5 known interactions • 2 major • 3 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Digoxin
Furosemide-induced hypokalemia (and hypomagnesemia) increases the risk of digoxin toxicity and serious cardiac arrhythmias.
Management: Monitor serum K+ and Mg2+ closely. Maintain K+ >4.0 mEq/L in patients on digoxin.
Aminoglycosides (gentamicin, tobramycin)
Additive ototoxicity — both loop diuretics and aminoglycosides are independently ototoxic. Combination dramatically increases risk of permanent hearing loss.
Management: Avoid combination when possible. If unavoidable, minimize dose and duration; monitor hearing.
ACE inhibitors / ARBs
Volume depletion from furosemide potentiates hypotension with ACE inhibitors; however, this combination is commonly and intentionally used in heart failure with careful monitoring.
Management: Start ACE inhibitor at low dose after initiating furosemide. Monitor BP and electrolytes.
NSAIDs (ibuprofen, naproxen)
NSAIDs reduce renal prostaglandin synthesis, antagonizing furosemide's diuretic effect and worsening fluid retention.
Management: Avoid NSAIDs in patients on furosemide for heart failure or edema. Acetaminophen is preferred.
Lithium
Furosemide reduces renal lithium clearance, increasing lithium levels and toxicity risk.
Management: Monitor lithium levels carefully when starting or changing furosemide.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Furosemide. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.