Diuretic

Furosemide (Lasix): Loop Diuretic Patient Guide

Furosemide is the most powerful diuretic — it removes excess fluid through urine. It's essential in heart failure but requires careful monitoring of kidney function and electrolytes.

Drug class
Loop diuretic
Removes fluid via
Kidneys (urine output)
Key tests
Potassium + eGFR
Take
Morning (to avoid night urination)

What Furosemide Treats

ConditionTypical Dose
Heart failure (mild)20–40 mg once daily
Heart failure (severe)80–250 mg daily, may need IV
Kidney disease oedema40–80 mg twice daily
Hypertension (refractory)40–80 mg daily
Acute pulmonary oedema40–80 mg IV — emergency use

Electrolytes to Monitor

ElectrolyteEffectTarget / Action
PotassiumFurosemide causes potassium LOSSKeep >3.5 mmol/L — supplement if low
SodiumCan fall (hyponatraemia) with high dosesKeep >135 mmol/L
MagnesiumCan fall with furosemideKeep >0.7 mmol/L
Creatinine / eGFRRises if over-diuresis (dehydration)A rise >20% needs dose review
Dehydration WarningSigns of too much furosemide: thirst, dizziness on standing, dry mouth, muscle cramps, dark urine. Contact your heart failure nurse or doctor if your weight drops more than 2 kg in 2 days.
Flexible DosingMany heart failure patients are taught to adjust their furosemide dose based on daily weight. Increase by 20–40 mg if weight rises >2 kg; reduce if signs of dehydration. Only do this if your doctor has specifically taught you this approach.
Why must I take furosemide in the morning?
Furosemide causes a strong surge in urine production within 1–2 hours of taking it. Taking it in the morning means this surge occurs during the day. Taking it in the evening causes repeated night-time toilet trips and disturbed sleep.
Will I need to take furosemide forever?
In chronic heart failure, yes — furosemide helps keep fluid from accumulating in the lungs and legs. Stopping it usually leads to rapid fluid reaccumulation. Never stop without consulting your doctor.
I'm on furosemide but my ankles are still swollen — why?
The ankles may not fully resolve, especially if you have venous insufficiency (valve problems in leg veins). Compression stockings and leg elevation help. Adding spironolactone or changing timing may help more.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.