Disal Tablets are indicated for the treatment of edema (pulmonary
congestion, ascites) associated with cardiac insufficiency and acute
noninflammatory tissue edema. In cases of edema involving cardiac
insufficiency, the continued use of heart stimulants such as digitalis
or its glycosides is indicated. The rationale for efficacious use of
diuretic therapy is determined by the clinical pathology producing the
edema.
Administer orally once or twice daily at 6 to 8 hour intervals. The
dosage should be adjusted to the individual’s response. In severe
edematous or refractory cases, the dose may be doubled or increased by
increments of 1.0 mg per pound of body weight. The established effective
dose should be administered once or twice daily. The daily schedule of
administration can be timed to control the period of micturition for the
convenience of the client or veterinarian. Mobilization of the edema may
be most efficiently and safely accomplished by utilizing an intermittent
daily dose schedule, i.e., every other day or 2 to 4 consecutive days
weekly.
Diuretic therapy should be discontinued after reduction of the edema,
or maintained after determining a carefully programmed dosage schedule
to prevent recurrence of edema. For long-term treatment, the dose can
generally be lowered after the edema has once been reduced.
Re-examination and consultations with the client will enhance the
establishment of a satisfactory dosage schedule. Clinical examination
and serum BUN, CO2 and electrolyte determinations should be
performed during the early period of therapy and periodically
thereafter, especially in refractory cases. Abnormalities should be
corrected or the drug temporarily withdrawn.
Dog: One-half to one 50 mg scored tablet per 25 pounds body weight.
One 12.5 mg scored tablet per 5 to 10 pounds body weight.
Administer once or twice daily, permitting a 6- to 8-hour interval
between treatments. In refractory or severe edematous cases, the dosage
may be doubled or increased by increments of 1 mg per pound body weight
as recommended.
Cat: 1 to 4 mg/kg [1/2 to 2 mg/lb] every 8-24 hours orally.
Contraindications: Animal reproductive studies have shown
that furosemide may cause fetal abnormality and the drug is
contraindicated in pregnant animals. Furosemide is contraindicated
in anuria, furosemide hypersensitivity, hepatic coma, or during
electrolytic imbalances. Monitor serum electrolytes, BUN and CO2
frequently. Monitor serum potassium levels and watch for signs of
hypocalcemia.
Corticosteroids cause an additive potassium-depletion effect.
Precautions: Disal Tablets are a highly effective
diuretic-saluretic which, if given in excessive amounts, may result
in dehydration and electrolyte imbalance. Therefore, the dosage and
schedule may have to be adjusted to the patient’s needs. The animal
should be observed for early signs of electrolyte imbalance, and
corrective measures administered. Early signs of electrolyte
imbalance are increased thirst, lethargy, drowsiness or
restlessness, fatigue, oliguria, gastro-intestinal disturbances and
tachycardia. Special attention should be given to potassium levels.
Disal Tablets may lower serum calcium levels and cause tetany in
rare cases of animals having an existing hypocalcemic tendency.7
8 9 10 11
Disal Tablets are contraindicated in anuria. Therapy should be
discontinued in cases of progressive renal disease if increasing
azotemia and oliguria occur during the treatment. Sudden alterations
of fluid and electrolyte imbalance in an animal with cirrhosis may
precipitate hepatic coma, therefore observation during period of
therapy is necessary. In hepatic coma and in states of electrolyte
depletion, therapy should not be instituted until the basic
condition is improved or corrected. Potassium supplementation may be
necessary in cases routinely treated with potassium-depleting
steroids. Active or latent diabetes may on rare occasions be
exacerbated by furosemide. Transient loss of auditory capacity has
been experimentally produced in cats following intravenous
injections of excessive doses of furosemide at a very rapid rate.12
13 14
Warnings: Disal Tablets are a highly effective diuretic
and, if given in excessive amounts, as with any diuretic, may lead
to excessive diuresis which could result in electrolyte imbalance,
dehydration and reduction of plasma volume, enhancing the risk of
circulatory collapse, thrombosis and embolism. Therefore, the animal
should be observed for early signs of fluid depletion with
electrolyte imbalance, and corrective measures administered.
Excessive loss of potassium in patients receiving digitalis or its
glycosides may precipitate digitalis toxicity. Caution should be
exercised in animals administered potassium-depleting steroids.
Correct potassium deficiency with proper dietary supplementation. If
animal needs potassium supplements, use oral liquid form, do not use
enteric-coated potassium tablets.
The concurrent use of furosemide with some antibiotics may be
inadvisable. There is evidence that the drug enhances the
nephrotoxic potential of aminoglycosides, cephalosporins and
polymyxins and increases the ototoxic effects of all aminoglycosides.
Sulfonamide diuretics have been reported to decrease arterial
responsiveness to pressor amines and to enhance the effect of
tubocurarine. Caution should be exercised in administering curare or
its derivatives to patients undergoing therapy with Disal Tablets
and it is advisable to discontinue Disal Tablets for one day prior
to any elective surgery.
ription: Disal (furosemide) is a potent loop diuretic
which is a derivative of anthranilic acid. The structure is:
Chemical Name: 4-Chloro-N-furfuryl-5-sulfamoylanthranilic acid.
Furosemide is pharmacodynamically characterized by the
following:
1) It is administered orally. It is easily absorbed from the
intestinal tract and begins to act in 30 to 60 minutes after
oral administration.1 2
2) Is a loop diuretic which inhibits reabsorption of sodium
and chloride at the ascending loop of Henle in the kidneys,
enhancing water excretion.3
3) A dose-response relationship and a ratio of minimum to
maximum effective dose range greater than tenfold.1
4) A high degree of efficacy, low inherent toxicity and a
high therapeutic index.
Actions: The therapeutic efficacy of Disal Tablets is
from the activity of the intact and unaltered molecule
throughout the nephron, inhibiting the reabsorption of sodium
not only in the proximal and distal tubule but also in the
ascending limb of the loop of Henle. The prompt onset of action
is a result of the drug’s rapid absorption and a poor lipid
solubility. The low lipid solubility and a rapid renal excretion
minimize the possibility of its accumulation in tissues and
organs or crystalluria. Disal Tablets have no inhibitory effect
on carbonic anhydrase or aldosterone activity in the distal
tubule. The drug possesses diuretic activity either in the
presence of acidosis or alkalosis.1 2 4 5 6
How Supplied:
Oral: Tablets
12.5 mg Tablets - Each tablet contains 12.5 mg of furosemide
50 mg Tablets - Each tablet contains 50 mg of furosemide
Available in bottles of 500 tablets
Toxicology: Furosemide demonstrates a very low order of
either acute or chronic toxicity. The drug is rapidly absorbed and
excreted by both glomerular filtration and tubular secretion. The
rates of excretion are of such a magnitude that cumulation of
furosemide does not occur despite repeated administrations.15
The main effect observed in clinical toxicity is an abnormality
of fluid and electrolyte imbalances. Ototoxicity resulting in
transient loss of hearing has been reported with furosemide.15
A safety study was performed in dogs to determine the effects of
Disal Tablets at increasing dosages and time elements. The dosage
levels were 2 mg/lb body weight (upper recommended dosage), 6 mg/lb
body weight (3X upper recommended dosage) and 10 mg/lb body weight
(5X upper recommended dosage). The treatment period ranged up to
nine days in length. Results demonstrate a mild dehydration at the
5X level with a slight elevation of hemoglobin and hematocrit
levels. Serum levels of potassium and chloride were slightly lowered
in the higher dosage groups. Cumulative evaluation of the data
demonstrates that Disal Tablets are safe when administered at the
upper level of the recommended dosage for a duration of nine
consecutive days.
NADA 129-034, Approved by FDA
Caution: Federal (U.S.A.) law restricts this drug to use
by or on the order of a licensed veterinarian.
Note: Store at controlled room temperature 59-86°F.