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Furosemide (Lasix) Side Effects & Generic Troubles

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Furosemide is a "loop" diuretic, meaning that it affects a special part of the kidney called the loop of Henle to facilitate salt elimination from the body along with extra fluid. This "water pill" not only kicks sodium out of the body (considered a beneficial action), it also promotes removal of other key minerals such as magnesium, potassium and calcium (an undesired consequence).

FUROSEMIDE QUESTIONS TO THE PEOPLE'S PHARMACY:

Q. As part of the medications I take for high blood pressure, I take Lasix two times per day, 40 mg each.

I am concerned as I just read that Lasix can potentially cause kidney damage or gout when taken over a period of time. I am very concerned that I have never been told about these serious side effects from my doctor. Are they true?

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Q. My Husband's doctor is concerned about his blood pressure. It has been fine until three days ago when at the doctor's office it was 140/80. (When we got home it was 125/75). The doctor doubled his dose of furosemide.

I frankly am afraid he is going to end up in the hospital! I would like to learn more about this drug. My husband fortunately works close to home; he sometimes urinates on himself because he can't always make it to the bathroom in time. He does operate heavy equipment at times and the dizziness thing is scary too. Please tell us more about furosemide.

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I take prescribed 20 mg Lasix twice a day. One doctor says to take potassium with it, but another doctor says no. I don't know what to do.

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Q. My wife (54 years old) started furosemide 20 mg twice a day for fluid retention. It has helped with that, but has caused hearing loss in both ears. She has been told to stop for two weeks and see her doctor for blood work afterwards

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Q. I have a very good friend who suffers from serious heart problems. He had a pacemaker implanted many years ago. That was replaced with a defibrillator pacemaker. He has been taking many medications for his heart problems, including furosemide (Lasix). He was diagnosed with diabetes about three years ago.

A few months ago, he was taken to the ER when he became very short of breath. They ran many tests and one doctor switched him from Lasix to torsemide (Demadex). Ever since this change, his blood sugar has been completely normal. Is diabetes a side effect of Lasix?

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FUROSEMIDE SIDE EFFECTS:

As you can see from the questions above, this diuretic is associated with a number of complications. Because it is a water pill (eliminates fluid from the body), it can cause numerous trips to the bathroom. As one reader reported above, it led to incontinence for her husband at work. Others complain that they have to get up numerous times a night to pee. More serious is dizziness. The same wife who worried that her husband had "accidents" at work also mentioned that he handled heavy equipment. The dizziness brought on by Lasix is very troublesome for someone in such a situation.

We also worry about depletion of potassium and magnesium. These electrolytes are essential for muscle function. When they are depleted from the body, muscle cramps are not an uncommon complication. Irregular heart rhythms can also occur and this can be a life-threatening situation if not corrected. Anyone on furosemide must have regular blood tests to make sure electrolytes don't get out of whack. In some cases potassium and magnesium supplements are necessary, but they require medical supervision and close monitoring to make sure the levels are like Goldilocks and the porridge (not too hot or too cold...too much or too little).

Other concerns mentioned above include hearing loss, gout and diabetes. These complications are all linked to Lasix.

Here are some other side effects to be alert for:

• Weakness, muscle cramps (linked to electrolyte depletion)
• Dehydration
• Irregular heart rhythms (contact an MD immediately)
• Dizziness, low blood pressure, especially when standing suddenly
• Ringing in ears, hearing loss (contact an MD immediately)
• Blood problems (contact a physician if bruising or anemia occurs)
• Blurred vision
• Skin rash, itching (potentially life threatening, contact an MD immediately!)
• Elevated uric acid levels, gout
• Elevated blood sugar, diabetes
• Increases in cholesterol levels and triglycerides
• Kidney damage

No one should ever stop furosemide suddenly without medical supervision. This drug is essential for certain heart patients, especially those with congestive heart failure. Keeping excess fluid under control is critical for such patients. But furosemide is a tricky drug and requires very close monitoring by an attentive health care provider. The drug can also interact dangerously with dozens of other medications, so the pharmacist must check any other medicine that is taken to make sure there are no incompatibilities.

FUROSEMIDE & GENERIC DRUG PROBLEMS

We have received a number of complaints that not all generic furosemide is created equal. We are especially worried about this problem for people with heart failure. If their medicine is not working as anticipated, it can lead to fluid accumulation and serious complications. We fear that the FDA has not been as vigilant about monitoring generic drugs as most health professionals think. Here are just a few stories for your consideration. If you suspect that your generic furosemide is not working as intended, let your physician and pharmacist know that this is a problem other people have encountered.

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"I have mild congestive heart failure and real bad edema, with my left leg especially. I take 80 mg Lasix twice a day. The brand name works quite well. Some of the generic furosemide seems to work but it seems to have a wide range of effectiveness from manufacturer to manufacturer.

"The generic furosemide that my mail order pharmacy sends me seems to do little or nothing. I may as well be taking chalk tablets. On this stuff I retained so much water that I would gain about 15-20 lbs or more and have shortness of breath. My legs would swell up badly. I have to keep a Lasix prescription at the local pharmacy and pay for it out of my own pocket to avoid problems."

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"I take furosemide, 20 mg tablets, and for a long time took Mylan brand generic. Then the pharmacy switched me to brand XXX generic. I immediately began 'drowning,' and my weight jumped 5 lbs overnight. I fortunately had some Mylan brand still on hand, switched back, lost the water, and three days later tried the brand XXX again. Same result. I am on an assigned Medicare Part D Plan, and as a result the Mylan has to be special-ordered and approved for me to get it.

"These are both generic forms of the same drug, but even among generics there are big differences. A major concern is that while I recognized the problem and took immediate action (and then tested the problem out again), there are a lot of elderly people on furosemide, for instance, who would not understand this type of problem with the pill. They could end up seriously ill, with their doctors blaming them for 'non-compliance' problems: "Mrs. D is not taking her furosemide as directed," when in fact it was the drug manufacturer at fault."

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Share your story about furosemide (Lasix) below. Has it worked well for you? Have you experienced any side effects? Have you had any problems with generic formulations?Others may benefit from your comments.

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Before I retired as a pharmacist, the two generic drugs that I received the most complaints about were generic Lasix and generic Ritalin.

Diagnosed with CHF and on Medicare, I was given generic Lasix, known as furosemide. Over time, this led to copious amounts of fluid retention in my abdomen and a terminal prognosis. My physical discomfort was only relieved through paracentesis (having the fluid manually drained by the hospital's radiologist) once every two weeks, along with discontinuing all medication. After six months of this treatment, I no longer retained fluid, followed a strict low-sodium diet, and now I feel fine.

I'm admittedly very overweight, but my BP at home runs between 120/70 and 130/80. However, at Dr office it's usually much higher on the first take but lowers on the second one. Last fall Dr finally told me to talke lasix (have significant problems with most other BP meds he has prescribed). After being on generic lasix for a couple days I developed difficulty passing urine and my left ankle became extremely swollen. I quit taking the stuff and reported the same to the Doc.

Dear Mr. & Mrs. Graedon: The information you give to all of us is priceless. You have saved an innumerable number of people, young and old,
from many, many problems - The People's Pharmacy News report is the only one I believe without question.

I know you must sleep well at night.
God bless . From a grateful Canadian.

PEOPLE'S PHARMACY RESPONSE:

Dear B.C.

You are so kind to take a few minutes out of your busy day to send us such a thoughtful message. It really means a lot and is what keeps us going.

Joe & Terry

Furosimide also poses an increased risk for osteoporosis by its inhibition of calcium re-absorption.

My husband took Furosimde for many years. We now know the Cardiologist who is caring for my husband was taking too many drugs that were not beneficial to him including Furosided. He was like a Zombie, just wanted to sit and do nothing.

After this Cardiologist took my husband off this drug, plus others, plus prescribing something else and reducing the amounts in other drugs, he miraculously became alive again. He is now 86 years old, has survived two dangerous life threatening surgeries, including a heart replacement one. He is now very active and building things like he use to that he loved to do. Does many tasks and does not want to sleep all day, eats well and so many other things.

I am hoping people who take this drug and many others that you have written about take heed and ask their Doctors to check their drugs out very carefully. When my husband had the heart surgery, he wasn't recovering well, I found out that he was taking this and other drugs that he shouldn't have been. Cardiologist immediately started checking out what I had found and was amazed that all those other Drs. were not checking his meds, dosage, etc.

Once again Dr. Gradeon and Mr. Gradeon, Thanks for such a wonderful column and all the information you write about alerting and showing us so many natural remedies to use instead of harmful drugs. Sincerely, Mrs W.

Some years ago I was hospitalized for two and a half months (part of the time in a coma) and was given Lasix to keep fluid retention at a minimum. I took it for a short while after coming home but then stopped. I now attribute my present problems to that time in the hospital.

Shortly after coming home I developed ringing in BOTH ears at the same time, hearing loss in BOTH ears at the same time, prediabetes which developed into type-2 even after diet changes, and high uric acid levels which developed into gout.

I have always been careful with my cooking and diet because my husband has high cholesterol and high blood pressure and it puzzled me that these things happened to me in a relatively short period of time.

Thank heaven for both of you and your column. It helps tremendously to know that when I need to check on something I will often find the answer on your website [www.peoplespharmacy.com]. Thank you.

PEOPLE'S PHARMACY RESPONSE:

Thank you for taking time to share such a thoughtful comment.

Hi. I was on Lasix (furosemide) for several years. I began taking it several years ago after I had severe, and painful, idiopathic edema in both legs. Since that time I have lost nearly 130 pounds (115 in the last 12 months), and requested my physician remove me from this and a couple other medications. She agreed, but now I have a problem. I had noticed before, when I would miss my morning meds, or take them a good bit later than normal, I had strange and uncomfortable side-effects, including the sensation of hot/cold cycling and general malaise. Last night I couldn’t sleep until I took some Benadryl and NyQuil to knock myself out. I am still slightly uncomfortable and have ringing in my ears. I don’t know how to make this better other than to 1) weather it out…oy… or 2) go back on the Lasix. I am the Queen of odd side-effects lol.

I have congenital bilateral lymphedema and have taken 40mg of lasix 3x daily for decades as successful treatment for this condition. I maintain potassium levels effectively through diet and supplements. I have never been able to take the generic version of lasix as it simply never works - tried numerous times to no avail. A year and a half ago I had a partial pancreatectomy and splenectomy and in Nov had a total knee replacement.

Everything went well for both until a few weeks after knee surgery when I broke out in hives that were difficult to treat and took 2 months and cortisone pack along with antihistimines to control. It just recently returned.

After getting blood tests back that showed possible chronic kidney disease I started doing research and found that lasix may be a factor in the complexity of what is now happening. I don't know how else to treat the lymphedema problem so that it is managed and not be impacted by the medication.

I am a proponent for alternative health and take probiotics, digestive enzymes and get weekly acupuncture treatments that have helped tremendously.
And I have a proactive and highly intelligent physician and am working with head of dermatology at Cleveland Clinic to treat recent rashes. Ultimately, this is a complex constellation of conditions that is a challenge in treating effectively.

My mother is 91 and I live with her. She has severe pain from neuroprophy (sp) both legs knees down and terrible pain and swelling. She takes pain meds when swelling is at it's height. 20 mg Lasix once day. Usually gets dizzy and has tinnitus even when not on water pill. Does Gatorade help with loss of salt and electrolytes? Drinking this, will it possibly keep these side effects at bay, since she is extreme fall risk? What other food or drink will or can assist with side effects, pls

I took Lasix for many years and did develop gout. I've been taking Allopurinol ever since. I completely stopped the Lasix a couple of years ago. Do you think I could stop the Allopurinol?

I had been on furosemide 40mg for about ten years. I was put on this medicine for high blood pressure and swelling of the legs and ankles. My doctor has retired and I was forced to find another doctor, who now has taken me off of furosemide. It has caused kidney damage also vertigo.

If I had continued to take furosemide, I would now probably be pushing up daisies.

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