Parenteral therapy should be reserved for patients unable to take oral medication or for patients in emergency clinical situations.
Furosemide is contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide.
Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dose and dose schedule must be adjusted to the individual patient's needs. (See DOSAGE AND ADMINISTRATION .)
Furosemide is contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide.
In patients with hepatic cirrhosis and ascites, furosemide therapy is best initiated in the hospital. In hepatic coma and in states of electrolyte depletion, therapy should not be instituted until the basic condition is improved. Sudden alterations of fluid and electrolyte balance in patients with cirrhosis may precipitate hepatic coma; therefore, strict observation is necessary during the period of diuresis. Supplemental potassium chloride and, if required, an aldosterone antagonist are helpful in preventing hypokalemia and metabolic alkalosis. If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, furosemide should be discontinued. Cases of tinnitus and reversible or irreversible hearing impairment and deafness have been reported. Reports usually indicate that furosemide ototoxicity is associated with rapid injection, severe renal impairment, the use of higher than recommended doses, hypoproteinemia or concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs. If the physician elects to use high dose parenteral therapy, controlled intravenous infusion is advisable (for adults, an infusion rate not exceeding 4 mg furosemide per minute has been used). (See PRECAUTIONS, Drug Interactions . )
The principal signs and symptoms of overdose with furosemide are dehydration, blood volume reduction, hypotension, electrolyte imbalance, hypokalemia and hypochloremic alkalosis, and are extensions of its diuretic action. The acute toxicity of furosemide has been determined in mice, rats and dogs. In all three, the oral LD 50 exceeded 1,000 mg/kg body weight, while the intravenous LD 50 ranged from 300 to 680 mg/kg. The acute intragastric toxicity in neonatal rats is 7 to 10 times that of adult rats. The concentration of furosemide in biological fluids associated with toxicity or death is not known. Treatment of overdosage is supportive and consists of replacement of excessive fluid and electrolyte losses. Serum electrolytes, carbon dioxide level and blood pressure should be determined frequently. Adequate drainage must be assured in patients with urinary bladder outlet obstruction (such as prostatic hypertrophy). Hemodialysis does not accelerate furosemide elimination.
NDC 55154-4452-5 FUROSEMIDE INJECTION, USP 40 mg/4 mL (10 mg/mL) 5 x 4 mL SINGLE DOSE VIALS
| Class | Version | Type | Effective |
|---|---|---|---|
| FUROSEMIDE Pharmacologic Class Indexing | 2 | Indexing - Pharmacologic Class | 20180813 |
| Product concept | Relation | Version | Effective |
|---|---|---|---|
| d80d3aff-3a63-4d7b-a2be-fd9388b04330 | Product name | 9 | 20250806 |
| 9061e89f-9c86-4196-b34b-886fc1673cc4 | Product name | 1 | 20140821 |
| Package NDC | Product | Description | Form | Quantity | Strength | SPL version |
|---|---|---|---|---|---|---|
| 55154-4452-5 | FUROSEMIDE | 5 in 1 BAG | INJECTION, SOLUTION | 5 | 8 | |
| 55154-4452-5 | FUROSEMIDE | 4 mL in 1 VIAL, SINGLE-DOSE | INJECTION, SOLUTION | 4 | 8 |
| Package NDC | Billing unit | Product NDC | DailyMed indexing SPL | SPL version | Effective |
|---|---|---|---|---|---|
| 36000-283-25 | ML - Milliliter | 36000-283 | 499969b8-4f07-45ac-be6e-1fd7890fa695 | 1 | 2014-08-01 |
| Product NDC | Package NDC |
|---|---|
| 55154-4452 | 55154-4452-5 |
| 36000-283 |
| Name | UNII | Kind |
|---|---|---|
| FUROSEMIDE | 7LXU5N7ZO5 | ACTIB |
| WATER | 059QF0KO0R | IACT |
| SODIUM CHLORIDE | 451W47IQ8X | IACT |
| SODIUM HYDROXIDE | 55X04QC32I | IACT |
| HYDROCHLORIC ACID | QTT17582CB | CNTM |
Rx Only
Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dose and dose schedule must be adjusted to the individual patient's needs. (See DOSAGE AND ADMINISTRATION .)
Furosemide is a diuretic which is an anthranilic acid derivative. Chemically, it is 4-chloro -N -furfuryl-5-sulfamoylanthranilic acid. Furosemide Injection 10 mg/mL is a sterile, non-pyrogenic solution in vials for intravenous and intramuscular injection. Furosemide is a white to off-white odorless crystalline powder. It is practically insoluble in water, sparingly soluble in alcohol, freely soluble in dilute alkali solutions and insoluble in dilute acids. The structural formula is as follows: Each mL contains: Furosemide 10 mg, Sodium Hydroxide 1.34 mg, Water for Injection q.s., Sodium Chloride for isotonicity, additional Sodium Hydroxide (q.s.) and, if necessary, Hydrochloric Acid (q.s.) to adjust pH between 8.0 and 9.3.
Investigations into the mode of action of furosemide have utilized micropuncture studies in rats, stop flow experiments in dogs and various clearance studies in both humans and experimental animals. It has been demonstrated that furosemide inhibits primarily the reabsorption of sodium and chloride not only in the proximal and distal tubules but also in the loop of Henle. The high degree of efficacy is largely due to this unique site of action. The action on the distal tubule is independent of any inhibitory effect on carbonic anhydrase and aldosterone. Recent evidence suggests that furosemide glucuronide is the only or at least the major biotransformation product of furosemide in man. Furosemide is extensively bound to plasma proteins, mainly to albumin. Plasma concentrations ranging from 1 to 400 mcg/mL are 91 to 99% bound in healthy individuals. The unbound fraction averages 2.3 to 4.1% at therapeutic concentrations. The onset of diuresis following intravenous administration is within 5 minutes and somewhat later after intramuscular administration. The peak effect occurs within the first half hour. The duration of diuretic effect is approximately 2 hours. In fasted normal men, the mean bioavailability of furosemide from furosemide tablets and furosemide oral solution is 64% and 60%, respectively, of that from an intravenous injection of the drug. Although furosemide is more rapidly absorbed from the oral solution (50 minutes) than from the tablet (87 minutes), peak plasma levels and area under the plasma concentration-time curves do not differ significantly. Peak plasma concentrations increase with increasing dose but times-to-peak do not differ among doses. The terminal half-life of furosemide is approximately 2 hours. Significantly more furosemide is excreted in urine following the intravenous injection than after the tablet or oral solution. There are no significant differences between the two oral formulations in the amount of unchanged drug excreted in urine.
Furosemide binding to albumin may be reduced in elderly patients. Furosemide is predominantly excreted unchanged in the urine. The renal clearance of furosemide after intravenous administration in older healthy male subjects (60 to 70 years of age) is statistically significantly smaller than in younger healthy male subjects (20 to 35 years of age). The initial diuretic effect of furosemide in older subjects is decreased relative to younger subjects. (See PRECAUTIONS: Geriatric Use .)
Based on PK results obtained from 51 premature infants (23 to 29 weeks gestational age (GA)) receiving repeated doses up to 4 times the maximum recommended total daily dose for intravenous (IV) administration (or 8 times the maximum recommended total daily dose for enteral administration), body weight and postnatal age were found to have an impact on furosemide clearance. Median clearance (normalized by dosing weight) was observed to increase from 8.9 (range: 2.1 to 21.2) ml/h/kg in infants with postnatal age (PNA)
Parenteral therapy should be reserved for patients unable to take oral medication or for patients in emergency clinical situations.
Furosemide is contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide.
In patients with hepatic cirrhosis and ascites, furosemide therapy is best initiated in the hospital. In hepatic coma and in states of electrolyte depletion, therapy should not be instituted until the basic condition is improved. Sudden alterations of fluid and electrolyte balance in patients with cirrhosis may precipitate hepatic coma; therefore, strict observation is necessary during the period of diuresis. Supplemental potassium chloride and, if required, an aldosterone antagonist are helpful in preventing hypokalemia and metabolic alkalosis. If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, furosemide should be discontinued. Cases of tinnitus and reversible or irreversible hearing impairment and deafness have been reported. Reports usually indicate that furosemide ototoxicity is associated with rapid injection, severe renal impairment, the use of higher than recommended doses, hypoproteinemia or concomitant therapy with aminoglycoside antibiotics, ethacrynic acid, or other ototoxic drugs. If the physician elects to use high dose parenteral therapy, controlled intravenous infusion is advisable (for adults, an infusion rate not exceeding 4 mg furosemide per minute has been used). (See PRECAUTIONS, Drug Interactions . )
Adverse reactions are categorized below by organ system and listed by decreasing severity. Gastrointestinal System Reactions 1. Hepatic encephalopathy in patients with hepatocellular insufficiency 2. Pancreatitis 3. Jaundice (intrahepatic cholestatic jaundice) 4. Increased liver enzymes 5. Anorexia 6. Oral and gastric irritation 7. Cramping 8. Diarrhea 9. Constipation 10. Nausea 11. Vomiting Systemic Hypersensitivity Reactions 1. Severe anaphylactic or anaphylactoid reactions (e.g. with shock) 2. Systemic vasculitis 3. Interstitial nephritis 4. Necrotizing angiitis Central Nervous System Reactions 1. Tinnitus and hearing loss 2. Paresthesias 3. Vertigo 4. Dizziness 5. Headache 6. Blurred vision 7. Xanthopsia Hematologic Reactions 1. Aplastic anemia 2. Thrombocytopenia 3. Agranulocytosis 4. Hemolytic anemia 5. Leukopenia 6. Anemia 7. Eosinophilia Dermatologic-Hypersensitivity Reactions 1. Exfoliative dermatitis 2. Bullous pemphigoid 3. Erythema multiforme 4. Purpura 5. Photosensitivity 6. Urticaria 7. Rash 8. Pruritus 9. Stevens-Johnson Syndrome 10. Toxic epidermal necrolysis Cardiovascular Reaction 1. Orthostatic hypotension may occur and be aggravated by alcohol, barbiturates or narcotics. 2. Increase in cholesterol and triglyceride serum levels. Other Reactions 1. Hyperglycemia 2. Glycosuria 3. Hyperuricemia 4. Muscle spasms 5. Weakness 6. Restlessness 7. Urinary bladder spasm 8. Thrombophlebitis 9. Transient injection site pain following intramuscular injection 10. Fever Whenever adverse reactions are moderate or severe, furosemide dosage should be reduced or therapy withdrawn. To report SUSPECTED ADVERSE REACTIONS, contact Baxter Healthcare Corporation. at 1-877-725-2747 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch .
The principal signs and symptoms of overdose with furosemide are dehydration, blood volume reduction, hypotension, electrolyte imbalance, hypokalemia and hypochloremic alkalosis, and are extensions of its diuretic action. The acute toxicity of furosemide has been determined in mice, rats and dogs. In all three, the oral LD 50 exceeded 1,000 mg/kg body weight, while the intravenous LD 50 ranged from 300 to 680 mg/kg. The acute intragastric toxicity in neonatal rats is 7 to 10 times that of adult rats. The concentration of furosemide in biological fluids associated with toxicity or death is not known. Treatment of overdosage is supportive and consists of replacement of excessive fluid and electrolyte losses. Serum electrolytes, carbon dioxide level and blood pressure should be determined frequently. Adequate drainage must be assured in patients with urinary bladder outlet obstruction (such as prostatic hypertrophy). Hemodialysis does not accelerate furosemide elimination.
Pediatric Patients: Parenteral therapy should be used only in patients unable to take oral medication or in emergency situations and should be replaced with oral therapy as soon as practical. The usual initial dose of Furosemide Injection (intravenously or intramuscularly) in pediatric patients is 1 mg/kg body weight and should be given slowly under close medical supervision. If the diuretic response to the initial dose is not satisfactory, dosage may be increased by 1 mg/kg not sooner than 2 hours after the previous dose, until the desired diuretic effect has been obtained. Doses greater than 6 mg/kg body weight are not recommended. Literature reports suggest that the maximum dose for premature infants should not exceed 1 mg/kg/day. (See WARNINGS, Pediatric Use . ) Furosemide Injection should be inspected visually for particulate matter and discoloration before administration.
Furosemide Injection, USP (10 mg/mL) Overbagged with 5 x 4 mL single-dose amber colored vials in each bag, NDC 55154-4452-5 WARNING: This Unit Dose package is not child resistant and is Intended for Institutional Use Only. Keep this and all drugs out of the reach of children. Do not use if solution is discolored. Store at 20° to 25°C (68° to 77°F); excursions permitted to 15˚ to 30˚C (59˚ to 86˚F) [See USP Controlled Room Temperature]. Protect from light. Manufactured for: Baxter Healthcare Corporation Deerfield, IL 60015 USA Manufactured by: Baxter Pharmaceuticals India Private Ltd Ahmedabad 382213, India Baxter is a registered trademark of Baxter International Inc. Distributed By: Cardinal Health Dublin, OH 43017 L53164430224 Rev.: 2025-06-30 1400008744
NDC 55154-4452-5 FUROSEMIDE INJECTION, USP 40 mg/4 mL (10 mg/mL) 5 x 4 mL SINGLE DOSE VIALS
| Version | Effective date | Source | Hydrated |
|---|---|---|---|
| 7 | 2025-10-03 | monthly-update | 2026-06-03 17:42:46 |
| 6 | 2024-03-07 | full-release | 2026-05-31 21:00:52 |