From the Guidelines
Furosemide 120 mg is not a recommended dose for most patients, as the maximum dose is generally considered to be 160 mg/day, according to the most recent guidelines 1.
Key Points to Consider
- Furosemide is a potent loop diuretic used to treat fluid overload conditions such as heart failure, liver disease, and kidney disease.
- The typical starting dose of furosemide is 20-40 mg/day, and the dose may be progressively increased according to the response and tolerability, with a generally accepted threshold of 160 mg/day to determine medical treatment refractoriness 1.
- Furosemide works by blocking sodium and chloride reabsorption in the kidneys, leading to increased urine output and reduction of excess fluid in the body.
- When taking furosemide, patients should be aware of potential side effects including dehydration, electrolyte imbalances (particularly potassium depletion), dizziness, and increased urination.
- Regular monitoring of kidney function and electrolyte levels is essential while on this medication.
Important Considerations for Use
- Patients should take furosemide as prescribed, typically in the morning to avoid nighttime urination, and should maintain adequate fluid intake unless otherwise directed by their healthcare provider.
- This medication should only be used under close medical supervision, especially when using high doses.
- The use of furosemide should be tailored to the individual patient's needs, taking into account their specific medical condition, kidney function, and potential side effects.
- In cases of hepatic encephalopathy, hyponatremia, acute kidney injury, or lack of response to treatment, diuretics should be stopped and the patient's status should be reevaluated 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition and Usage of Furosemide
- Furosemide is a loop diuretic used in the treatment of heart failure and other conditions characterized by fluid retention [(2,3,4,5)].
- It works by increasing urine production, which helps to reduce fluid buildup in the body [(2,3,4,5)].
Dosage and Classification
- A dose of 40 mg/day of oral furosemide is considered high-dose in Japanese patients with chronic heart failure 2.
- In another study, furosemide doses were classified as low dose (1-59 mg/d), medium dose (60-119 mg/d), or high dose (≥120 mg/d) 4.
- Furosemide 120 mg would be classified as a high-dose, which has been associated with increased mortality and hospitalization risks 4.
Comparison with Other Diuretics
- Studies have compared the efficacy and safety of furosemide with other diuretics, such as torsemide and bumetanide [(3,5,6)].
- Some studies suggest that torsemide may be more efficacious and safer than furosemide in patients with heart failure [(3,6)].
- However, other studies have found no significant difference in mortality and rehospitalization rates between torsemide and furosemide 6.