Furosemide
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied Health
• This diuretic drug is known to deplete potassium and magnesium levels. Discuss supplementation with your physician or pharmacist.1
• Other nutrients may be lost due to increased urinary excretion. Supplementation with zinc, vitamin B1, vitamin B6, riboflavin (B2), and vitamin C may be necessary. Consult with your pharmacist for more information about vitamin and mineral supplementation.2
• Furosemide may interact with herbs that have cardiac properties: black hellebore, calamus, cereus, cola, coltsfoot, devil's claw, European mistletoe, fenugreek, fumitory, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, pleurisy root, squill bulb leaf scales, white horehound, mate, scotch broom flower, shepherd's purse, and wild carrot3
• Cascara Sagrada, Rhubarb and Senna may increase potassium loss caused by Furosemide.4
• Avoid natural Licorice products which may contribute to fluid retention.5
• These herbs may have diuretic properties which may intensify the effects of furosemide: Alfalfa, Angelica, Astragalus, Basil, Bean Pod, Buckthorn, Burdock, Butcher’s Broom, Buchu, Celery, Cleavers, Cornflower, Dandelion, Elecampane, Elder, Goat's Rue, Hempnettle, Horsetail, Indian-Hemp, Juniper, Marigold, Meadowsweet, Parsley, Rauwolfia, Sarsaparilla, Sweet clover, Turmeric, and Vervain.6
References1 Whang R, Whang DD, Ryan MP. Refractory potassium repletion--a consequence of magnesium deficiency. Arch Intern Med 1992;152:40-45.
1 Martin B, Milligan K. Diuretic-associated hypomagnesiumia in the elderly. Arch Intern Med 1987;147:1768-71.
1 Quamme GA: Renal magnesium handling--New insights in understanding old problems, Kidney Int, 1997, 52(5):1180-95.
1 Schwinger RH, Erdmann E: Heart failure and electrolyte disturbances, Methods Find Exp Clin Pharmacol, 1992, 14(4):315-25.
1 Linderman RD: Hypokalemia--causes, consequences, and correction, Am J Med Sci, 1976, 272(1):5-17.
1 Lucker PW, Witzmann HK: Influence of magnesium and potassium deficiency on renal elimination and cardiovascular function demonstrated by impedance cardiography, Magnesium, 1984, 3(4-6):265-73.
2 Roe, DA: Handbook on Drug and Nutrient Interactions, 5th edition, 1994.
2 Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90.
2 Suki WN, Yium JJ, Von Minden M, et al: Acute treatment of hypercalcemia with furosemide, N Engl J Med, 1970, 283(16):836-40.
2 Brady JA, Rock CL, Horneffer MR: Thiamin status, diuretic medications, and the management of congestive heart failure, J Am Diet Assoc, 1995, 95(5):541-4.
2 Seligmann H, Halkin K, Rauchfleisch S, et al: Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy - a pilot study, Am J Med, 1991, 91(2):151-5.
2 Mydlik M, Derzsiova K, Zemberova E, et al: The effect of furosemide on urinary excretion of oxalic acid, vitamin C and vitamin B6 in chronic kidney failure, Vnitr Let, 1998, 44(3):127-31.
2 Mydlik M, Derzsiova K, Zemberova E, et al: Metabolism of vitamin B6 and its requirement in chronic renal failure, Kidney Int Suppl, 1997, 62:S56-9.
2 Wester PO: Urinary zinc excretion durign treatment with different diuretics, Acta Med Scand, 1980, 208(3):209-12.
3 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
3 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
3 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
4 De Smet PAGM et al: Adverse effects of herbal drugs 2, 1993.
4 Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
5 Wichtl M: Herbal Drugs and Phytopharmaceuticals, 1994.
5 Shintani S, Murase H, Tsukagoshi H, Shiigai T. Glycyrrhizin (licorice)-induced hypokalemic myopathy. Report of two cases and review of the literature. Eur Neurol 1992;32:44-51.
6 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
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Disclaimers
The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.
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