藥劑部參考美國 Johns Hopkins 大學研究團隊所建立的 NxP (Nephrotoxic Potential) 專家共識分級清單，本品具「顯著以上腎毒性風險」，被認定具中度至高度腎損傷潛勢，特別是同時合併其他腎毒性藥物、脫水、高齡或既有腎功能異常的患者族群，應更加注意。

【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，用於老年人時須謹慎使用(監測血鈉值)。

高血壓 (diuretics) 利尿劑 (loop diuretics)
Edema: Management of edema associated with heart failure, cirrhosis of the liver (ie, ascites), or renal disease (including nephrotic syndrome); acute pulmonary edema

Inhibits reabsorption of sodium and chloride in the ascending loop of Henle and proximal and distal renal tubules, interfering with the chloride-binding cotransport system, thus causing increased excretion of water, sodium, chloride, magnesium, and calcium

1. Anuria
2. History of hypersensitivity to furosemide

Use with caution due to the potential reduction in placental blood flow.

The manufacturer recommends that caution be used if administered to a breastfeeding woman.

Edema:
1. Naive to loop diuretics: Initial 20-40 mg once then titrate as needed to an effective dose
2. Refractory edema or acute decompensation in patients taking oral loop diuretics: Initial 1 to 2.5 times the total daily oral maintenance dose once (eg, a patient taking oral furosemide 40 mg twice daily at home [80 mg/day] can be given 80 mg to 200 mg IV as an initial bolus); then titrate as needed to an effective dose

1. eGFR >30 mL/minute/1.73 m2: No dosage adjustment necessary
2. eGFR ≤30 mL/minute/1.73 m2: Higher doses may be required to achieve desired diuretic response due to decreased secretion into the tubular fluid. However, single doses >160 to 200 mg IV (or oral equivalent) are unlikely to result in additional diuretic effect