EFFECT OF FUROSEMIDE ORAL SOLUTION VERSUS FUROSEMIDE TABLETS ON DIURESIS AND ELECTROLYTES IN PATIENTS WITH MODERATE CONGESTIVE-HEART-FAILURE

Oral furosemide solution was claimed to produce a greater diuretic res ponse than furosemide tablets in patients with congestive heart failur e. The aim of this study was to assess this observation and to further investigate the effects on the electrolyte balance. We compared the e ffects of oral furosemide in tablets versus oral furosemide solution o n serum levels as well as on 4- and cumulative 24-hour urinary volume and sodium, potassium, calcium, magnesium and zinc excretions in 10 pa tients with moderate congestive heart failure due to ischemic heart di sease. Oral furosemide (40-80 mg) was given at the usual once-daily do sage. No change in serum electrolyte levels has been found. All urinar y parameters, except zinc, were significantly greater during the first 4 h following oral solution as compared with tablets (volume p<0.001, sodium p<0.001, potassium p<0.05, calcium p<0.003, magnesium p<0.05). However, after 24 h, significant differences were found in urinary vo lume (p<0.03) and sodium excretion (p<0.004) only. We conclude that: ( 1) oral furosemide solution provides a more potent 24-hour diuretic an d natriuretic effect than an identical dosage in tablet form, without entailing greater cumulative urinary losses of potassium, calcium, mag nesium, and zinc; (2) following the first 4 h of furosemide solution, brisk diuresis, kaliuresis, and magnesiuria are produced, and (3) desp ite the urinary losses, serum electrolytes remained within normal limi ts at 4 and 24 h.