Lasix vs. Demadex

Lasix is a potent diuretic (water pill) used to eliminate water and salt from the body. In the kidneys, salt (sodium and chloride), water, and other small molecules are filtered out of the blood and into the kidney tubules. Lasix works by blocking the absorption of sodium, chloride, and water from the filtered fluid, causing an increase in urine output.

Demadex is a diuretic used to treat edema due to congestive heart failure, kidney disease, chronic kidney failure, or liver disease. It also treats high blood pressure. It works by blocking the reabsorption of sodium and water that have been filtered out of the blood in the kidneys. Demadex belongs to a class of diuretic drugs called "loop" diuretics, which also includes Lasix and Bumex.

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Side Effects of Lasix and Demadex

Lasix

Common side effects of Lasix include low blood pressure, dehydration, and electrolyte depletion (sodium, potassium). Other important side effects may include increased blood sugar and uric acid levels.

Demadex

Demadex can cause low levels of potassium, magnesium, sodium, and calcium. It may also cause dehydration, with symptoms such as dry mouth, thirst, weakness, drowsiness, reduced kidney function, heart arrhythmias, muscle aches, nausea, and vomiting. Possible serious side effects include atrial fibrillation, chest pain, gastrointestinal bleeding, high blood sugar, increased uric acid, low blood potassium, low blood pressure, dehydration, shunt thrombosis, rectal bleeding, fainting, ventricular tachycardia, serious skin reactions, allergic reactions, pancreatitis, and reduced number of white blood cells and platelets. Levels of potassium and other electrolytes should be monitored during treatment with Demadex.

Dosage of Lasix vs. Demadex

Lasix

• The usual starting oral dose for edema in adults is 20 to 80 mg as a single dose. The same dose or an increased dose may be administered 6 to 8 hours later. Doses may be increased by 20 to 40 mg every 6 to 8 hours until the desired effect occurs. The effective dose may be administered once or twice daily. Some patients may require 600 mg daily.
• The starting oral dose for children is 2 mg/kg. The starting dose may be increased by 1 to 2 mg/kg every 6 hours until the desired effect is achieved. Doses greater than 6 mg/kg are not recommended.
• The recommended dose for treating hypertension is 40 mg twice daily. The dose of other blood pressure medications should be reduced by half when Lasix is added.

Demadex

• Demadex comes in tablets of 5, 10, 20, and 100 mg.
• Patients can take the tablets at any time without regard to meals.
• For the treatment of heart failure, the initial dose is 10 to 20 mg by mouth or injection once daily. The dose may be doubled until the desired diuretic effect is achieved. The maximum dose is 200 mg daily.
• Chronic kidney failure is treated with 20 to 200 mg orally or by injection once daily.
• The dose for treating high blood pressure is 2.5 to 10 mg orally once daily.
• Liver cirrhosis is treated with 5 to 40 mg orally or by injection once daily. It is combined with aldosterone antagonists or potassium-sparing diuretics.

Drug Interactions with Lasix and Demadex

Lasix

• Administration of Lasix with aminoglycoside antibiotics or ethacrynic acid may cause hearing damage.
• Lasix competes with aspirin for elimination in the urine and may lead to high blood levels of aspirin and aspirin toxicity.
• Lasix may reduce excretion of lithium by the kidneys, causing increased blood levels of lithium.
• Sucralfate reduces the action of Lasix by binding it in the intestine. Ingestion of Lasix and sucralfate should be separated by two hours.
• When combined with other antihypertensive drugs, there is an increased risk of low blood pressure or reduced kidney function.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) may interfere with the blood pressure-reducing effect of Lasix.

Demadex

Several medicines may cause interactions with Demadex.

• Demadex can cause low blood potassium, calcium, and magnesium levels. Combining Demadex with other diuretics can exaggerate the losses of potassium and magnesium.
• The body’s ability to eliminate lithium may decrease in patients receiving Demadex. Monitoring of lithium levels in blood is recommended.
• Indomethacin can reduce the diuretic and blood pressure-lowering effects of other loop diuretics and it probably can do the same with Demadex. Other nonsteroidal anti-inflammatory drugs may interact similarly.
• Concomitant use of Demadex and aminoglycosides may increase the risk of hearing impairment.
• Probenecid decreases the diuretic effect of Demadex by reducing secretion of Demadex into the kidney tubules.

Safe Use of Lasix and Demadex During Pregnancy or Breastfeeding

Lasix

• Lasix is secreted in breast milk. Nursing mothers should avoid breastfeeding while taking Lasix.

Demadex

• The safety of Demadex in pregnant women has not been established.
• It’s not known whether Demadex is excreted in human milk.

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Summary

Lasix and Demadex are diuretics used to treat edema due to various conditions. They are also used to treat high blood pressure.