The bioavailability of oral furosemide markedly reduced in preterm infants – estimated at 20%15 compared to ~60% in adults.16 94% is plasma protein bound.15 (LOE IV GOR C)
Furosemide is primarily cleared via renal secretion (60–70%).16 Clearance is reduced in renal impairment.
Safety: Furosemide results in renal excretion of calcium, sodium, chloride and potassium.17 Prolonged and high dose use of furosemide, especially in the context of other ototoxic treatments (including aminoglycosides), has been associated with ototoxicity.18–20 Blood concentrations exceeding 0.05 mg/mL may be associated with ototoxicity.14 (LOE III-2 GOR B). Prolonged furosemide treatment and treatment combined with acetazolamide is associated with nephrocalcinosis.10, 21 (LOE I GOR B)
Alternate day furosemide may be associated with a lower risk of electrolyte and mineral abnormalities.23
References
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1. O'Reilly PH, Consensus Committee of the Society of Radionuclides in N. Standardization of the renogram technique for investigating the dilated upper urinary tract and assessing the results of surgery. BJU Int. 2003;91:239-43.
2. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al, American College of C, American Heart Association Task Force on Practice G, American College of Chest P, International Society for H, Lung T, Heart Rhythm S. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154-235.
3. Stewart A, Brion LP. Intravenous or enteral loop diuretics for preterm infants with (or developing) chronic lung disease. Cochrane Database Syst Rev. 2011:CD001453.
4. Brion LP, Primhak RA, Yong W. Aerosolized diuretics for preterm infants with (or developing) chronic lung disease. Cochrane Database Syst Rev. 2006:CD001694.
5. Kassab M, Khriesat WM, Anabrees J. Diuretics for transient tachypnoea of the newborn. Cochrane Database Syst Rev. 2015;11:CD003064.
6. Stewart A, Brion LP, Soll R. Diuretics for respiratory distress syndrome in preterm infants. Cochrane Database Syst Rev. 2011:CD001454.
7. Balegar VK, Kluckow M. Furosemide for packed red cell transfusion in preterm infants: a randomized controlled trial. J Pediatr. 2011;159:913-8.e1.
8. Brion LP, Campbell DE. Furosemide for symptomatic patent ductus arteriosus in indomethacin-treated infants. Cochrane Database Syst Rev. 2001:CD001148.
9. Lee BS, Byun SY, Chung ML, Chang JY, Kim HY, Kim EA, Kim KS, Pi SY. Effect of furosemide on ductal closure and renal function in indomethacin-treated preterm infants during the early neonatal period. Neonatology. 2010;98:191-9.
10. Whitelaw A, Kennedy CR, Brion LP. Diuretic therapy for newborn infants with posthemorrhagic ventricular dilatation. Cochrane Database Syst Rev. 2001:CD002270.
11. Alqahtani F, Koulouridis I, Susantitaphong P, Dahal K, Jaber BL. A meta-analysis of continuous vs intermittent infusion of loop diuretics in hospitalized patients. J Crit Care. 2014;29:10-7.
12. Salvador DR, Rey NR, Ramos GC, Punzalan FE. Continuous infusion versus bolus injection of loop diuretics in congestive heart failure. Cochrane Database Syst Rev. 2005:CD003178.
13. Wu MY, Chang NC, Su CL, Hsu YH, Chen TW, Lin YF, Wu CH, Tam KW. Loop diuretic strategies in patients with acute decompensated heart failure: a meta-analysis of randomized controlled trials. J Crit Care. 2014;29:2-9.
14. Pacifici GM. Clinical pharmacology of the loop diuretics furosemide and bumetanide in neonates and infants. Paediatr Drugs. 2012;14:233-46.
15. Peterson RG, Simmons MA, Rumack BH, Levine RL, Brooks JG. Pharmacology of furosemide in the premature newborn infant. J Pediatr. 1980;97:139-43.
16. Van Wart SA, Shoaf SE, Mallikaarjun S, Mager DE. Population-based meta-analysis of furosemide pharmacokinetics. Biopharm Drug Dispos. 2014;35:119-33.
17. Atkinson SA, Shah JK, McGee C, Steele BT. Mineral excretion in premature infants receiving various diuretic therapies. J Pediatr. 1988;113:540-5.
18. Borradori C, Fawer CL, Buclin T, Calame A. Risk factors of sensorineural hearing loss in preterm infants. Biol Neonate. 1997;71:1-10.
19. Robertson CM, Alton GY, Bork KT, Joffe AR, Tawfik GC, Sauve RS, Moddemann DM, Ross DB, Rebeyka IM. Bilateral sensory permanent hearing loss after palliative hypoplastic left heart syndrome operation. Ann Thorac Surg. 2012;93:1248-53.
20. Robertson CM, Tyebkhan JM, Peliowski A, Etches PC, Cheung PY. Ototoxic drugs and sensorineural hearing loss following severe neonatal respiratory failure. Acta Paediatr. 2006;95:214-23.
21. Gimpel C, Krause A, Franck P, Krueger M, von Schnakenburg C. Exposure to furosemide as the strongest risk factor for nephrocalcinosis in preterm infants. Pediatr Int. 2010;52:51-6.
22. Pacifici GM. Clinical Pharmacology of Furosemide in Neonates: A Review. Pharmaceuticals 2013;6:1094-1129.
23. Rush MG, Engelhardt B, Parker RA, Hazinski TA. Double-blind, placebo-controlled trial of alternate-day furosemide therapy in infants with chronic bronchopulmonary dysplasia. J Pediatr. 1990;117:112-8.
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