Identification: Furosemide 40 mg
When you encounter a white, round pill with the imprint 'RE 23' on one side and a break-line on the reverse, you can confirm its identity as Furosemide 40 mg. The tablet is typically 8mm in diameter. While this specific imprint was associated with Furosemide tablets manufactured by Ohm Laboratories and distributed by Ranbaxy Pharmaceuticals, various generic manufacturers produce Furosemide tablets with different imprints, though RE-23 is one of the more recognized ones.
Understanding Furosemide: A Powerful Loop Diuretic
Furosemide belongs to a class of medications called loop diuretics, which are among the most potent available. Its primary action is to inhibit the reabsorption of sodium and chloride in the loop of Henle in the kidneys. This inhibition prevents the kidneys from retaining water, leading to a significant increase in urine production and the excretion of excess fluid and electrolytes from the body.
Unlike weaker diuretics, furosemide can produce a rapid and profound diuresis, which makes careful medical supervision and dose management essential. The onset of action for an oral dose is typically within one hour, with the peak effect occurring within the first two hours. This fast action is why patients are often advised to avoid taking the medication late in the day, to prevent frequent nighttime urination.
Clinical Applications of Furosemide (RE-23)
Furosemide is prescribed for a range of conditions where excess fluid accumulation, known as edema, needs to be managed.
- Edema: This is the most common use, addressing swelling associated with congestive heart failure, liver disease (such as cirrhosis with ascites), and various types of renal (kidney) disease, including nephrotic syndrome. By removing excess fluid, it can alleviate symptoms like shortness of breath and swelling in the arms, legs, and abdomen.
- High Blood Pressure (Hypertension): Furosemide can be used alone or in combination with other antihypertensive medications to treat high blood pressure. Lowering blood pressure is crucial for reducing the risk of strokes, heart attacks, and kidney problems.
- Acute Pulmonary Edema: In emergency situations, an injectable form of furosemide may be used to rapidly treat acute pulmonary edema, a condition where excess fluid accumulates in the lungs.
Important Safety Information and Side Effects
Furosemide is a potent medication with a boxed warning from the FDA, highlighting the risk of severe fluid and electrolyte depletion if given in excessive amounts. Regular monitoring by a healthcare provider is necessary during treatment.
Common Side Effects
- Frequent urination
- Dizziness or lightheadedness, especially when standing up quickly (orthostatic hypotension)
- Headache
- Muscle cramps or weakness
- Nausea and gastrointestinal irritation
Serious Side Effects and Risks
- Electrolyte Imbalance: Furosemide can cause low levels of potassium (hypokalemia), magnesium (hypomagnesemia), and calcium (hypocalcemia).
- Dehydration: Excessive fluid loss can lead to dehydration and a reduction in blood volume.
- Ototoxicity: In rare cases, high doses or rapid administration, especially when combined with other ototoxic drugs like aminoglycoside antibiotics, can cause tinnitus and reversible or irreversible hearing impairment.
- Drug Interactions: Medications such as NSAIDs (e.g., ibuprofen) can reduce the effectiveness of furosemide and increase the risk of kidney problems. Co-administration with lithium should also be avoided due to the risk of lithium toxicity.
Comparison: Furosemide vs. Thiazide Diuretics
Furosemide is a loop diuretic, which differs significantly from another common class of diuretics called thiazides (e.g., hydrochlorothiazide) in its potency and primary site of action.
| Feature | Furosemide (Loop Diuretic) | Hydrochlorothiazide (Thiazide Diuretic) |
|---|---|---|
| Potency | High ('High-Ceiling') | Moderate |
| Site of Action | Loop of Henle | Distal convoluted tubule |
| Duration of Action | Relatively short (6-8 hours for oral tablet) | Longer (up to 12 hours or more) |
| Main Use | Severe edema, acute fluid overload | Routine management of hypertension and mild edema |
| Calcium Excretion | Increases calcium excretion | Decreases calcium excretion |
| Use in Renal Failure | More effective in cases of severe renal failure | Less effective with advanced renal impairment |
Manufacturer and Prescription Details
The RE-23 imprint, a specific type of Furosemide 40 mg, was manufactured by Ohm Laboratories Inc. and marketed by Ranbaxy Pharmaceuticals Inc., with some packaging handled by Rebel Distributors Corp.. It is important to note that many generic versions of Furosemide exist, so tablets with different markings can also contain the same active ingredient.
Furosemide is a prescription-only medication. It is crucial to use it only under the guidance and monitoring of a healthcare professional. Self-medicating with Furosemide can lead to serious health complications, especially concerning dehydration and electrolyte imbalances. If you have this pill, consult your doctor or pharmacist to confirm its use and determine if it is right for your condition.
Conclusion
In summary, if you have identified a pill marked 'RE-23,' it is Furosemide 40 mg, a potent diuretic used for managing fluid retention from various conditions, including heart failure, liver disease, and high blood pressure. Because of its strength, Furosemide requires careful medical supervision to avoid serious side effects like dehydration and electrolyte imbalance. Patients should follow their doctor's dosage instructions precisely and report any adverse effects. Regular lab tests are often necessary to monitor electrolyte levels and kidney function while taking this medication.
For additional information, you can consult the official FDA drug label for Furosemide: FUROSEMIDE tablet - dailymed.nlm.nih.gov.
