呋塞米
Furosemide
4-chloro-2-(furan-2-ylmethylamino)-5-sulfamoylbenzoic acid
別名: Lasix · Salix · Disal · Dimazon · Frusecare · Frusedale · Libeo · Frusol · frusemide · furosemidum · LB-502
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Injection
須由已驗證獸醫確認
組合給藥限制（全部適用）
- q12-24h
- q6-8h
NA
必須一併考量的臨床脈絡 (2)
- NOTE: Watch units closely when calculating doses. Do not confuse CRI dosages using mg/kg/hour with μg/kg/minute.
- Furosemide injection should be stored at room temperature. A precipitate may form if the injection is refrigerated, but it will resolubilize when warmed without alteration in potency. The human injection (10 mg/mL) should not be used if it has a yellow color. The veterinary injection (50 mg/mL) normally has a slight yellow color.
Adjunctive therapy for systemic hypertension
- q8-24h
NA
必須一併考量的臨床脈絡 (3)
- NOTE: Watch units closely when calculating doses. Do not confuse CRI dosages using mg/kg/hour with μg/kg/minute.
- ■ Furosemide may be given with or without food. If your animal vomits or acts sick after receiving this medicine on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.
- Store furosemide protected from light at room temperature up to 25°C (77°F). Furosemide tablets should be protected from moisture and stored in light-resistant, well-closed containers. Tablets may discolor with exposure to light, and discolored tablets should be discarded. The oral solution should be stored at room temperature and protected from light and freezing; discard opened bottles after 90 days.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
呋塞米（Furosemide）是一種強效且起效迅速的袢利尿劑，在獸醫學中廣泛用於管理體液過載的情況。它是治療多種動物充血性心力衰竭 (CHF) 和肺水腫的基石。透過促進大量排尿，它能迅速降低心臟前負荷並緩解靜脈充血。
除了主要的心臟應用外，呋塞米還用於：
- 少尿性腎衰竭： 將少尿轉化為多尿並促進尿液流動。
- 高血鈣症： 促進腎臟排泄鈣（需要事先進行體液擴充）。
- 運動誘發性肺出血 (EIPH)： 在賽馬中作預防性使用以減少鼻出血。
- 乳房水腫： FDA 批准用於牛隻產後。
由於其藥效強大，呋塞米可能導致顯著的體液和電解質變化，因此必須仔細監測水合狀態和血清電解質（尤其是鉀）。
作用機轉
Furosemide acts primarily on the thick ascending limb of the loop of Henle in the nephron.
- Inhibition of NKCC2: It reversibly binds to and inhibits the Na⁺/K⁺/2Cl⁻ cotransporter on the luminal membrane → prevents the reabsorption of sodium, potassium, and chloride.
- Loss of Medullary Hypertonicity: This disruption abolishes the hypertonic medullary interstitium → impairs the kidney's ability to concentrate urine → results in profound, dose-dependent diuresis.
- Electrolyte Excretion: It significantly increases the renal excretion of water, Na⁺, K⁺, Cl⁻, Ca²⁺, Mg²⁺, H⁺, NH₄⁺, and bicarbonate.
- Hemodynamic Effects: Furosemide induces mild renal venodilation and transiently increases glomerular filtration rate (GFR) via prostaglandin release. This venodilation provides rapid relief in acute cardiogenic pulmonary edema, often before the onset of significant diuresis.
安全性與警告
禁忌症
- Anuria
- Hypersensitivity to furosemide
- Progressive renal disease if increasing azotemia and oliguria occur during therapy
- Seriously depleted electrolytes
- Severe dehydration
- Severe electrolyte depletion
- Hepatic coma
- Pericardial effusion where cardiac tamponade is confirmed
不良反應
- Fluid and electrolyte abnormalities (hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia)
- Prerenal azotemia (secondary to dehydration)
- Ototoxicity (especially in cats with high-dose IV therapy)
- Gastrointestinal distress
- Hematologic effects (anemia, leukopenia)
- Weakness and restlessness
- Hypokalaemia
- Hypochloraemia
- Hypocalcaemia
- Hypomagnesaemia
- Hyponatraemia
- Polyuria/polydipsia (PU/PD)
- Prerenal azotaemia
- Gastrointestinal disturbances
- Leucopenia
- Anaemia
- Electrolyte depletion (hypokalemia, hyponatremia, hypochloremia)
- Polyuria and polydipsia
注意事項
Use with caution in patients with pre-existing electrolyte or water balance abnormalities, impaired hepatic function (may precipitate hepatic coma), and diabetes mellitus. Monitor carefully in patients with conditions leading to fluid loss (e.g., vomiting, diarrhea). Patients hypersensitive to sulfonamides may also be hypersensitive to furosemide. Ensure animals have normal food and water intake to prevent imbalances.
藥物交互作用
Increased risks for hypotension, particularly in patients who are volume or sodium depleted secondary to diuretics
Increased risk for ototoxicity
Loop diuretics may increase the risk for nephrotoxicity development; hypokalemia
Increased risk for GI ulceration; hypokalemia
Furosemide-induced hypokalemia may increase the potential for digoxin toxicity
Furosemide may alter insulin requirements
Furosemide may prolong neuromuscular blockade
Furosemide can reduce uricosuric effects
Loop diuretics can reduce the excretion of salicylates
Furosemide may potentiate effects
Pharmacologic effects of theophylline may be enhanced when used with furosemide
Potentiates nephrotoxicity and ototoxicity
Increased risk of hypokalaemia
Increased risk of hypokalaemia
Decreased diuretic efficacy and predisposes to nephrotoxicity, particularly with poor renal perfusion
Inhibits muscle relaxation qualities
Increases the effects of suxamethonium
Increased risk of hypotension and renal impairment; however, concurrent use is standard of care for heart failure with appropriate monitoring.
Increased risk of ototoxicity and nephrotoxicity.
監測
- Serum electrolytes (especially potassium, sodium, calcium, magnesium)
- Blood glucose
- Hydration status
- Blood pressure, if indicated
- Clinical signs of edema, patient weight, if indicated
- Evaluation of ototoxicity, particularly with prolonged therapy or in cats
- Resting respiratory rate (at home by owner)
- Serum electrolytes (Potassium, Sodium, Chloride, Calcium, Magnesium)
- Renal parameters (BUN, Creatinine)
- Clinical signs of ototoxicity (especially in cats)
- Serum electrolytes (especially Potassium, Sodium, Chloride)
- Renal function (BUN, Creatinine)
- Clinical signs of edema/heart failure resolution
藥物動力學
半衰期
吸收
In dogs, oral bioavailability is approximately 77%. In humans, 60-75% absorbed following oral administration. Diuretic effect takes place within 5 minutes after IV administration and within 1 hour after oral dosing. Peak effects occur ~30 minutes after IV and 1-2 hours after PO.
分佈
Approximately 95% bound to plasma proteins in both azotemic and normal patients.
代謝
Undergoes some hepatic metabolism (glucuronidation).
排除
Excreted primarily via the kidneys.
過量
The LD50 in dogs after oral administration is >1000 mg/kg; after IV injection >300 mg/kg. Chronic overdosing at 10 mg/kg for six months in dogs led to development of calcification and scarring of the renal parenchyma.
Acute overdosage may cause severe electrolyte and water balance problems, CNS effects (ranging from lethargy to coma and seizures), and cardiovascular collapse.
Treatment:
- Empty the gut after recent oral ingestion using standard protocols.
- Avoid concomitant cathartics as they may exacerbate fluid and electrolyte imbalances.
- Aggressively monitor and treat electrolyte and water balance abnormalities supportively.
- Monitor respiratory, CNS, and cardiovascular status.
可用產品
劑型
- Oral Solution (Syrup)
- Injection
- Oral tablets
- Injectable solution (IV/IM/SC)
- Injectable: 50 mg/ml solution
- Oral: 10 mg tablet
- Oral: 20 mg tablet
- Oral: 40 mg tablet
- Oral: 20 mg/5 ml sugar-free solution
- Oral: 40 mg/5 ml sugar-free solution
- Oral: 50 mg/5 ml sugar-free solution
獸醫用
- Furosemide Tablets: 12.5 mg, & 50 mg; Salix, Disal, generic
- Furosemide Oral Solution (Syrup): 10 mg/mL in 60 mL; generic
- Furosemide for Injection: 50 mg/mL (5%) in 50 mL & 100 mL vials; Disal Injection, Salix Injection, generic
- Dimazon 10 mg, 50 mg tablets
- Dimazon 5% injectable solution
- Frusecare 40 mg tablets
- Frusedale 40 mg tablets
- Libeo 10 mg, 40 mg chewable tablets
人用標示
- Furosemide Oral Tablets: 20 mg, 40 mg, & 80 mg; Lasix; generic
- Furosemide Oral Solution: 10 mg/mL in 60 mL & 120 mL; 40 mg/5 mL in 500 mL & UD 5 mL & 10 mL; generic
- Furosemide Injection: 10 mg/mL in 2 mL (20 mg), 4 mL (40 mg) & 10 mL (100 mg) single-dose vials; generic
- Lasix 20 mg, 40 mg tablets
- Lasix oral solution
- Lasix injectable solution
- Frusol
各地核准狀態
POM-V classification in the UK.
POM-V, POM.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Tablets should be stored in light-resistant, well-closed containers. Oral solution should be stored at room temperature and protected from light and freezing. Injection should be stored at room temperature. A precipitate may form if the injection is refrigerated, but will resolubilize when warmed without alteration in potency. Unstable at an acid pH, but very stable under alkaline conditions.
飼主須知
呋塞米（通常以商品名 Lasix 為人所知）是一種強效的利尿劑或「水丸」，用於幫助您的寵物排出體內多餘的水分。它最常被開立用於治療心力衰竭或肺部積水。
重要提示： 因為這種藥物會從體內排除水分，您的寵物排尿次數會明顯增加，尿量也會變大。請務必確保您的寵物隨時有充足的新鮮飲水，以防止嚴重脫水。
- 居家監測： 如果您的寵物正在接受心臟病治療，獸醫可能會要求您計算寵物的休息呼吸頻率（睡眠時每分鐘的呼吸次數）。這是確保藥物劑量正確的關鍵工具。
- 何時聯繫獸醫： 如果您注意到脫水或電解質不平衡的跡象，例如過度口渴極度嗜睡、虛弱、焦躁不安、排尿減少、嘔吐或心跳過快，請立即聯繫您的獸醫。
- 給藥： 請嚴格遵循獸醫的給藥指示。在未諮詢獸醫的情況下，請勿自行更改劑量，因為清除積水和導致脫水之間的平衡非常微妙。
VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠商最新仿單。