Show
26 May 2019
Topic(s):
Pharmacology and Pharmacotherapy
Athens, Greece – 26 May 2019: Drug therapy for patients with stable heart failure can be simplified by stopping diuretics, according to late breaking results from the ReBIC-1 trial presented today1 at Heart Failure 2019, a scientific congress of the European Society of Cardiology (ESC).
Diuretics are commonly prescribed for symptom relief in patients with heart failure. The drugs get rid of the excess fluids (congestion) which cause shortness of breath, swollen legs, coughing, and weight gain. Once the symptoms have resolved, patients are maintained on a low dose due to concerns that symptoms may return. Observational research has shown that long-term diuretic use is associated with a worse prognosis. The ReBIC-1 trial examined the safety and tolerability of withdrawing the diuretic furosemide in outpatients with stable chronic heart failure. The trial was conducted by the Brazilian Research Network in Heart Failure (ReBIC), which includes 11 tertiary care university hospitals in Brazil. Eligible criteria were: no or mild symptoms (defined as New York Heart Association functional class I to II), reduced left ventricular ejection fraction (45% or below), no heart failure-related hospital admission within the last six months, and receiving low-dose furosemide (40 to 80 mg per day) for at least six months. A total of 188 patients were randomly allocated to maintain or withdraw furosemide. Patients in the withdrawal group received a placebo pill. Both patients and investigators were blinded to the treatment allocation. The trial had two coprimary outcomes: 1) patient reported dyspnoea using a visual analogue scale at four time points across 90 days; and 2) the proportion of patients maintained without additional diuretics during the 90-day follow-up (on top of the randomly allocated diuretic or placebo). There was no difference between groups in the self-perception of dyspnoea during the 90-day follow-up period. Also, 72 patients (75.3%) in the withdrawal group and 78 patients (83.9%) in the maintenance group were free of furosemide reuse during follow-up (p=0.16). Senior author Dr Andréia Biolo, of the Federal University of Rio Grande do Sul, who presented the results in Athens, said: “The results show that patients with stable heart failure who stop diuretics do not have more dyspnoea than those who continue taking the drug. Withdrawal also does not lead to increased reuse of diuretics – around 20% of patients in both groups needed a top-up, presumably for symptom relief.” Dr Rohde said the findings indicate that diuretics can be safely discontinued in heart failure patients meeting the trial’s eligibility criteria. “Most patients we see in the heart failure outpatient clinic fulfil the trial criteria and could benefit from this strategy,” he said. No extra follow-up is needed for patients who quit taking diuretics, noted Dr Biolo. “Patients can be followed-up in the usual way,” she said. “And, as we do now, patients should be educated to seek medical help if they become breathless, get oedema, or have sudden weight gain which indicates fluid retention.” ENDS
Authors: ESC Press Office Tel: +33 (0)4 8987 2499 Mobile: +33 (0)7 8531 2036 Email: Follow us on Twitter @ESCardioNews The hashtag for Heart Failure 2019 and the World Congress on Acute Heart Failure is #heartfailure2019. Funding: Brazilian National Council for Scientific and Technological Development (CNPq, Brazil). Disclosures: None. References 1The abstract ‘Furosemide Withdrawal in Stable Chronic Outpatients with Heart Failure: a Double-blind, Multicenter, Randomized Trial’ will be presented during the session Late breaking trial II - Chronic heart failure on Sunday 26 May at 08:30 to 10:00 EEST in the Trianti lecture room. About Heart Failure and the World Congress on Acute Heart Failure Heart Failure and the World Congress on Acute Heart Failure are annual congresses of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). About the Heart Failure Association The Heart Failure Association (HFA) is a branch of the European Society of Cardiology (ESC). Its aim is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives. Information for journalists attending Heart Failure 2019 Heart Failure 2019 and the World Congress on Acute Heart Failure will be held 25 to 28 May at the Megaron Athens International Conference Centre in Athens, Greece. Explore the scientific programme.
Furosemide is used alone or in combination with other medications to treat high blood pressure. Furosemide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, kidney, and liver disease. Furosemide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation. Lasix is a loop diuretic that eliminates water and salt from the body to help lower blood pressure
Lasix side effects | Serious side effects | How long do side effects last? | Warnings | Interactions | How to avoid side effects Lasix is the brand name of a prescription tablet that treats fluid retention (edema) due to congestive heart failure, cirrhosis of the liver, or kidney disease. Lasix is also used to lower blood pressure in people with high blood pressure (hypertension) and, frequently, with kidney problems, as well. The active ingredient in Lasix, furosemide, is a loop diuretic (“water pill”) that increases the body’s elimination of water and salt, reducing excess fluids from the body’s tissues and lowering blood pressure. Like all diuretics, Lasix can cause side effects and interact with other drugs. A careful review of the pros and cons of taking Lasix is a vital first step in deciding to start treatment. RELATED: Learn more about Lasix Lasix’s most common side effects include:
Like all water pills, Lasix has several serious and potentially severe side effects including:
Most minor adverse effects are temporary and wear off in about six to eight hours after taking the dose of Lasix. Other common side effects may take longer to resolve such as dehydration, electrolyte imbalance, elevated blood sugar, or high cholesterol. Serious side effects may require treatment and take several days to resolve. Swelling of the pancreas or blood disorders such as anemia (low blood cell counts) may require days or weeks to resolve. Hearing loss and tinnitus are serious side effects that are typically temporary. However, there is a rare chance of permanent hearing loss in those using other medications that are toxic to the ears or with reduced kidney function. Circulatory collapse due to severe dehydration or coma due to liver dysfunction are potentially life-threatening and will require intensive hospital care. Like all prescription drugs, Lasix may be restricted or avoided completely in some people with certain medical conditions. Misusing or taking too much Lasix can also create problems. Abuse and dependenceLasix is not a drug that causes dependence nor is it commonly abused or misused outside of competitive athletics. Withdrawal symptoms, however, are possible when Lasix is discontinued. When Lasix is no longer taken, the body sometimes overcompensates by retaining too much water and salt. As a result, fluid builds up in the body’s tissues and bloodstream, causing rebound edema and high blood pressure for a few days. While generally harmless, people with heart disease or heart failure will require observation and monitoring after Lasix treatment ends. To avoid this rebound effect, healthcare providers may gradually reduce the Lasix dose to discontinuation or place the patient on a low-sodium diet. OverdoseThe maximum daily dose for Lasix tablets is 600 mg. A Lasix overdose can produce severe dehydration, low blood volume, low potassium, and severe electrolyte depletion. Symptoms of an overdose include extreme thirst, extreme weakness, heavy sweating, hot or dry skin, muscle pains or cramps, changes in heartbeat, nausea, vomiting, and fainting. If too much Lasix has been taken, emergency medical care is required. RestrictionsAll people taking Lasix will be monitored for signs of:
Lasix is contraindicated (prohibited) for use in people with:
People with certain medical conditions may require a restricted dose or close monitoring for side effects:
Ask a doctor or other healthcare professional about the risks and benefits of taking Lasix while pregnant or breastfeeding. It is recommended that Lasix should only be used in pregnant women if the potential benefits outweigh the risk to their unborn child because the overall safety is not completely known. I Lasix reduces lactation for nursing mothers and appears in breast milk, so this medication is often avoided in these women. Lasix interactionsBecause of possible drug interactions, Lasix should not be taken with certain types of drugs. Some medications should never be combined with Lasix and other medications should try to be avoided, but several types of drugs will require caution and possible dose adjustments when taken with Lasix. Two drugs are never combined with Lasix:
Because of the risk of dehydration, electrolyte imbalances, kidney damage, or circulatory collapse, drugs to be avoided or used cautiously with Lasix include:
Medications that can affect blood pressure such as: Finally, other medications to avoid or use cautiously are:
People taking Lasix or any other diuretic may experience unwanted side effects. As a tablet, people generally take Lasix every day, sometimes for a prolonged period. A few safety guidelines can help maximize its benefits while minimizing the risk of side effects. 1. Take Lasix as directedFollow all the directions given by a healthcare provider or printed on the prescription label. The standard dose is 40–120 mg per day for edema and 10-40 mg twice daily for hypertension. If the dose is divided into two daily doses, do not skip a dose or combine two doses into one. Do not take more or less than prescribed until consulting with a doctor or healthcare professional. 2. Tell the doctor about all medical conditions and medicationsMany medical conditions and drugs can affect the safety of taking Lasix, so make sure the prescribing doctor or healthcare professional is well-informed about:
3. Watch for signs of dehydration or electrolyte imbalanceA doctor or healthcare provider will explain how much and what kind of fluids to take after a dose of Lasix. These may be restricted to ensure the success of the therapy. Still, watch for signs of severe dehydration or electrolyte depletion. These include:
If fluids are not restricted, immediately take fluids at signs of dehydration. If fluids are restricted, call a healthcare provider for medical advice. To avoid electrolyte imbalances, people will often be prescribed potassium supplementation such as Klor-Con. Additionally, healthcare providers may recommend changes in a person’s diet to increase the amount of potassium. Use extra caution on hot summer days, as people are more likely to get dehydrated and lose electrolytes. People can either avoid or limit their time spent outdoors on hot days and always carry a water bottle. Since some people can become more sensitive to sunlight while taking Lasix, it’s good to be cautious of sunny days and wear sunscreen or protective clothing. 4. Keep all follow-up appointments and frequently monitor self at homeTo avoid some of the more serious side effects, make sure that all appointments are kept and necessary tests are taken. The purpose of these tests and visits is partly to monitor any adverse effects before they become serious medical problems. Some people with pre-existing medical conditions may be asked to regularly monitor body weight, blood pressure, or blood sugar. Check these values faithfully with store-bought bathroom scales, blood pressure cuffs, or blood glucose testers. Record the values and show them to the doctor during office visits. Depending on the pre-existing condition, people taking Lasix should make sure to discuss with a doctor their goal blood pressure range, ideal blood sugar range or how much weight they can gain or lose. 5. Plan your activities around the dosing scheduleA healthcare professional may ask that Lasix always be taken at a certain time of day. Remember: frequent urination is the most common effect of taking Lasix. It’s a good idea to delay certain activities for at least four to six hours after a dose is taken. Some people may not be put on a strict schedule. In that case, the dose can be taken at a time more convenient to the day’s activities. 6. Avoid taking a late doseTaken too late in the day, Lasix may make it hard to sleep because of running to the bathroom frequently. Most healthcare professionals will advise people not to take Lasix after a certain time, like 4 P.M. Ask a doctor, pharmacist, or another healthcare provider how late in the day Lasix can be taken without ruining a good night’s sleep. 7. Avoid some common over-the-counter drugsPopular pain-relievers (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve), can reduce the effectiveness of Lasix and increase the risks to the kidney or ears. Also, over-the-counter (OTC) laxatives, such as Miralax and magnesium citrate, increase the risk of dehydration and electrolyte depletion. Ask a doctor or other healthcare provider about alternatives to commonly used OTC drugs when taking Lasix. Related resources: |
What happens when you stop taking Lasix
Pos Terkait
Copyright © 2024 idkuu.com Inc.
