Aminoglycoside antibiotics | Furosemide may increase the ototoxic potential of aminoglycoside antibiotics, especially in the presence of impaired renal function [see Warnings and Precautions (5.3)]. | Avoid combination except in life-threatening situations. |
Ethacrynic acid | Possibility of ototoxicity [see Warnings and Precautions (5.3)]. | Avoid concomitant use with ethacrynic acid. |
Salicylates | May experience salicylate toxicity at lower doses because of competitive renal excretory sites. | Monitor for symptoms of salicylate toxicity. |
Cisplatin | There is a risk of ototoxic effects if cisplatin and furosemide are given concomitantly [see Warnings and Precautions (5.3)]. | |
Cisplatin and nephrotoxic drugs | Nephrotoxicity | Administer furosemide at lower doses and with postitive fluid balance when used to achieve forced diuresis during cisplatin treatment. Monitor renal function. |
Paralytic agents | Furosemide has a tendency to antagonize the skeletal muscle relaxing effect of tubocurarine and may potentiate the action of succinylcholine. | Monitor for skeletal muscle effect. |
Lithium | Furosemide reduces lithium's renal clearance and add a high-risk of lithium toxicity. | Avoid concomitant use with lithium. |
Angiotensin converting enzyme inhibitors or angiotensin II receptor blockers | May lead to severe hypotension and deterioration in renal function, including renal failure. | Monitor for changes in blood pressure and renal function and interrupt or reduce the dosage of furosemide, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers if needed. |
Antihypertensive drugs | Furosemide may add to or potentiate the therapeutic effect of other antihypertensive drugs. | Monitor for changes in blood pressure and adjust the dose of other antihypertensive drugs if needed. |
Adrenergic blocking drugs or peripheral adrenergic blocking drugs | Potentiation occurs. | Monitor for changes in blood pressure and adjust the dose of adrenergic blocking drugs if needed. |
Norepinephrine | Furosemide may decrease arterial responsiveness (vasoconstricting effect) to norepinephrine. | Monitor blood pressure (or mean arterial pressure). |
Chloral hydrate | In isolated cases, intravenous administration of furosemide within 24 hours of taking chloral hydrate may lead to flushing, sweating attacks, restlessness, nausea, increase in blood pressure, and tachycardia. | Concomitant use with chloral hydrate is not recommended. |
Methotrexate and other drugs undergoing renal tubular secretion | Furosemide may decrease renal elimination of other drugs that undergo tubular secretion. High-dose treatment of furosemide may result in elevated serum levels of these drugs and may potentiate their toxicity. | Monitor serum levels of drugs undergoing renal tubular secretion and adjust the dose if needed. |
Cephalosporin | Furosemide can increase the risk of cephalosporin-induced nephrotoxicity even in the setting of minor or transient renal impairment. | Monitor for changes in renal function. |
Cyclosporine | Increased risk of gouty arthritis secondary to furosemide-induced hyperuricemia and cyclosporine impairment of renal urate excretion. | Monitor serum urate levels. |
Thyroid hormones | High-doses (> 80 mg) of furosemide may inhibit the binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by an overall decrease in total thyroid hormone levels. | Monitor the total thyroid hormone levels. |