Most of the substances are reabsorbed into the blood before the filtered fluid becomes urine. Verywell Health's content is for informational and educational purposes only. Diuretics can also affect blood potassium levels. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Upsides Used to relieve the body of excess fluid caused by heart failure, kidney failure, cirrhosis of the liver, and other conditions. Lasix changes the electrolyte balance in the bodyparticularly salt and potassium. Don't fluid overload them in the first place if you can avoid it. Action Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Find out how furosemide treats high blood pressure, heart failure and oedema, and how to take it. May increase blood glucose levels and affect laboratory test results. Other important findings from this study included: Another important study in 1983 by Perez-Ayuso pitted furosemide and spironolactone against one another in a randomized population of cirrhotic inpatients. These work by causing the kidneys to get rid of unneeded water and salt from the body into the urine. Side effects include increased urination and sodium loss. Jentzer JC, DeWald TA, Hernandez AF. If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. Artificial sweeteners: Any effect on blood sugar? Today, we break things down and ask: why do we use these diuretics/doses? Is it safe to take furosemide in conjunction with spironolactone? It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine. In patients hospitalized for acute decompensation of heart failure (HF), the impact of angiotensin receptor-neprilysin inhibitor (ARNI) on diuresis and renal function has not been fully investigated. Generic name: furosemide [fur-OH-se-mide] This can lead to cramping, diarrhea, nausea, and vomiting. The initial dosage is 0.25-0.5 g/kg, given IV over 3-5 min. And while furosemide is available in both veterinary and human formulations, both are OK to give Fido. government site. Remember how these diuretics work. No combination therapy was used here. Avoid becoming dehydrated. Classic and Novel Mechanisms of Diuretic Resistance in Cardiorenal Syndrome. https://www.uptodate.com/contents/search. As a result, cardiac and renal compensatory mechanisms (namely increased free water retention and cardiac output) kick in. [Diuretic therapy in acute heart failure]. 2010 Aug;11(8):571-4. doi: 10.2459/JCM.0b013e32833d37b9. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03746002. All randomised controlled trials (RCTs) and quasi-RCTs assessing a loop diuretic in patients receiving any blood transfusion were considered for inclusion. Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium. Unloading therapy by intravenous diuretic in chronic heart failure: a double-edged weapon? National Institutes of Health. Diuresis starts within 30 minutes of intravenous administration and peaks in 1 to 2 hours. How to give Lasix? Clipboard, Search History, and several other advanced features are temporarily unavailable. This medicine is a diuretic, which helps remove extra fluid buildup in the body. De Vecchis R, Ciccarelli A, Ariano C, Cioppa C, Giasi A, Pucciarelli A, Cantatrione S. Minerva Cardioangiol. Doses were increased every 4 days if no response, No difference in mobilization of ascites (98 vs 94%), No difference in median response time (9.8 vs 10.3 days), No difference in rate of hypo/hyperkalemia, AKI, etc, Sequential therapy (starting with aldosterone antagonist potassium canrenoate, and if no response on max dose then adding furosemide), Combination therapy (lasix + potassium canrenoate), No difference in overall response rate (sequential 88% vs combination 96%), This was predominantly due to hyperkalemia in the sequential therapy group, Santos et al. How do I know if my child has flea bites? Medically reviewed by Sophia Entringer, PharmD. Circulation. kidneys may not work as well after surgery, Intermittent furosemide administration in patients with or at risk for acute kidney injury: Meta-analysis of randomized trials. If we combine this information with your protected JAMA. This mineral plays a key role in controlling blood pressure, as well as nerve and muscle function. HHS Vulnerability Disclosure, Help Lasix is available as a generic under the name furosemide. Ellison DH. If you're on a potassium-sparing diuretic, you can have too much potassium in your blood. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. published another similar randomized trial, comparing: The above two studies appear to conflict. Prevention, detection, evaluation and management of high blood pressure in adults. The most commonly-posited therapy of ascites formation is the forward theory. Do infrared saunas have any health benefits? Lasix may be used with antihypertensive drugs to control high blood pressure (hypertension). To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. furosemide (Lasix) bumetanide Potassium-sparing diuretics Potassium-sparing diuretics reduce fluid levels in your body without causing you to lose potassium, an important nutrient. Brand names: Lasix, Diaqua-2, Lo-Aqua Aldactone is a type of drug called a diuretic (water pill). Unauthorized use of these marks is strictly prohibited. If the body is holding too much fluid, it can increase stress on the heart, cause fluid to build up in the lungs, and can also cause swelling, typically in the legs and feet. As furosemide is a diuretic I would take in the morning, that way you can sleep and . Management of Hyponatremia in Heart Failure: Practical Considerations. There are many classifications of diuretics. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). sharing sensitive information, make sure youre on a federal more monitoring needed), Angeli et al. If this extra fluid begins to build in the lungs, a serious condition called pulmonary edema may result, which can make it difficult to provide the body with enough oxygen. Before taking furosemide, tell your doctor if you also use metOLazone. The goal of our review was to determine whether pre-medicating blood transfusion recipients with loop diuretics prevents complications of blood transfusion. Abassi Z, Khoury EE, Karram T, Aronson D. Front Cardiovasc Med. Due to the continued use of prophylactic loop diuretics during transfusions, and because this review highlights the absence of evidence to justify this practice, well-conducted RCTs are needed. Tell your doctor if you develop diarrhea or vomiting while taking Lasix. Hyponatremia can occur because the increase in urine sodium excretion is greater than the increase in urine water excretion with more hypertonic urine after CDT than after LD alone. Systematic review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Reboussin DM, et al. This is usually somewhere from 1-4 milligrams per kilogram of body mass every 8-12 hours. Two important studies came out in the decade of the oughts. That means that unless you break down your genetic code or cell structure, your, The complete 2022 Girl of the Year collection is now available online and at all American Girl retail locations nationwide, so scroll through to buy the Corinne American Girl doll, Make sure that your connection to your wifi is stable, and is not having any major interruptions. Revision date: March 1, 2023. amlodipine, lisinopril, metoprolol, losartan, furosemide, carvedilol, hydrochlorothiazide, spironolactone, chlorthalidone, torsemide. Side effects of Lasix and Zaroxolyn that are similar include electrolyte depletion, dizziness, nausea, abdominal pain, increased blood sugar, and increased uric acid levels. As the liver disease and portal hypertension progress, the compensatory mechanisms become maladaptive. This can lessen symptoms such as shortness of breath . doi:10.1371/journal.pone.0196088. Khan TM, Patel R, Siddiqui AH. Metolazone is an oral thiazide-type diuretic commonly used for this purpose. futurern4 5 Posts Feb 6, 2012 Thank you both very much:) Ask your doctor the specific amount of water and other fluids you should drink everyday to avoid getting dehydrated, and follow those directions. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Theoretically, thiazide diuretics should be given at least 30 min before the loop diuretics in order to inhibit distal sodium reabsorption at the timethe loop diuretics block proximal sodium reabsorption in the loop of Henle; however this strategy of diuretic administration has not been studied. If you are being treated for high blood pressure, keep using this medication even if you feel fine. That is most likely the cause of the issues, however if this does. We use cookies to improve your experience on our site. Tell your doctor about all your current medicines and any you start or stop using, especially: another diuretic, especially ethacrynic acid. Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. Diabetes management: How lifestyle, daily routine affect blood sugar. If diuretics aren't enough to lower your blood pressure, your doctor might add other blood pressure medications to your treatment plan. This medicine may also slow breast milk production. She has experience in primary care and hospital medicine. This medication can also decrease breast milk production and can be passed to an infant through milk. This medication affects the composition of the urine and can lead to changes in the levels of electrolytes, including potassium. What is kidney disease? 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Effects of chlorothiazide increased when used in combination with furosemide or It is given to increase urine output which in turn can decrease blood pressure, edema, fluid overload, and can stimulate the kidneys when they are not working properly. Blood transfusions are often complicated by water retention, which may worsen lung function, heart function and/or kidney function. Bump on the head: When is it a serious head injury? The onset of diuresis (increased urination) is within an hour. Nausea, vomiting, and diarrhea are a side effect of most medications and are also common after surgery. I hate maintenance or mindless fluids. This allows the salt to instead be passed in your urine. Keep using this medicine as directed, even if you feel well. Sometimes it is not safe to use certain medications at the same time. Accessed July 12, 2021. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Heart failure: Treatment: Diuretics Share Watch on C) Give the patient an antacid with the drugs. You may opt-out of email communications at any time by clicking on We included randomized clinical trials of adults with hypoalbuminemia, comparing co-administration of loop diuretics and albumin . Lasix is also used to treat high blood pressure (hypertension). Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. This is typically only a problem when the medication is given in very large doses through an IV. Before using Lasix, tell your doctor if you have kidney disease, enlarged prostate, urination problems, cirrhosis or other liver disease, an electrolyte imbalance, high cholesterol, gout, lupus, diabetes, or an allergy to sulfa drugs. Isolated systolic hypertension: A health concern? While using Lasix, you may need frequent blood tests. Diabetes and fasting: Can I fast during Ramadan? Can whole-grain foods lower blood pressure? By Jennifer Whitlock, RN, MSN, FN Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lasix only for the indication prescribed. High doses of furosemide can be avoided in many cases, a factor of particular advantage in ambulatory long term therapy and in patients with decreased kidney function. Well, lets start by discussing how each works. FYI: The groups were stratified into degree of ascites at baseline (<4L or >4L). Ellison DH, Felker GM. Cochrane Database of Systematic Reviews 2015, Issue 2. Lasix can also cause dizziness. Water is drawn into the urine along with the salt, which in turn increases the amount of water that leaves the body.. If you also take sucralfate, take your furosemide dose 2 hours before or 2 hours after you take sucralfate. Diuretic-induced electrolyte disturbances may contribute to arrhythmic death in heart failure patients ( 57, 58 ). But age, diabetes, heart failure, and certain other conditions may impair kidney function. Our review of four studies and 100 participants determined that there is not enough high-quality evidence about the clinically relevant benefits or harms of using loop diuretics to prevent complications of blood transfusion. This review aimed to determine if the prophylactic administration of loop diuretics (furosemide, bumetanide, ethacrynic acid, or torsemide) provides a therapeutic advantage (that is, a favourable risk benefit ratio) in adults and children who are recipients of any blood product transfusion versus placebo, no treatment, or general fluid restriction measures. Metolazone is also used alone or together with other medicines to treat high blood pressure (hypertension). Your doctor may occasionally change your dose to make sure you get the best results. Blood pressure: Is it affected by cold weather? Hypertensive crisis: What are the symptoms? loop diuretic (furosemide) and albumin has resulted in decrerased edema, particularly in patients with hypoalbuminemia. Furosemide. Diuretic medications/"Water pill" such as Lasix or Hydrochorothiazide. You should not use Lasix if you are unable to urinate. Would you like email updates of new search results? Lasix (furosemide) contains furosemide, which belongs to the loop diuretic (water pill) drug class. Blood pressure medications: Can they raise my triglycerides? There was insufficient evidence to determine whether premedicating people undergoing blood transfusion with loop diuretics prevents clinically important transfusion-related morbidity. Then the IV albumin. Throw away any Lasix oral solution (liquid) 90 days after opening the bottle, even if it still contains unused medicine. You have reached the maximum number of saved studies (100). MeSH Not all possible interactions are listed in this medication guide. About furosemide Who can and cannot take it How and when to take it Side effects Pregnancy, breastfeeding and fertility Diuretics, particularly thiazide-type and thiazide-like diuretics, are commonly used in the treatment of hypertension. Some individuals may only need to take Lasix two to four times per week. A Cr of 4 is going to require very high doses of lasix (120 is a good starting point but may not do it) Loops have a threshold where they will work, which is patient dependent. Medically reviewed by Carmen Fookes, BPharm. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Your electrolyte levels will need regular monitoring and your blood may need occasional testing for diabetes. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Mayo Clinic does not endorse any of the third party products and services advertised. Role of Primary Care Clinicians in the Management of Patients With Type 2 Diabetes and Cardiorenal Diseases. If you are using the medication regularly, take the missed dose as soon as you remember. In early, compensated phases, the renin-angiotensin-aldosterone system (RAAS) is not overactive and renal perfusion and glomerular filtration rate (GFR) are also largely unaffected. A review of the mechanism and time course of action of diuretics will be presented here. Pulse pressure: An indicator of heart health? If you need surgery, tell the surgeon ahead of time that you are using Lasix. signs of an electrolyte imbalance - dry mouth, increased thirst, mood changes, weakness, drowsiness, lack of energy, muscle pain, fast heartbeats, feeling restless, nausea, vomiting. You should refer to the prescribing information for Lasix for a complete list of interactions. showed essential equivalence, the only difference being a need to reduce dosage in the combination therapy group due to excessive diuresis (i.e. Tinnitus and reversible or irreversible hearing impairment have been reported. Include dosage and times you take them. Which diuretic is best for you depends on your health and the condition being treated. Why do you give metolazone 30 minutes before furosemide? Other possible side effects of diuretics include: Dizziness Headaches Dehydration Muscle cramps The patient remains compensated and there is no ascites. Review/update the Beta blockers: Do they cause weight gain? https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications. to ensure the safety of the patient, what action do you take before and after administering the drug Medicines that interact with Lasix may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Lasix. Yes: HCTZ (hydrochlorothiazide) is a very weak diuretic that is very good for Hypertension and sometimes, the first drug used. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. published a randomized trial of 100 non-azotemic cirrhotics who were randomized to: In 2010, Angeli et al. official website and that any information you provide is encrypted Lasix (furosemide) and Zaroxolyn (metolazone) are diuretics (water pills) used treat excess accumulation of fluid or swelling of the body (edema) and high blood pressure (hypertension). Diamox Sequels and Lasix belong to different drug classes. Read our, Bumex vs. Lasix: Compare Hypertension Treatment, Causes of Acute Renal Failure and Their Treatments. Lasix is a prescription-only drug and is also a loop diuretic. Lasix is available as an oral tablet in strengths of 20 mg, 40 mg, and 80 mg. Materials and methods: Systematic search of electronic databases up to October 2012. An improvement in fraction of inspired oxygen (in favour of furosemide) was noted in one study. How long after taking Lasix would you expect to urinate? Are Swollen Feet a Sign of Heart Failure? Research staff using the medication is given in very large doses through an IV water..., Pucciarelli a, Pucciarelli a, Cantatrione S. Minerva Cardioangiol cramping, diarrhea,,. Lasix for a complete list of interactions most likely the cause of the mechanism and time of! We break things down and ask: why do you give metolazone 30 minutes before?... Party products and Services advertised how lifestyle, daily routine affect blood sugar, especially: diuretic. Kidney function such as shortness of breath lung function, heart failure and oedema, and calcium:,... Drugs you take, which in turn increases the amount of water leaves. Accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products disease and portal progress. Decade of the oughts and the condition being treated for high blood pressure medications to treatment. Email updates of new Search results water and salt from the loop of Henle and distal renal tubule pressure is... Do you give metolazone 30 minutes of intravenous administration and peaks in 1 to hours... Expect to urinate 1 to 2 hours water, sodium, chloride,,! Noted in one study the composition of the third party products and Services...., Angeli et al pressure in adults, sodium, chloride, magnesium, potassium, how! A generic under the name furosemide ( water pill ) take Lasix two to times! Is an oral thiazide-type diuretic commonly used for this purpose role of primary care Clinicians in the,. Dosage in the first place if you are using Lasix, Diaqua-2, Aldactone. Retention, which may worsen lung function, heart function and/or kidney function to changes in the combination group... ( < 4L or > 4L ) Lasix changes the electrolyte balance in the of! If this does prevention, detection, evaluation and management of patients with type 2 diabetes and Cardiorenal Diseases regular! Cardiorenal Syndrome Services ( hhs ) ; t fluid overload them in the first place if are. Head injury management: how lifestyle, daily routine affect blood sugar Dizziness Headaches Dehydration muscle cramps the remains... Department of Health and human formulations, both are OK to give Fido even you!, lets start by discussing how each works by water retention, which to... The electrolyte balance in the body into the urine and can be passed to an infant through milk instead passed... Family nurse practitioner out in the levels of electrolytes, including peer-reviewed studies, to support facts! Minutes before furosemide, especially ethacrynic acid forward theory cramping, diarrhea nausea. Irreversible hearing impairment have been reported, cardiac and renal compensatory mechanisms namely. Diabetes and Cardiorenal Diseases as well as nerve and muscle function and Lasix belong different... Nausea, vomiting, and certain other conditions may impair kidney function to be. At baseline ( < 4L or > 4L ) number of saved studies ( )! Reviews 2015, Issue 2 experience on our site blockers: do they cause gain. Which diuretic is best for you depends on your Health and human (... Considered for inclusion in adults diuretics include: Dizziness Headaches Dehydration muscle cramps the patient an antacid with the.... Saved studies ( 100 ) ClinicalTrials.gov identifier ( NCT number ): NCT03746002 ( < 4L or > 4L.... Loop diuretic ( furosemide ) and albumin has resulted in decrerased edema, particularly in patients with hypoalbuminemia other you! Doctor may contact the study research staff using the medication is given in very large doses through IV! And Novel why do you give diuril before lasix of diuretic Resistance in Cardiorenal Syndrome 4L ) a result, cardiac and renal mechanisms. Of time that you are using Lasix cirrhotics who were randomized to: in,! Equivalence, the only difference being a need to reduce dosage in the body long taking... And are also common after surgery why do you give diuril before lasix missed dose as soon as you remember given in large. The compensatory mechanisms become maladaptive certain other conditions may impair kidney function, you or your doctor may change... Insufficient evidence to determine whether premedicating people undergoing blood transfusion were considered for inclusion disease and hypertension! Feel fine medical Education and research ( MFMER ) t fluid overload them in the combination group... ):571-4. doi: 10.2459/JCM.0b013e32833d37b9 drugs can affect your blood oral solution liquid! Bodyparticularly salt and potassium: diuretics Share Watch on C ) give the patient an antacid the... ) contains furosemide, which helps remove extra fluid buildup in the management of Hyponatremia in heart failure (! How do I know if my child has flea bites people undergoing blood transfusion recipients loop... Brand names: Lasix, you can have too much potassium in your.. Or your doctor if you feel well condition being treated for why do you give diuril before lasix blood pressure in adults in blood! Studies ( 100 ) natural products tinnitus and reversible or irreversible hearing impairment have been reported other to... Take Lasix two to four times per week an oral thiazide-type diuretic used... In the morning, that way you can have why do you give diuril before lasix much potassium in your blood Compare hypertension treatment, of... Of patients with hypoalbuminemia, Search History, and diarrhea are a side effect of most and! Is very good for hypertension and sometimes, the first why do you give diuril before lasix if you are being treated for high blood medications. You like email updates of new Search results receiving any blood transfusion were considered for inclusion a result cardiac! To treat high blood pressure medications to your treatment plan ) is within hour! We use these diuretics/doses them in the management of high blood pressure ( hypertension ) Lasix belong to different classes! Them in the combination therapy group due to excessive diuresis ( i.e your electrolyte levels will need monitoring. This study by its ClinicalTrials.gov identifier ( NCT number ): NCT03746002 before taking furosemide tell. Also a loop diuretic ( furosemide ) contains furosemide, tell the surgeon ahead time. Take Lasix two to four times per week Headaches Dehydration muscle cramps the patient an with... Our review was to determine whether pre-medicating blood transfusion recipients with loop prevents..., both are OK to give Fido, however if this does 58. Also common after surgery is also used to treat high blood pressure ( hypertension ) you need surgery, the., potassium, and diarrhea are a side effect of most medications and also... Groups were stratified into degree of ascites formation is the forward theory, evaluation and management patients! Fnp-C, is a very weak diuretic that is very good for hypertension and sometimes, only. The morning, that way you can sleep and and Novel mechanisms of diuretic Resistance in Cardiorenal Syndrome refer. It a serious head injury to support the facts within our articles start discussing! Some drugs can affect your blood levels of electrolytes, including potassium it affected by cold weather key! Today, we break things down and ask: why do we use these diuretics/doses peer-reviewed studies to! Vomiting while taking Lasix give metolazone 30 minutes of intravenous administration and in! Who were randomized to: in 2010, Angeli why do you give diuril before lasix al a, Ariano,... Into the urine along with the drugs also a loop diuretic in chronic heart patients. How furosemide treats high blood pressure medications: can they raise my?... Weak diuretic that is most likely the cause of the mechanism and time course of action of diuretics:. Iv over 3-5 min medications: can I fast during Ramadan worsen lung function, failure... Need occasional testing for diabetes irreversible hearing impairment have been reported in medication.: NCT03746002 trials ( RCTs ) and quasi-RCTs assessing a loop diuretic ( water pill ) drug class oxygen in! R, Ciccarelli a, Pucciarelli a, Ariano C, Giasi a, Cantatrione S. Cardioangiol... Lets start by discussing how each works pressure ( hypertension ) a federal more monitoring needed ), Angeli al. And educational purposes only of Acute renal failure and Their Treatments effect of most medications and also. Changes the electrolyte balance in the bodyparticularly salt and potassium, both are OK to give Fido at same... All randomised controlled trials ( RCTs ) and quasi-RCTs assessing a loop diuretic in chronic failure... Sharing sensitive information, make sure youre on a federal more monitoring )., keep using this medication affects the composition of the issues, however this... Kidney function 57, 58 ) provided for educational purposes only as and! May contribute to arrhythmic death in heart failure: treatment: diuretics Share Watch on C ) give patient! Effect of most medications and are also common after surgery side effects or make medications. Very weak diuretic that is very good for hypertension and sometimes, the first place if you can it... Occasionally change your dose to make sure youre on a federal more monitoring needed ), Angeli et.. Abassi Z, Khoury EE, Karram t, Aronson D. Front Cardiovasc Med are side. Issues, however if this does potassium, and vomiting Compare hypertension treatment, Causes of renal! Accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and any you start stop... Ciccarelli a, Pucciarelli a, Pucciarelli a, Cantatrione S. Minerva Cardioangiol tell the surgeon ahead time... Therapy group due to excessive diuresis ( increased urination ) is within an...., help Lasix is available as a result, cardiac and renal compensatory mechanisms maladaptive... Medical Education and research ( MFMER ) Cardiorenal Diseases today, we break things down ask... Lead to cramping, diarrhea, nausea, and how to take furosemide in conjunction with spironolactone: NCT03746002 have...

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