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discontinue therapy if azotemia and oliguria occur during treatment of severe progressive renal disease FDA-approved product labeling for many medications have included a broad contraindication in patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely to occur In cirrhosis, electrolyte and acid/base imbalances may lead to hepatic encephalopathy; prior to initiation of therapy, correct electrolyte and acid/base imbalances, when hepatic coma is present High doses ( 80 mg) of furosemide may inhibit binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by overall decrease in total thyroid hormone levels In patients at high risk for radiocontrast nephropathy furosemide can lead to higher incidence of deterioration in renal function after receiving radiocontrast compared to high-risk patients who received only intravenous hydration prior to receiving radiocontrast Observe patients regularly for possible occurrence of blood dyscrasias, liver or kidney damage, or other idiosyncratic reactions Cases of tinnitus and reversible or irreversible hearing impairment and deafness reported Hearing loss in neonates has been associated with use of furosemide injection; in premature neonates with respiratory distress syndrome, diuretic treatment with furosemide in the first few weeks of life may increase risk of persistent patent ductus arteriosus (PDA), possibly through a prostaglandin-E-mediated process Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in elderly patients Increases in blood glucose and alterations in glucose tolerance tests (with abnormalities of fasting and 2 hour postprandial sugar) have been observed, and rarely, precipitation of diabetes mellitus reported Patients with severe symptoms of urinary retention (because of bladder emptying disorders, prostatic hyperplasia, urethral narrowing), the administration of furosemide can cause acute urinary retention related to increased production and retention of urine; these patients require careful monitoring, especially during initial stages of treatment Hypokalemia may develop with furosemide, especially with brisk diuresis, inadequate oral electrolyte intake, when cirrhosis is present, or during concomitant use of corticosteroids, ACTH, licorice in large amounts, or prolonged use of laxatives Pregnancy category: C; 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possibly compatible at 0.1 mg/m L), clarithromycin, diltiazem, diphenhydramine, dobutamine, dopamine, doxorubicin (incompatible at furosemide 10 mg/m L and doxorubicin 2 mg/m L; possibly compatible at furosemide 3 mg/m L and doxorubicin 0.2 mg/m L), droperidol, eptifibatide, esmolol, famotidine(? ), fenoldopam, gatifloxacin, gemcitabine, gentamicin(? ), hydralazine, idarubicin, labetalol, levofloxacin, meperidine, metoclopramide, midazolam, milrinone, morphine, netilmicin, nicardipine, ondansetron, quinidine, thiopental, vecuronium, vinblastine, vincristine, vinorelbine Not specified: Tetracycline Additive: Cimetidine, epinephrine, heparin, nitroglycerin, potassium chloride, verapamil Syringe: Heparin Y-site: Epinephrine, fentanyl, heparin, norepinephrine, nitroglycerin, potassium chloride, verapamil(? ), vitamins B and C Injection: Inject directly or into tubing of actively running IV over 1-2 minutes Administer undiluted IV injections at rate of 20-40 mg/min; not to exceed 4 mg/min for short-term intermittent infusion; in children, give 0.5 mg/kg/min, titrated to effect Use infusion solution within 24 hours The above information is provided for general informational and educational purposes only. 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