What Is Furosemide, and What Are the Risks of Abuse?

High blood pressure is common in the United States. In fact, according to the Centers for Disease Control and Prevention, about 75 million American adults have been diagnosed with the condition.

High blood pressure is serious. If left untreated, it can damage the heart, raise the risk of stroke and lead to other serious health conditions. But unfortunately, some of the treatments used to address heart disease can lead to other health issues.

For example, high blood pressure is often treated with the drug furosemide. This drug has been associated with abuse and addiction.

Furosemide Basics

The cardiovascular system is meant to absorb some fluctuations in pressure. When people engage in a strenuous activity and the heart works harder, blood moves through the body very quickly. That speed comes with an increase in pressure. Just as a garden hose feels firm when the water from the spigot is on and running, and it feels slack when the water is turned off, blood vessels are also meant to tense and relax when flow levels change.

People with high blood pressure don’t experience these episodes of relaxation. Their blood vessels are always taut and tense, even when these people are at rest.

Furosemide helps because it causes the kidneys to expel unneeded water. To return to the hose metaphor, this drug helps to turn the spigot and slow down the flow of fluid through the body. That reduced volume also reduces pressure placed on blood vessels.

Furosemide is an effective therapy, but it’s not a cure for high blood pressure. People who take it must continue to take it (or a similar type of therapy) in order to keep high blood pressure under control.

Since so many people have high blood pressure, and since furosemide is a form of ongoing therapy, it’s reasonable to suspect that there are many of these pills lurking in medicine cabinets all across the country. This is where the risk of abuse comes into play.

Understanding Furosemide Abuse

Healthy people shouldn’t need diuretics or so-called “water pills” like furosemide in order to regulate the work of the kidneys. These organs are designed to do their work efficiently without the help or prompting of outsiders. But there are people who choose to abuse this drug, and their reasons for engaging in abuse can be varied.

Athletes, for example, may abuse furosemide in order to:

  • Lose weight. Wrestlers and other athletes who are required to maintain a specific weight may appreciate the ability to reduce the water weight they’re carrying.
  • Excrete illegal drugs. Some athletes who use substances to boost their performance may use water pills to remove traces of the drugs from their bloodstreams.
  • Enhance the performance of drugs. Taking water pills can help some athletes to get a bigger punch from other drugs they take.
  • Retain illicit drugs. There are some forms of drugs that stay in the body longer when blood volume is low. Using furosemide could help those drugs to do their work longer.

In a study published in the British Journal of Pharmacology, researchers found that 7.9% of all positive drug tests from the World Anti-Doping Agency (WADA) contained illicit diuretics like furosemide. This statistic seems to suggest that the abuse of this type of drug isn’t uncommon.
People who have eating disorders may also use and abuse diuretics like furosemide during the course of their disease. In an article written by the Meduza Project, the authors suggest that furosemide is remarkably effective in helping people to lose weight very quickly, particularly from the face. People who want to have prominent cheekbones might turn to the drug to help them achieve this result.

Remember that furosemide works by causing the kidneys to go into overdrive and excrete more water from the body. Most of the tissues within the human body are bathed in water. Pushing the water out of the body, thinning out the blood and reducing overall volume, can cause a drop in weight. Those dehydrated tissues take up less space, so the body looks thinner and much more angular.

For someone who has an eating disorder, seeing lower numbers on a scale paired with seeing a smaller body in the mirror can be enticing. Someone who sees success one time with the drug might be tempted to abuse the drug again to bring about the same changes.
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The Physical Toll of Furosemide Abuse

The kidneys are the body’s filters. Every minute of every day, they work hard to remove impurities from the body. They also strike a balance between water and salt within the body. Kidneys can, and often do, recover after an injury. But the damage furosemide abuse can do is significant, and there are times when it cannot be reversed. People who abuse this drug for long periods may be left with kidneys that simply cannot remove toxins.

Even when taken at the advised dosage, furosemide can cause serious side effects. Those side effects can include:

  • Rashes
  • Nausea
  • Diarrhea
  • Abdominal pain
  • Jaundice
  • Tinnitus
  • Light sensitivity
  • Dizziness

People who take the drug to treat high blood pressure are advised to visit their doctors regularly, so the medical team can ensure that the medication is working properly and not causing unusual side effects or health issues. People who abuse the drug may take two or three times the advised dose, simply because they want the effects of the drug and aren’t overly concerned with health effects. People like this may do a significant amount of damage to bodily systems, and they may not have access to a medical team that can guide the use and prevent ongoing health concerns.

Furosemide has been associated with an overdose. People who take too much of this drug and overwhelm the body’s natural processes may experience such a violent, sudden health issue that they simply collapse. As Mayo Clinic points out, a furosemide overdose is considered a medical emergency.

Anyone who experiences these signs needs to get medical attention right away:

  • Seizures
  • Sunken eyes
  • Weak pulse
  • Increased or irregular heart rate
  • Muscle cramps
  • Pain, tingling, numbness, or weakness in the limbs or lips
  • Rapid breathing

In a hospital setting, someone who is experiencing a furosemide overdose can be given fluids to replace what’s been lost through the kidneys. Doctors can use other medications to slow down and regulate the heart rate. They can also use supportive therapies to ensure that the person stays warm, calm, and hydrated until the crisis passes.

Someone who abuses the drug may do so in private, and that means an overdose could happen when there is no one nearby to call for help. Someone like this may become unresponsive while alone, and family members may not see the issue until it’s too late. Similarly, some people who abuse the drug may hide that abuse so carefully that family members simply don’t know that the risk of overdose exists. These family members may pass off exhaustion as simply evidence of a tough day, and they may not offer the help that’s needed.

Combining Furosemide and Other Drugs

Risks of furosemide are compounded when the drug is mixed with other drugs. For example, Medscape lists 164 drugs that have been associated with health risks when used in combination with furosemide. Doctors are encouraged to monitor their patients closely when they are taking furosemide along with medications, such as:

  • Benazepril
  • Buprenorphine
  • Enalapril
  • Ephedrine
  • Fentanyl

Reactions can typically be attributed to kidney overwork. Furosemide causes the kidneys to work so hard to remove water from the body that the filtration system breaks down. These other drugs can build up within the body, especially as the blood volume drops, and that can lead to secondary overdoses.
Furosemide can also cause some other drugs to leave the body too quickly, and that can cause health effects as well. Someone taking a medication to help with depression, for example, may not get the full impact of that medication while abusing furosemide. The abuse may cause the prescription depression medication to leave the body long before it’s had a chance to amend brain chemistry.

Furosemide Withdrawal Syndrome

woman having furosemide withdrawal syndrome

Healing from abuse of furosemide begins with medical detox. While simply stopping use and abuse of the drug may seem smart and reasonable, the person who abused the drug may have a tolerance to and need for the medication. Stopping use of the drug rapidly could cause significant health issues.

In a study of 141,810 people performed via eHealthMe, researchers found that women with pain who take OxyContin and furosemide tend to experience a withdrawal syndrome. But anyone who abuses the drug for a long enough period of time could experience problems that benefit from medical detox therapy.

Typically, doctors help people adjust to a life without furosemide by performing a slow, supervised taper of the drug. Each day, the person takes a little bit less of the drug until the dose is so tiny that it’s no longer needed. This taper allows the body to adjust to the absence of the drug quite slowly, and with each passing day, the body remembers how to regulate key systems without the influence of the drug.

Tapers like this have been studied in people who take furosemide for heart issues. In one such study, published in the American Journal of Cardiology, the withdrawal process was considered successful in almost all patients.

Someone who abuses the drug may need a longer or shorter taper in order to achieve sobriety. Working with a medical professional is key. Doctors can monitor how well the body is adjusting to the taper, and they can make the process move more quickly or slowly, depending on how well the body is adjusting. Doctors can also watch over how a person is feeling during the medical detox process. Someone who experiences severe paranoia or depression during the taper may need a slower process or therapy help. When a doctor is involved, that help can be given at the right time.

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Support for Lasting Sobriety

doctor and patient discussing furosemide treatment options for detox

People who abuse furosemide can learn to live without the drug. When the medical detox process is complete, there is more work to do. While medical detox can help to remove the drug from the tissues of the body, the person’s habits and emotions may continue to call out for the drug. The key at this stage of recovery is to help the person build up systems that support a life of sobriety.

The National Institute on Drug Abuse says that effective treatment for prescription drug abuse begins with therapy that is specific to that type of drug. For people who abuse furosemide in concert with another mental health challenge, such as exercise addiction or eating disorders, therapy should address these issues and how they can trigger the abuse of drugs. Therapy can also help the person to build habits that support a healthy lifestyle. When the urge to pick up drugs appears, the person can have new skills at the ready to deal with those urges, so the risk of relapse drops.

Support groups can also help to support the sobriety process. While there is no specific support group for furosemide abuse, there are support groups that target the abuse of prescription drugs. Here, people have an opportunity to talk to and learn from other people who have also struggled with addiction. They have a chance to work individually with someone in active recovery. They have the chance to engage in social activities with people who are committed to sobriety. These are benefits that can be hard to achieve outside of support groups. Tapping into them can be a wise way to keep relapses from taking hold.

Addictions are strong, and someone in the grips of an addiction may not see a way out. But the reality is that there are so many people in the United States who are in active recovery from addiction. They demonstrate how a commitment to change can lead to big returns. Taking that first step and asking for help is how this healing begins.

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