2.2.2 Loop diuretics - South & West

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2.2 Diuretics Toggle Pages

2.2.1 Thiazides and related diuretics 2.2.2 Loop diuretics 2.2.3 Potassium-sparing diuretics and aldosterone antagonists 2.2.4 Potassium-sparing diuretics with other diuretics 2.2.5 Osmotic diuretics

Chapter 2: Cardiovascular Toggle Parent Pages

Management of atrial fibrillation Drugs that prolong the QT interval Anticoagulation prescribing guidance Management of suspected deep vein thrombosis (DVT) and pulmonary embolism (PE) Secondary prevention of stroke / TIA in primary care Management of angina Chronic heart failure guidance Management of hypertension Management of blood lipids 2.1 Positive inotropic drugs 2.2 Diuretics 2.3 Anti-arrhythmic drugs 2.4 Beta-adrenoceptor blocking drugs 2.5 Hypertension and heart failure 2.6 Nitrates, calcium-channel blockers, and other antianginal drugs 2.7 Sympathomimetics 2.8 Anticoagulants and protamine 2.9 Antiplatelet drugs 2.10 Stable angina, acute coronary syndromes, and fibrinolysis 2.11 Antifibrinolytic drugs and haemostatics 2.12 Lipid regulating drugs 2.13 Local sclerosants 2.14 Miscellaneous cardiovascular preparations

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2.2.2 Loop diuretics

First Line

Second Line

Specialist

Hospital Only

Furosemide

Tablets 20mg, 40mg, 500mg (£0.67 = 40mg daily)
Oral solution sugar free 20mg in 5ml, 40mg in 5ml, 50mg in 5ml (£14.81 = 20mg in 5ml x 150ml)
Injection 10mg in 1ml

Indications

Oedema

Dose

Oral, initially 40mg in the morning; maintenance 20–40mg daily; resistant oedema, 80–120mg daily

Bumetanide

Tablets 1mg, 5mg (£1.70 = 1mg daily)
Oral solution sugar free 1mg in 5ml (£258.00 = 150ml)

Indications

Oedema

Dose

Oral: 1mg in the morning, repeated after 6–8 hours if necessary; severe cases, 5mg daily increased by 5mg every 12–24 hours according to response; Elderly, 500 micrograms daily may be sufficient

Notes

Bumetanide may be better absorbed than furosemide in patients with severe Chronic Heart Failure. Consider changing back to furosemide when symptoms are under control.