netFormulary Leicestershire Health Community NHS
Medicines Formulary  
 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.02.02  Expand sub section  Loop diuretics
  • Furosemide (40-60mg) has a similar effect to bumetanide (1mg) for most clinical uses. Diuresis is complete within 6 hours of oral administration with both drugs therefore if necessary they can be given twice in one day without disturbing sleep.
  • Bioavailability of oral bumetanide is sometimes better than furosemide particularly in patients with right-sided congestive heart failure associated with liver/ splanchnic congestion.
  • The therapeutic effect of loop diuretics can be measured by monitoring the patientís weight on a daily basis.
  • In acute heart failure, small doses of parenteral loop diuretics are valuable (onset of action approximately 5 minutes after IV injection).
  • Large doses of loop diuretics may be required in renal failure.
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Link  Leicestershire Evaluation: Torasemide in Resistant Heart Failure
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Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety. All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry   


Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).  

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Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.   

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Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.  

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Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence see comments under individual entries.   


Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.