After trying very hard to help someone with cirrhosis this week (and losing the battle), I am still doing research on Furosemide. I am heartbroken that this man was not able to turn things around. He was being given Furosemide in the hospital, and I suspect they gave him a higher dose than normal because they said he wasn't a candidate for a paracentesis. They were worried he'd bleed to death.
Please scroll down to see the LONG LIST of side effects of Furosemide. I've taken the liberty of looking up some of the complex-sounding side effects, and pasting their definitions, further down the page. I had to look up at least half of these definitions. You'll see a lot of fancy terms for things we'd be able to understand a lot better if they just put it in layman's terms, but sometimes I think these companies don't want us to understand this stuff. Interstitial nephritis is what happens when there's inflammation between the kidney tubules (translation: KIDNEY FAILURE - and I have seen people die from this after taking furosemide). Urticaria is another word for HIVES. Pruritis is another word for: REALLY BAD ITCHING.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/016273s066lbl.pdf
Sometimes I read these side effects and can't help thinking... why are they giving this stuff???? Can't they come up with something better??
You can see Dr. Najeeb talk about this, in this video, below (which I've also featured on THIS PAGE), that Furosemide can increase bilirubin levels. Please scroll to around the 46:30 mark in the video. He talks about how important "hepatic uptake" is. It displaces unconjugated bilirubin from plasma proteins. Sulfonamides used newborns, for meningitis, can also displace the bilirubin from bilirubin binding proteins. And Penicillin can do the same thing. And I think he was also saying that Rifampin can do the same thing (at least,, some drug that causes contact lenses to turn pink, and Rifampin is the drug known to do that). He pronounced it a little differently from Rifampin but I am pretty sure that is what he meant. Sorry I am totally digressing...
The gist I get is that the unconjugated bilirubin is supposed to turn into the conjugated (water soluble) form so that it can be eliminated from the body, but furosemide can prevent this process from happening.
This is a really good video... I appreciate this woman breaking down how bilirubin is conjugated. She puts this stuff in layman's terms in a way that's easier to understand!
LASIX
®
(furosemide)
Tablets 20, 40, and 80 mg
WARNING
LASIX
®
(furosemide) is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis (increased or excessive production of urine) 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.)
ADVERSE REACTIONS
Adverse reactions are categorized below by organ system and listed by decreasing severity.
Gastrointestinal System Reactions
1. hepatic encephalopathy
in patients with
6. oral and gastric irritation
hepatocellular insufficiency
7. cramping
2. pancreatitis
8. diarrhea
7. cramping
Reference ID: 3106803
3. jaundice (intrahepatic choles
tatic jaundice)
9. constipation
4. increased liver enzymes
10. nausea
5. anorexia
11. vomiting
Systemic Hypersensitivity Reactions
1. Severe anaphylactic or anaphylactoid reactions (e.g. with shock)
2. systemic vasculitis Necrotizing vasculitis also called Systemic necrotizing vasculitus (SNV) is a category of vasculitis, comprising vasculitides that present with necrosis. Examples include giant cell arteritis, microscopic polyangiitis, and granulomatosis with polyangiitis
3. interstitial nephritis inflammation of the kidneys. AKA KIDNEY FAILURE. Interstitial nephritis (or tubulo-interstitial nephritis) is a form of nephritis affecting the interstitium of the kidneys surrounding the tubules, i.e., is inflammation of the spaces between renal tubules.
3. interstitial nephritis inflammation of the kidneys. AKA KIDNEY FAILURE. Interstitial nephritis (or tubulo-interstitial nephritis) is a form of nephritis affecting the interstitium of the kidneys surrounding the tubules, i.e., is inflammation of the spaces between renal tubules.
4. necrotizing angiitis Systemic necrotizing vasculitis (SNV) is an inflammation of blood vessel walls. It typically affects small and medium vessels. This inflammation can interrupt your normal blood flow. It results in skin and muscle damage, including necrosis.
Central Nervous System Reactions
1. tinnitus and hearing loss
4. dizziness
2. paresthesias an abnormal sensation, typically tingling or pricking (“pins and needles”), caused chiefly by pressure on or damage to peripheral nerves.
5. headache
3. vertigo
6. blurred vision
7.
xanthopsia a color vision deficiency in which there is a
predominance of yellow in vision due to a yellowing of the optical
media of the eye. The most common cause is digoxin's inhibitory action
on the sodium pump, and the development of cataracts which can cause a
yellow filtering effect.
Hematologic Reactions
1. aplastic anemia a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged.[1] This causes a deficiency of all three blood cell types (pancytopenia): red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia).[2][3] Aplastic refers to inability of the stem cells to generate mature blood cells.
5. leukopenia a reduction in the number of white cells in the blood, typical of various diseases.
2. thrombocytopenia
a condition in which you have a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that help blood clot. Platelets stop bleeding by clumping and forming plugs in blood vessel injuries.
a condition in which you have a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that help blood clot. Platelets stop bleeding by clumping and forming plugs in blood vessel injuries.
6. anemia
3. agranulocytosis
also known as agranulosis or granulopenia, is an acute condition involving a severe and dangerous leukopenia (lowered white blood cell count), most commonly of neutrophils causing a neutropenia in the circulating blood. It is a severe lack of one major class of infection-fighting white blood cells.
also known as agranulosis or granulopenia, is an acute condition involving a severe and dangerous leukopenia (lowered white blood cell count), most commonly of neutrophils causing a neutropenia in the circulating blood. It is a severe lack of one major class of infection-fighting white blood cells.
7. eosinophilia an increase in the number of eosinophils in the blood, occurring in response to some allergens, drugs, and parasites, and in some types of leukemia
Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels ofeosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).
Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels ofeosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).
4. hemolytic anemia a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over. Red blood cells are disc-shaped and look like doughnuts without holes in the center. These cells carry oxygen to your body.
Dermatologic-Hypersensitivity Reactions
1. toxic epidermal necrolysis Toxic epidermal necrolysis (TEN) is a potentially life-threatening dermatologic disorder characterized by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis and/or death (see the image below). Mucous membrane involvement can result in gastrointestinal hemorrhage, respiratory failure, ocular abnormalities, and genitourinary complications.
3. erythema multiforme
6. exfoliative dermatitis
3. erythema multiforme
Erythema
multiforme (EM) is an acute, self-limited, and sometimes recurring skin
condition that is considered to be a type IV hypersensitivity reaction
associated with certain infections, medications, and other various
triggers. [1]
Erythema
multiforme may be present within a wide spectrum of severity. Erythema
multiforme minor represents a localized eruption of the skin with
minimal or no mucosal involvement
4. drug rash with eosinophilia and systemic symptoms. an increase in the number of eosinophils in the blood, occurring in response to some allergens, drugs, and parasites, and in some types of leukemia.
Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels ofeosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).
Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels ofeosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).
5. acute generalized exanthematous pustulosis (AGEP)
(also known as pustular drug eruption and toxic pustuloderma) is a rare
skin reaction that in 90% of cases is related to medication
administration. AGEP is characterized by sudden skin eruptions that
appear on average five days after a medication is started.
pustulosis or AGEP is an uncommon skin eruption characterised by superficial pustules. AGEP is usually classified as a severe adverse reaction (SCAR) to a prescribed drug.
6. exfoliative dermatitis
7. bullous pemphigoid
Bullous pemphigoid (BUL-us PEM-fih-goid) is a rare skin condition that causes large, fluid-filled blisters. The blisters develop on areas of skin that often flex — such as the lower abdomen, upper thighs or armpits. Bullous pemphigoid is most common in people older than age 60.Bullous pemphigoid occurs when your immune system attacks a thin layer of tissue below your outer layer of skin. The reason for this abnormal immune response is unknown, although it sometimes can be triggered by taking certain medications.Treatment usually includes medications, such as prednisone, and other drugs that suppress the immune system. Bullous pemphigoid can be life-threatening, especially for older people who are already in poor health.
8. purpura Purpura, also called blood spots or skin hemorrhages, refers to purple-colored spots that are most recognizable on the skin. The spots may also appear on organs or mucous membranes, including the membranes on the inside of the mouth.Purpura occurs when small blood vessels burst, causing blood to pool under the skin. This can create purple spots on the skin that range in size from small dots to large patches. Purpura spots are generally benign, but may indicate a more serious medical condition, such as a blood clotting disorder.
9. photosensitivity
10. rash
12. urticaria (AKA: hives)
Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. They may also burn or sting.
Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. They may also burn or sting.
Cardiovascular Reaction
1. Orthostatic hypotension may occur and be aggravated by alcohol, barbiturates or narcotics. defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position.
2. Increase in cholesterol and triglyceride serum levels
Other Reactions
1. hyperglycemia an excess of glucose in the bloodstream, often associated with diabetes mellitus
6. restlessness
2. glycosuria a condition characterized by an excess of sugar in the urine, typically associated with diabetes or kidney disease.
7. urinary bladder spasm
3. hyperuricemia Hyperglycemia or high blood sugar is an abnormally high blood glucose (blood sugar) level in the blood. Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes. ... The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate.
8. thrombophlebitis inflammation of the wall of a vein with associated thrombosis, often occurring in the legs during pregnancy.
4. muscle spasm
9. fever
5. weakness
Whenever adverse reactions are moderate or se
vere, LASIX dosage should be reduced or therapy
withdrawn.
8
Reference ID: 3106803
OVERDOSAGE
The principal signs and symptoms of over
dose with LASIX are dehydration, blood volume
reduction, hypotension, electrolyte imbalance, h
ypokalemia and hypochloremic alkalosis, and
are extensions of its diuretic action.
The acute toxicity of LASIX has been determined
in mice, rats and dogs. In all three, the oral
LD
50
exceeded 1000 mg/kg body weight, while the intravenous LD
50
ranged from 300 to 680
mg/kg. The acute intragastric toxicity in neonata
l rats is 7 to 10 times that of adult rats.
I hope this post may help people see why I say that the VERY FIRST thing you should do, when you are diagnosed with cirrhosis, is to look up all the drugs you or your loved one, have been prescribed.
You can print out a sheet, to keep track of the drugs, and the side effects, on this page.
http://healing-liver-cirrhosis.blogspot.com/2017/01/look-up-all-side-effects-of-all-your.html
Ellie
I hope this post may help people see why I say that the VERY FIRST thing you should do, when you are diagnosed with cirrhosis, is to look up all the drugs you or your loved one, have been prescribed.
You can print out a sheet, to keep track of the drugs, and the side effects, on this page.
http://healing-liver-cirrhosis.blogspot.com/2017/01/look-up-all-side-effects-of-all-your.html
Ellie
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