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Is It Safe To Increase The Dosage Of Furosemide For Edema?
Question: Hi, I have very swollen legs feet knees and ankles. Blood test is showing some cells in liver not quite right will have another test in 10 days time. Normally 45kg now 50kg due to water. Been taking salazopyrin for rheumatoid arthritis for over 3 months, 500mg twice a day and have stopped taking that. Also went to hospital for 4 nights with very low blood sugar and heart was going 40 to the dozen. I am now on warfarin 3.5mg a day and not diabetic. Used to have palpitations in my twenties now 70. My question is can I take 2 40mg furosemide a day instead of 1 to help stop me stomping around and huffing and puffing, skin is very tight and hard to bend my knees. Also had severe shingles 6 weeks ago and have Amitriptyline 10mg taking 2 10mg at night. Do not smoke or drink.
Have had these huge as legs for 3 weeks now and can not fit any shoes on.
Have had these huge as legs for 3 weeks now and can not fit any shoes on.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms could be related to heart failure.
I would recommend you performing a cardiac ultrasound to examine your cardiac function and structure.
As your liver function tests have resulted abnormal, I would recommend you to closely monitor INR, as you are taking warfarin, because in altered liver function you may have an increased risk of bleeding, especially when on warfarin.
Regarding furosemide, you can raise the dose to two tablets per day, divided every 12 hours. Although your liver function tests have resulted altered, this is not a high dose of furosemide (the maximal dose is much higher).
I would also recommend you to reduce salt and water intake. This will help you reduce the water retention.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms could be related to heart failure.
I would recommend you performing a cardiac ultrasound to examine your cardiac function and structure.
As your liver function tests have resulted abnormal, I would recommend you to closely monitor INR, as you are taking warfarin, because in altered liver function you may have an increased risk of bleeding, especially when on warfarin.
Regarding furosemide, you can raise the dose to two tablets per day, divided every 12 hours. Although your liver function tests have resulted altered, this is not a high dose of furosemide (the maximal dose is much higher).
I would also recommend you to reduce salt and water intake. This will help you reduce the water retention.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank-you for your reply. My INR is being closeiy monitored-will go back to Dr to-morrow with legs. Have taken another furosemide thank goodness. Also have a rash on lower legs back and arms and can not stop scratching. Have applied Betamethasone and now DP-HC Lotion 1%
Brief Answer:
My opinion:
Detailed Answer:
Hi again,
Regarding your legs and arms rash, I would explain that this may be an expression of rheumatoid vasculitis; a complication of rheumatoid arthritis.
In a subset of patients with rheumatoid arthritis, there is presence of inflammation in the small and medium-sized blood vessels, mainly in the arteries that carry blood to the skin, nerves, and internal organs.
These are generally expressed as skin nodules and rash.
But, form the other side, also drugs used to relieve rheumatoid arthritis symptomatolgy, are accused of being responsible for skin complications (including rash).
In addition, limbs swelling (edema) may trigger pruritis (scratching) and subsequent skin rash.
As you see, it is necessary a comprehensive differential diagnosis of your skin rash.
Coming to this point, a careful physical examination, checking the effects of properly treating limb edema and rheumatoid therapy modification, could give a reliable response to this issue.
I recommend consulting with your prescribing physician on the above mentioned issues.
Wishing you a good health!
Regards,
Dr. Iliri
My opinion:
Detailed Answer:
Hi again,
Regarding your legs and arms rash, I would explain that this may be an expression of rheumatoid vasculitis; a complication of rheumatoid arthritis.
In a subset of patients with rheumatoid arthritis, there is presence of inflammation in the small and medium-sized blood vessels, mainly in the arteries that carry blood to the skin, nerves, and internal organs.
These are generally expressed as skin nodules and rash.
But, form the other side, also drugs used to relieve rheumatoid arthritis symptomatolgy, are accused of being responsible for skin complications (including rash).
In addition, limbs swelling (edema) may trigger pruritis (scratching) and subsequent skin rash.
As you see, it is necessary a comprehensive differential diagnosis of your skin rash.
Coming to this point, a careful physical examination, checking the effects of properly treating limb edema and rheumatoid therapy modification, could give a reliable response to this issue.
I recommend consulting with your prescribing physician on the above mentioned issues.
Wishing you a good health!
Regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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