From the FDA Drug Label
Dermatologic-Hypersensitivity Reactions ... pruritis The management options for itching associated with furosemide (Lasix) use are:
- Reducing the dosage of Furosemide tablets
- Withdrawing Furosemide therapy 1
From the Research
Management options for itching associated with furosemide (Lasix) include discontinuing the medication if possible or switching to an alternative diuretic such as bumetanide or torsemide. If furosemide must be continued, symptomatic treatment can be implemented with oral antihistamines, however, given the recent evidence 2, second-generation antihistamines like cetirizine (10 mg daily) or loratadine (10 mg daily) are preferred over diphenhydramine due to their favorable side effect profile. Topical treatments may help provide relief, including:
- calamine lotion
- colloidal oatmeal baths
- moisturizers applied after bathing Corticosteroid creams such as hydrocortisone 1% can be used for short periods on affected areas. For severe cases, a short course of oral corticosteroids might be considered under medical supervision. The itching occurs because furosemide can trigger histamine release or cause photosensitivity reactions in some patients, as seen in cases of anaphylaxis 3. It's essential to report persistent or severe itching to a healthcare provider, as it could indicate a more serious hypersensitivity reaction requiring immediate medical attention. Staying well-hydrated and avoiding direct sun exposure may also help minimize furosemide-associated skin reactions. Alternative diuretics like torasemide may have different side effect profiles, including reduced risk of certain adverse effects 4, which could be considered when managing patients with furosemide-associated itching. The use of furosemide in various clinical contexts, such as acute kidney injury 5 or syndrome of inappropriate antidiuresis (SIAD) 6, should be carefully evaluated, considering both its benefits and potential risks, including the development of itching or other skin reactions.