Route of administration: intramuscular or intravenous.
Intravenous furosemide must be injected or infused slowly; a rate of 4mg per minute must not be exceeded. In patients with severe impairment of renal function (serum creatinine >5mg/dl), it is recommended that an infusion rate of 2.5mg per minute is not exceeded.
Intramuscular administration must be restricted to exceptional cases where neither oral nor intravenous administration are feasible. It must be noted that intramuscular injection is not suitable for the treatment of acute conditions such as pulmonary oedema.
To achieve optimum efficacy and suppress counter-regulation, a continuous furosemide infusion is generally to be preferred to repeated bolus injections. Where continuous furosemide infusion is not feasible for follow-up treatment after one or several acute bolus doses, a follow-up regimen with low doses given at short intervals (approx. 4 hours) is to be preferred to a regimen with higher bolus doses at longer intervals.
Doses of 20 to 50mg intramuscularly or intravenously may be given initially. If larger doses are required, they should be given increasing by 20mg increments and not given more often than every two hours. If doses greater than 50mg are required it is recommended that they be given by slow intravenous infusion. The recommended maximum daily dose of furosemide administration is 1,500mg.
Elderly: The dosage recommendations for adults apply, but in the elderly furosemide is generally eliminated more slowly. Dosage should be titrated until the required response is achieved.
Children: Parenteral doses for children range from 0.5 to 1.5mg/kg body weight daily up to a maximum total daily dose of 20mg.