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Pharmacokinetics.

When administered, the bioavailability is 64%. Cmax increases with increasing dose, but the time to reach the maximum does not depend on the dose and varies widely, depending on the patient’s condition. T1 / 2 – about 2 hours In plasma, 91-99% binds to the protein, 2,4-4,1% is in a free state. Biotransformed, mainly in glucuronide.
It is excreted in the urine (after / in the injection more than when ingestion).

The onset of a diuretic effect upon ingestion is already observed within 1 hour, the maximum of action is 1-2 hours, the duration is 6-8 hours. With IV introduction, the onset of action is in 5 minutes, a maximum after 30 minutes, duration is about 2 hours With IV introduction causes the expansion of veins, quickly reduces preload, reduces pressure in the left ventricle and pulmonary artery system, reduces systemic pressure.

Method of administration and dose.

When prescribing Lasix®, it is recommended to use its lowest doses, sufficient to achieve the desired therapeutic effect.
The drug is administered intravenously and in exceptional cases intramuscularly (when intravenous or drug administration is not possible). Intravenous administration of the drug Lasix® is carried out only when,
when taking the drug inside is not possible or there is a violation of absorption of the drug in the small intestine or if it is necessary to obtain the most rapid effect. When using the intravenous drug Lasix®, it is always advisable to transfer the patient as early as possible to oral Lasix®.
When administered intravenously, Lasix® should be administered slowly. The rate of intravenous administration should not exceed 4 mg per minute. In patients with severe renal failure (serum creatinine> 5 mg / dl), it is recommended that the intravenous rate of Lasix® does not exceed 2.5 mg per minute.
To achieve optimal efficiency and suppress counter-regulation (activation of the renin-angiotensin and antinatriuretic neurohumoral regulating units), a prolonged intravenous infusion of the Lasix® preparation should be preferred as compared to repeated intravenous bolus administration of the drug.
If, after one or more bolus intravenous injections in acute conditions, there is no possibility of a continuous intravenous infusion, it is more preferable to administer low doses with small intervals between administrations (after about 4 hours),
than intravenous bolus administration of higher doses with large intervals of time between administrations.
Solution for parenteral
The introduction has a pH of about 9 and does not have buffer properties. At pH below 7, the active ingredient may fall into the sediment, so when diluting the Lasix® preparation,
so that the pH of the resulting solution ranged from neutral to slightly alkaline. You can use physiological saline for breeding. The diluted solution of the preparation Lasix® should be used as early as possible. The recommended maximum daily dose for intravenous administration for adults is 1500 mg.
In children, the recommended dose for parenteral administration is 1 mg / kg body weight (but not more than 20 mg per day). The duration of treatment is determined by the doctor individually, depending on the indications.

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