{"hq_id":"hq-c-org-000360","name":"Furosemide","context":"human_adult","risk_level":"high","schema":"legacy","note":"Synthesis unavailable: compound lacks vectorizable regulatory classifications. Raw safety data returned.","data":{"risk_level":"high","summary":"Furosemide (Lasix; frusemide outside North America; 4-chloro-N-furfuryl-5-sulfamoylanthranilic acid) is a loop diuretic — FDA-approved for edema associated with heart failure, hepatic cirrhosis, and renal disease, and for hypertension; one of the most widely used diuretics globally. Mechanism: inhibits Na-K-2Cl cotransporter (NKCC2) in the thick ascending limb of the loop of Henle, producing powerful diuresis; single oral dose eliminates several liters of urine. Electrolyte disturbances: the most clinically significant adverse effects — hypokalemia (potassium losses in urine; clinical risk of arrhythmias, especially in patients on digoxin), hyponatremia, hypomagnesemia, hypochloremic metabolic alkalosis; electrolyte monitoring essential. Ototoxicity: furosemide causes dose- and rate-dependent ototoxicity (hearing loss, tinnitus) — risk highest with rapid IV administration and concurrent aminoglycoside use; in neonates, ototoxicity risk is particularly concerning; use the lowest effective dose. Sulfonamide moiety: furosemide contains a sulfonamide group; historical concern about cross-reactivity in sulfonamide-allergic patients; clinical cross-reactivity between furosemide and sulfonamide antibiotics is not well-supported by evidence — most patients with sulfonamide antibiotic allergy can receive furosemide without reaction. Bioavailability variability: oral bioavailability varies from 10–100% in patients with heart failure due to bowel edema — IV furosemide required in decompensated heart failure where GI absorption is compromised. Resistance: loop diuretic resistance in advanced heart failure is common; mechanisms include reduced renal perfusion, enhanced distal tubular sodium reabsorption, nephron remodeling; combination with thiazide diuretics ('sequential nephron blockade') overcomes resistance.","source_refs":["fda_furosemide_label_2023","aspca_apcc_cardiac_drugs_2023","r60-2026-09-26-d867-cc1-iarc-list-of-classifications-loc-app","r60-2026-09-30-d918-oehha-prop65-list-csv-own-url","r60-2026-10-02-d-955-s9-d955-s9-osha-table-z-1","ctx_pred_dtxsid6020648"]},"meta":{"synthesis_version":"n/a","timestamp":"2026-10-28T19:00:58.619Z"},"_notice":"ALETHEIA output is reference data, not professional advice. Not a substitute for primary agency sources or qualified professionals. See https://aletheia.holisticquality.io/disclaimer.","_disclaimer_url":"https://aletheia.holisticquality.io/disclaimer","available_contexts":["human_adult","human_child","dog","exposure_ingestion","human_teen","human_elderly","human_infant","human_pregnant"]}