah, D., Souich, P. du, 1999. Role of Plasma Protein Binding on Renal Metabolism and Dynamics of Furosemide in the Rabbit. Drug Metab Dispos 27, 81–85.

  109. Plumb, 2024. Furosemide [WWW Document]. URL https://app.plumbs.com/drug/mbPAOQoO7DPROD?source=recently-viewed (accessed 9.18.24).

  110. Poissonnier, C., Ghazal, S., Passavin, P., Alvarado, M.-P., Lefort, S., Trehiou-Sechi, E., Saponaro, V., Barbarino, A., Delle Cave, J., Marchal, C.-R., Depré, B., Vannucci, E., Tissier, R., Verwaerde, P., Chetboul, V., 2020. Tolerance of torasemide in cats with congestive heart failure: a retrospective study on 21 cases (2016-2019). BMC Vet Res 16, 339. https://doi.org/10.1186/s12917-020-02554-6

  111. Ponikowski, P., Voors, A.A., Anker, S.D., Bueno, H., Cleland, J.G.F., Coats, A.J.S., Falk, V., González-Juanatey, J.R., Harjola, V.-P., Jankowska, E.A., Jessup, M., Linde, C., Nihoyannopoulos, P., Parissis, J.T., Pieske, B., Riley, J.P., Rosano, G.M.C., Ruilope, L.M., Ruschitzka, F., Rutten, F.H., van der Meer, P., Members, A.F., Reviewers, D., 2016. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Journal of Heart Failure 18, 891–975. https://doi.org/10.1002/ejhf.592

  112. Porciello, F., Rishniw, M., Ljungvall, I., Ferasin, L., Haggstrom, J., Ohad, D.G., 2016. Sleeping and resting respiratory rates in dogs and cats with medically-controlled left-sided congestive heart failure. The Veterinary Journal 207, 164–168. https://doi.org/10.1016/j.tvjl.2015.08.017

  113. Potter, B.M., Ames, M.K., Hess, A., Poglitsch, M., 2019. Comparison between the effects of torsemide and furosemide on the renin-angiotensin-aldosterone system of normal dogs. Journal of Veterinary Cardiology 26, 51–62. https://doi.org/10.1016/j.jvc.2019.11.003

  114. Prandota, J., 1991. High doses of furosemide in children with acute renal failure. A preliminary retrospective study. Int Urol Nephrol 23, 383–392. https://doi.org/10.1007/BF02549611

  115. Pruchnicki, M.C., Dasta, J.F., 2002. Acute renal failure in hospitalized patients: part II. Ann Pharmacother 36, 1430–1442. https://doi.org/10.1345/aph.1A340

  116. PubChem, 2024. Furosemide [WWW Document]. URL https://pubchem.ncbi.nlm.nih.gov/compound/3440 (accessed 9.13.24).

  117. Raisbeck, M.F., Hewitt, W.R., McIntyre, W.B., 1983. Fatal nephrotoxicosis associated with furosemide and gentamicin therapy in a dog. J Am Vet Med Assoc 183, 892–893.

  118. Reusch, B., 2005. Investigation and management of cardiovascular disease in rabbits. In Practice 27, 418–425. https://doi.org/10.1136/inpract.27.8.418

  119. Roche-Catholy, M., Van Cappellen, I., Locquet, L., Broeckx, B.J.G., Paepe, D., Smets, P., 2021. Clinical relevance of serum electrolytes in dogs and cats with acute heart failure: A retrospective study. J Vet Intern Med 35, 1652–1662. https://doi.org/10.1111/jvim.16187

  120. Rybak, L.P., 1982. Pathophysiology of furosemide ototoxicity. J Otolaryngol 11, 127–133.

  121. Rybak, L.P., Whitworth, C., Scott, V., 1991. Comparative acute ototoxicity of loop diuretic compounds. Eur Arch Otorhinolaryngol 248, 353–357. https://doi.org/10.1007/BF00169028

  122. Saba, M., Davoodabadi, A., Ghaffari, A., Gilasi, H., Haghpanah, B., 2020. Combination adjunctive nebulized furosemide and salbutamol versus single agent therapy in COPD patients: A randomized controlled trial. Ann Med Surg (Lond) 57, 85–90. https://doi.org/10.1016/j.amsu.2020.07.005

  123. Sayer, M. b., Atkins, C. e., Fujii, Y., Adams, A. k., DeFrancesco, T. c., Keene, B. w., 2009. Acute Effect of Pimobendan and Furosemide on the Circulating Renin-Angiotensin-Aldosterone System in Healthy Dogs. Journal of Veterinary Internal Medicine 23, 1003–1006. https://doi.org/10.1111/j.1939-1676.2009.0367.x

  124. Schnellbacher, R., Olson, E.E., Mayer, J., 2012. Emergency Presentations Associated with Cardiovascular Disease in Exotic Herbivores. Journal of Exotic Pet Medicine, Emergency Presentation of Exotic Mammal Herbivores 21, 316–327. https://doi.org/10.1053/j.jepm.2012.09.007

  125. Schober, K.E., Rush, J.E., Luis Fuentes, V., Glaus, T., Summerfield, N.J., Wright, K., Lehmkuhl, L., Wess, G., Sayer, M.P., Loureiro, J., MacGregor, J., Mohren, N., 2021. Effects of pimobendan in cats with hypertrophic cardiomyopathy and recent congestive heart failure: Results of a prospective, double-blind, randomized, nonpivotal, exploratory field study. J Vet Intern Med 35, 789–800. https://doi.org/10.1111/jvim.16054

  126. Scruggs, S.M., Rishniw, M., 2013. Dermatologic adverse effect of subcutaneous furosemide administration in a dog. J Vet Intern Med 27, 1248–1250. https://doi.org/10.1111/jvim.12156

  127. Shankar, S.S., Brater, D.C., 2003. Loop diuretics: from the Na-K-2Cl transporter to clinical use. Am J Physiol Renal Physiol 284, F11-21. https://doi.org/10.1152/ajprenal.00119.2002

  128. Shilliday, I.R., Quinn, K.J., Allison, M.E., 1997. Loop diuretics in the management of acute renal failure: a prospective, double-blind, placebo-controlled, randomized study. Nephrol Dial Transplant 12, 2592–2596. https://doi.org/10.1093/ndt/12.12.2592

  129. Shimoyama, N., Shimoyama, M., 2002. Nebulized furosemide as a novel treatment for dyspnea in terminal cancer patients. J Pain Symptom Manage 23, 73–76. https://doi.org/10.1016/s0885-3924(01)00367-0

  130. Silverstein, D.C., Hopper, K. (Eds.), 2009. Small animal critical care medicine. Saunders Elsevier, St. Louis, Mo.

  131. SPC, 2024a. Dimazon 50 mg/ml Solution for Injection [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/current/search-results (accessed 12.28.23).

  132. SPC, 2024b. Disposition kinetics of furosemide in dogs - PubMed [WWW Document]. URL https://pubmed.ncbi.nlm.nih.gov/7325754/ (accessed 12.8.23).

  133. SPC, 2024c. Frusedale 40 mg Oral Tablets [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A003210 (accessed 12.28.23).

  134. SPC, 2024d. Frusemide 40 mg Tablets [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A005945 (accessed 12.28.23).

  135. SPC, 2024e. Furosemide 10mg/ml Oral Solution - Summary of Product Characteristics (SmPC) - (emc) [WWW Document]. URL https://www.medicines.org.uk/emc/product/2460/smpc#gref (accessed 12.29.23).

  136. SPC, 2024f. Furosemide 20 mg/5 ml Oral Solution - Summary of Product Characteristics (SmPC) - (emc) [WWW Document]. URL https://www.medicines.org.uk/emc/product/4576/smpc#gref (accessed 12.29.23).

  137. SPC, 2024g. Furosemide Tablets BP (Vet) 20 mg [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/current/search-results (accessed 12.28.23).

  138. SPC, 2024h. Furosemide Tablets BP (Vet) 40 mg [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A003335 (accessed 12.28.23).

  139. SPC, 2024i. Furosivet 20 mg Tablets for Dogs and Cats [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A010184 (accessed 12.28.23).

  140. SPC, 2024j. Furosoral 10 mg Tablets for Cats and Dogs [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A009114 (accessed 12.28.23).

  141. SPC, 2024k. Furosoral 40 mg Tablets for Cats and Dogs [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A009115 (accessed 12.28.23).

  142. SPC, 2024l. Libeo 40 mg Chewable Tablets for Dogs [WWW Document]. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A008670 (accessed 12.28.23).

  143. Stevens, E.L., Uyehara, C.F.T., Southgate, W.M., Nakamura, K.T., 2012. Furosemide Differentially Relaxes Airway and Vascular Smooth Muscle in Fetal, Newborn, and Adult Guinea Pigs. American Review of Respiratory Disease. https://doi.org/10.1164/ajrccm/146.5_Pt_1.1192

  144. Su, Y., Zhang, Y.-J., Tu, G.-W., Hou, J.-Y., Ma, G.-G., Hao, G.-W., Xu, R.-H., Luo, Z., 2024. Furosemide Responsiveness Predicts Acute Kidney Injury Progression After Cardiac Surgery. Ann Thorac Surg 117, 432–438. https://doi.org/10.1016/j.athoracsur.2023.07.011

  145. Sudo, T., Hayashi, F., Nishino, T., 2000. Responses of Tracheobronchial Receptors to Inhaled  Furosemide in Anesthetized Rats. Am J Respir Crit Care Med 162, 971–975. https://doi.org/10.1164/ajrccm.162.3.2001001

  146. Suzuki, S., Ishikawa, T., Hamabe, L., Aytemiz, D., Huai-Che, H., Fukushima, R., Machida, N., Tanaka, R., 2011. The Effect of Furosemide on Left Atrial Pressure in Dogs with Mitral Valve Regurgitation. Journal of Veterinary Internal Medicine 25, 244–250. https://doi.org/10.1111/j.1939-1676.2010.0672.x

  147. Tammela, T.L.J., Longhurst, P.A., Wein, A.J., Levin, R.M., 1993. The Effect of Furosemide-Induced Diuresis on Rabbit Micturition and Bladder Contractile Function. The Journal of Urology 150, 204–208. https://doi.org/10.1016/S0022-5347(17)35447-2

  148. Tidholm, A., 2006. Survival in dogs with dilated cardiomyopathy and congestive heart failure treated with digoxin, furosemide and propranolol: A retrospective study of 62 dogs. J Vet Cardiol 8, 41–47. https://doi.org/10.1016/j.jvc.2006.01.003

  149. To, A., Davila, C., Stroope, S., Walton, R., 2023. Case report: Resolution of oligo-anuric acute kidney injury with furosemide administration in a cat following lily toxicity. Front Vet Sci 10, 1195743. https://doi.org/10.3389/fvets.2023.1195743

  150. Todd, M.M., 2013. Hyperosmolar therapy and the brain: a hundred years of hard-earned lessons. Anesthesiology 118, 777–779. https://doi.org/10.1097/ALN.0b013e3182815980

  151. Todd, M.M., Cutkomp, J., Brian, J.E., 2006. Influence of mannitol and furosemide, alone and in combination, on brain water content after fluid percussion injury. Anesthesiology 105, 1176–1181. https://doi.org/10.1097/00000542-200612000-00017

  152. Trepanier, L.A., 2005. Potential interactions between non-steroidal anti-inflammatory drugs and other drugs. Journal of Veterinary Emergency and Critical Care 15, 248–253. https://doi.org/10.1111/j.1476-4431.2005.00167.x

  153. Trepanier, L.A., 2004. Idiosyncratic toxicity associated with potentiated sulfonamides in the dog. Journal of Veterinary Pharmacology and Therapeutics 27, 129–138. https://doi.org/10.1111/j.1365-2885.2004.00576.x

  154. Tsutsumi, E., Fujiki, H., Takeda, H., Fukushima, H., 1979. Effect of furosemide on serum clearance and renal excretion of digoxin. J Clin Pharmacol 19, 200–204. https://doi.org/10.1002/j.1552-4604.1979.tb01652.x

  155. Uechi, M., Matsuoka, M., Kuwajima, E., Kaneko, T., Yamashita, K., Fukushima, U., Ishikawa, Y., 2003. The Effects of the Loop Diuretics Furosemide and Torasemide on Diuresis in Dogs and Cats. J. Vet. Med. Sci. 65, 1057–1061. https://doi.org/10.1292/jvms.65.1057

  156. Uwera, J., S, N., M, A., 2015. A novel mechanism for the anticonvulsant effect of furosemide in rat hippocampus in vitro. Brain research 1625. https://doi.org/10.1016/j.brainres.2015.08.014

  157. van der Zande, J.A., Greutmann, M., Tobler, D., Ramlakhan, K.P., Cornette, J.M.J., Ladouceur, M., Collins, N., Adamson, D., Paruchuri, V.P., Hall, R., Johnson, M.R., Roos-Hesselink, J.W., on behalf of the ROPAC Investigators Group, 2024. Diuretics in pregnancy: Data from the ESC Registry of Pregnancy and Cardiac disease (ROPAC). Eur J Heart Fail 26, 1561–1570. https://doi.org/10.1002/ejhf.3301

  158. Vergés, J., Héroux, L., Maurice, H., du Souich, P., 1995. Extrahepatic metabolism of frusemide in anaesthetized rabbits. Br J Pharmacol 116, 2407–2412. https://doi.org/10.1111/j.1476-5381.1995.tb15087.x

  159. Vora, V., Crawford, A., 2011. The role of postoperative furosemide therapy in the treatment of pleural effusion following kyphosis/scoliosis surgery. J Child Orthop 5, 283–287. https://doi.org/10.1007/s11832-011-0351-5

  160. Wallach, S., Charbon, G.A., Beijer, H.J., Endeman, H.J., Hoeke, J.O., Schrijver, J., Struyvenberg, A., 1983. Effects of furosemide on biliary secretion, pancreatic blood flow, and pancreatic exocrine secretion. J Clin Pharmacol 23, 401–413. https://doi.org/10.1002/j.1552-4604.1983.tb01783.x

  161. Wang, D.J., Gottlieb, S.S., 2008. Diuretics: Still the mainstay of treatment. Critical Care Medicine 36, S89. https://doi.org/10.1097/01.CCM.0000296272.68078.6B

  162. Wang, L.A., Smith, P.B., Laughon, M., Goldberg, R.N., Ku, L.C., Zimmerman, K.O., Balevic, S., Clark, R.H., Benjamin, D.K., Greenberg, R.G., Best Pharmaceuticals for Children Act – Pediatric Trials Network Steering Committee, 2018. Prolonged furosemide exposure and risk of abnormal newborn hearing screen in premature infants. Early Hum Dev 125, 26–30. https://doi.org/10.1016/j.earlhumdev.2018.08.009

  163. Wang, L.C., Papangelou, A., Lin, C., Mirski, M.A., Gottschalk, A., Toung, T.J.K., 2013. Comparison of equivolume, equiosmolar solutions of mannitol and hypertonic saline with or without furosemide on brain water content in normal rats. Anesthesiology 118, 903–913. https://doi.org/10.1097/ALN.0b013e31828156ff

  164. Watson, M., 2011. Furosemide. Journal of Exotic Pet Medicine 20, 60–63. https://doi.org/10.1053/j.jepm.2010.11.014

  165. Yoon, S.-S., Byun, J.-W., Kim, M.-J., Bae, Y.-C., Shin, Y.-K., Yoon, S., Lee, G., Song, J.-Y., 2011. Natural occurrence of grape poisoning in two dogs. J Vet Med Sci 73, 275–277. https://doi.org/10.1292/jvms.10-0177

  166. Zaccara, G., S, L., M, C., E, R., 2020. Drug treatments in patients with cardiac diseases and epilepsy. Acta neurologica Scandinavica 142. https://doi.org/10.1111/ane.13249

  167. Zhao, G., Xu, C., Ying, J., Lü, W., Hong, G., Li, M., Wu, B., Yao, Y., Lu, Z., 2020. Association between furosemide administration and outcomes in critically ill patients with acute kidney injury. Critical Care 24, 75. https://doi.org/10.1186/s13054-020-2798-6

UK SPCs

  1. Dimazon 50 mg/ml Solution for Injection [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/current/search-results (accessed 12.28.23).

  2. Frusedale 40 mg Oral Tablets [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A003210 (accessed 12.28.23).

  3. Frusemide 40 mg Tablets [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A005945 (accessed 12.28.23).

  4. Furosemide 10mg/ml Oral Solution - Summary of Product Characteristics (SmPC) - (emc) [WWW Document], n.d. URL https://www.medicines.org.uk/emc/product/2460/smpc#gref (accessed 12.29.23).

  5. Furosemide 20 mg/5 ml Oral Solution - Summary of Product Characteristics (SmPC) - (emc) [WWW Document], n.d. URL https://www.medicines.org.uk/emc/product/4576/smpc#gref (accessed 12.29.23).

  6. Furosemide Tablets BP (Vet) 20 mg [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/current/search-results (accessed 12.28.23).

  7. Furosemide Tablets BP (Vet) 40 mg [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A003335 (accessed 12.28.23).

  8. Furosivet 20 mg Tablets for Dogs and Cats [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A010184 (accessed 12.28.23).

  9. Furosoral 10 mg Tablets for Cats and Dogs [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A009114 (accessed 12.28.23).

  10. Furosoral 40 mg Tablets for Cats and Dogs [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A009115 (accessed 12.28.23).

  11. Libeo 40 mg Chewable Tablets for Dogs [WWW Document], n.d. URL https://www.vmd.defra.gov.uk/productinformationdatabase/product/A008670 (accessed 12.28.23).

Evidence

Monograph Details

Criteria

  • Active Substance: Furosemide

Resources

Development Team

  • Monograph Author(s): S McArthur B Vet Med MRCVS (last updated 25/11/2024)

  • Monograph Editor(s): TBA (last updated 25/11/2024)

Monograph Contact

Mono Details
bottom of page