Edemann Warnings

Furosemide is a potent diuretic, which, if given in excessive amount, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required and dose schedule must be adjusted to the individual patient's needs.
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, aldosterone antagonists 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 in cases of tinnitus since reversible and irreversible hearing impairment have been reported. Usually, reports indicate that diuretic treatment with furosemide in the 1st few weeks in premature neonates with respiratory distress syndrome may increase the risk of persistent patent ductus arteriosus (PDA), possibly through a prostaglandin E-mediated process.