Furosemide Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

High pH: Administer via a central venous access device or via large peripheral vein
For Y-site compatibility see below

Furosemide 50mg per 5ml ampoule

Furosemide injection 20mg per 2ml ampoule

Already in solution

Draw up using a 5 micron filter needle

Sodium chloride 0.9%

Intermittent intravenous infusion (administer using an electronically controlled infusion device)

May be given diluted in any volume of sodium chloride 0.9% (e.g. 50ml)(ref 1), however the rate of administration must not exceed 4mg per minute (i.e. 40mg in 10 minutes, 80mg in 20minutes, 120mg in 30minutes)
If a 50ml infusion volume is used the residual volume in the infusion line must be flushed through at the same rate to avoid significant underdosing
Maximum rate of administration in severe renal impairment (serum creatinine greater than 440micromol/L) is 2.5mg per minute

Continuous intravenous infusion (administer using an electronically controlled infusion device)

May be given diluted in any volume of sodium chloride 0.9% and administered as a continuous infusion, rate adjusted according to the dose required (maximum rate 4mg per minute)
Can also be given undiluted (ref 1)
Maximum rate of administration in severe renal impairment (serum creatinine greater than 440micromol/L) is 2.5mg per minute

Slow intravenous injection (doses of up to 50mg): Not advised. Rate makes this impractical.

Administer at a maximum rate of 4mg per minute
Maximum rate of administration in severe renal impairment (serum creatinine greater than 440micromol/L) is 2.5mg per minute.

Usual dose

A dose of 20 to 50mg may be given initially, increased if necessary in steps of 20mg, the increases not more often than every 2 hours. (according to BNF)
The interval between doses is a clinical decision based on the patient status and response to treatment
The maximum licensed dose by the IV route is 1500mg per day.

Renal impairment

Furosemide may precipitate in solutions of low pH and therefore sodium chloride 0.9% is the ONLY suitable infusion fluid
Rapid administration (greater than 4mg/min) and high doses may cause tinnitus and deafness (ref 1)
To achieve optimum efficacy and suppress counter regulation, a continuous infusion is preferred to repeated bolus injections
Formerly known as frusemide

20mg/2ml, 50mg/2ml Accord SPC December 2021

Lasix 20mg/2ml SPC August 2021

1: Injectable Medicines Administration Guide Medusa downloaded 10th Oct 2022

Loop diuretic