Interactions for Lasix and prednisone - Medicine.com (2023)

Drug Interactions

Moderate

Lasix + Prednisone

The following applies to the ingredients:Furosemide (found in Lasix) and Prednisone

MONITOR: The concomitant use of corticosteroids and agents that deplete potassium (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins) may result in increased risk of hypokalemia. Corticosteroids can produce hypokalemia and other electrolyte disturbances via mineralocorticoid effects, the degree of which varies with the agent (from most to least potent: fludrocortisone - cortisone/hydrocortisone - prednisolone/prednisone - other glucocorticoids) and route of administration (i.e. systemic vs. local). However, large systemic doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. When used pharmacologically, adrenocorticotropic agents such as corticotropin have similar mineralocorticoid activities as cortisone and hydrocortisone.

MANAGEMENT: Patients receiving potassium-depleting agents with corticosteroids should be monitored closely for development of hypokalemia, particularly if fludrocortisone or large doses of another corticosteroid or adrenocorticotropic agent is given. Potassium supplementation may be necessary. Patients should be advised to notify their physician if they experience signs of electrolyte disturbances such as weakness, lethargy, and muscle pains or cramps.

References

  1. Thomas TP"The complications of systemic corticosteroid therapy in the elderly."Gerontology 30 (1984): 60-5
  2. Seale JP, Compton MR"Side-effects of corticosteroid agents."Med J Aust 144 (1986): 139-42
  3. Morris GC, Egan JG, Jones MK"Hypokalaemic paralysis induced by bolus prednisolone in Graves' disease."Aust N Z J Med 22 (1992): 312
  4. Powell JR"Steroid and hypokalemic myopathy after corticosteroids for ulcerative colitis. Systemic and tropical application."Am J Gastroenterol 52 (1969): 425-32
  5. Chrousos GA, Kattah JC, Beck RW, Cleary PA"Side effects of glucocorticoid treatment. Experience of the Optic Neuritis Treatment Trial."JAMA 269 (1993): 2110-2
  6. Thorn GW"Clinical considerations in the use of corticosteroids."N Engl J Med 274 (1966): 775-81
  7. "Product Information. Hydeltrasol (prednisolone)."Merck & Company Inc (2001):
  8. Ramsahoye BH, Davies SV, el-Gaylani N, Sandeman D, Scanlon MF"The mineralocorticoid effects of high dose hydrocortisone."BMJ 310 (1995): 656-7

Drug and Food Interactions

No food interactions were found for selected drugs:Lasix, prednisone.

This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Drug and Pregnancy Interactions

The following applies to the ingredients:Prednisone

This drug should only be used during pregnancy if the benefit outweighs the potential risk to the fetus

AU TGA pregnancy category: A
US FDA pregnancy category: C
US FDA pregnancy category: D (delayed-release tablets)

Comments:
-Observe for signs and symptoms of hypoadrenalism in infants exposed to this drug in utero.
-Women who become pregnant while using this drug should be apprised of the potential fetal risks.
-The short-term use of corticosteroids antepartum for the prevention of respiratory distress syndrome does not seem to pose a risk to the fetus or newborn infant.

Teratogenicity including increased incidence of cleft palate have occurred in animal studies. A number of cohort and case controlled studies in humans suggest maternal corticosteroid use in the first trimester produces a slight increased risk of cleft lip with or without cleft palate (increased from 1 out of 1000 to 3 to 5 out of 1000 infants). Reduced placental and birth weight have been recorded in animals and humans after long term treatment. There is the possibility of adrenal cortex suppression in the newborn with long term use in the mother; however the short term use of corticosteroids antepartum for the prevention of respiratory distress syndrome does not seem to pose a risk to the fetus or the newborn infant. Maternal pulmonary edema has been reported with inhibition of uterine contractions and fluid overload. There are no adequate and well controlled studies in pregnant women.

Use of prednisolone (active metabolite) at high doses for an extended period of time (30 mg/day for a minimum of 4 weeks) has caused reversible disturbances of spermatogenesis that persisted for several months after discontinuation.

AU TGA pregnancy category A: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

US FDA pregnancy category D: There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

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References

  1. "Product Information. Deltasone (prednisone)."Pharmacia and Upjohn (2001):
  2. Cerner Multum, Inc."UK Summary of Product Characteristics."O 0
  3. Cerner Multum, Inc."Australian Product Information."O 0
  4. "Product Information. Rayos (prednisone)."Horizon Therapeutics USA Inc (2016):
  5. "Product Information. PredniSONE (prednisone)."Watson Pharmaceuticals (2016):

The following applies to the ingredients:Furosemide (found in Lasix)

This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus; use is contraindicated according to some authorities.

AU TGA pregnancy category: C
US FDA pregnancy category: C

Comments: Use of this drug during pregnancy requires monitoring of electrolytes, hematocrit, and fetal growth.

Animal studies have revealed evidence of fetolethality. There are no controlled data in human pregnancy.

AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

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References

  1. "Product Information. Lasix (furosemide)."sanofi-aventis (2007):
  2. Cerner Multum, Inc."UK Summary of Product Characteristics."O 0
  3. Cerner Multum, Inc."Australian Product Information."O 0
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Drug and Breastfeeding Interactions

The following applies to the ingredients:Furosemide (found in Lasix)

Caution is recommended as use is contraindicated according to some authorities.

Excreted into human milk: Yes

Comments: The effects in the nursing infant are unknown.

References

  1. "Product Information. Lasix (furosemide)."sanofi-aventis (2007):
  2. Cerner Multum, Inc."UK Summary of Product Characteristics."O 0
  3. Cerner Multum, Inc."Australian Product Information."O 0
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The following applies to the ingredients:Prednisone

This drug should be used only if clearly needed

Excreted into human milk: Yes

Comments:
-If this drug is necessary, the lowest dose should be prescribed; theoretically, if high maternal doses are necessary, the dose the infant receives may be minimized by avoiding breastfeeding for 4 hours following dosing and using prednisolone instead of prednisone.

Amounts of glucocorticoids excreted into breast milk are low with a total infant daily dose calculated to be up to 0.23% of the maternal daily dose. For doses up to 10 mg/day, the amount of drug an infant receives via breast milk is undetectable; however the milk/plasma ratio increases with doses above 10 mg/day (e.g., 25% of the serum concentration is found in breast milk when dose is 80 mg/day). If this drug is necessary, the lowest dose should be prescribed as high doses of corticosteroids for long periods could produce infant growth and development problems and interfere with endogenous corticosteroid production. High doses might occasionally cause temporary loss of milk supply.

References

  1. "Product Information. Deltasone (prednisone)."Pharmacia and Upjohn (2001):
  2. Cerner Multum, Inc."UK Summary of Product Characteristics."O 0
  3. Cerner Multum, Inc."Australian Product Information."O 0
  4. United States National Library of Medicine"Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
  5. "Product Information. Rayos (prednisone)."Horizon Therapeutics USA Inc (2016):
  6. "Product Information. PredniSONE (prednisone)."Watson Pharmaceuticals (2016):

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

MajorHighly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
ModerateModerately clinically significant. Usually avoid combinations; use it only under special circumstances.
MinorMinimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
UnknownNo interaction information available.

Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a healthcare professional. Use of this content is subject to our terms of use & medical disclaimer.

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