[Physical compatibility of furosemide in intravenous mixtures for continuous perfusion]

Patients in the intensive care units simultaneously receive concomitantly many drugs, with limited venous accesses. Thus, several different perfusions must be administered jointly through the same catheter. Furosemide is a solution with no buffer capacity that is easily precipitated. In spite of the recommendation on its data sheet stating that it should not be used with other drugs, studies found in the bibliography suggest that it has physicochemical compatibility with other drugs. However, the concentrations studied do not always coincide with those used in the clinical practice.

To study and verify the physical compatibility of furosemide in intravenous mixture.

An experimental study in vitro, in which furosemide was mixed with 12 drugs at a 1:1 proportion was performed. A total of 40 samples were obtained and the following variables were evaluated at different intervals, 0, 15, 30, 60 and 120 min: ph of mixture, color changes, presence of turbidity and precipitation. To do so, visual observation procedures, ph measurements and spectrophotometer absorption at 450 and 620 nm were used.

Forty samples, 13 simples, 12 doubles and 15 triples, were obtained. Those mixtures that did not show physical changes, pH variation and absorption variation were considered compatible.

Furosemide is physically compatible with bicarbonate solution, heparin, insulin, morphine and nitroglycerin and incompatible with amiodarone, cisatracurium, haloperidol, midazolam and urapidil.