Diuretics, Loop (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For loop diuretics, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to bumetanide, ethacrynic acid, furosemide, sulfonamides (sulfa drugs), or thiazide diuretics (water pills). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Studies have not been done in pregnant women. However, studies in animals have shown this medicine to cause harmful effects.

In general, diuretics are not useful for normal swelling of feet and hands that occurs during pregnancy. Diuretics should not be taken during pregnancy unless recommended by your doctor.

Breast-feeding - These medicines have not been reported to cause problems in nursing babies. Furosemide passes into breast milk; it is not known whether bumetanide or ethacrynic acid passes into breast milk.

Children - Although there is no specific information comparing the use of loop diuretics in children with use in any other age group, these medicines are not expected to cause different side effects in children than they do in adults.

Older adults - Dizziness, lightheadedness, or signs of too much potassium loss may be more likely to occur in the elderly, who are more sensitive to the effects of this medicine. Elderly patients may also be more likely to develop blood clots.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking loop diuretics, it is especially important that your health care professional know if you are taking any other medicines.

Other medical problems - The presence of other medical problems may affect the use of loop diuretics. Make sure you tell your doctor if you have any other medical problems, especially:

• Diabetes mellitus (sugar diabetes) - Loop diuretics may increase the amount of sugar in the blood

• Gout or
• Hearing problems or
• Pancreatitis (inflammation of the pancreas) - Loop diuretics may make these conditions worse

• Heart attack, recent - Use of loop diuretics after a recent heart attack may increase the chance of side effects

• Kidney disease (severe) or
• Liver disease - Higher blood levels of the loop diuretic may occur, which may increase the chance of side effects

• Lupus erythematosus (history of) - Ethacrynic acid and furosemide may make this condition worse