Abstract
Serial plasma levels of furosemide were measured in 14 premature newborns by high-pressure liquid chromatography following an intravenous dose of 1 mg/kg. All neonates were less than 21 days of age with birth weights ranging from 700 to 2500 grams. The half-life for furosemide calculated from the elimination rate constant was 19.95 ± 3.0 hours (mean ± s. err.) in these infants. The plasma clearance was determined to be 10.58 ± 2.1 ml/kg/hour. Equilibrium dialysis revealed more than 90% protein binding of furosemide by the newborn. The volume of distribution measured from the kinetic data was 0.24 ± .03 L/kg and is consistent with extensive binding of furosemide within the vasculature. Several infants were re-studied and found to have an adult half-life by four months of age.
No correlation was observed between birth weight or postnatal age and the elimination of furosemide within the group studied.
These data are very different from those reported for either adults or older children and indicate that the frequency for administration of furosemide to the newborn within the first three weeks of life should be no more than twice daily if drug accumulation is to be avoided. Furthermore, the prolonged half-life of furosemide in the newborn may contribute to altered elimination or toxicity of other drugs (e.g., aminoglycosides) in this age-group.
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Peterson, R., Rumack, B. & Brooks, J. 263 FUROSEMIDE PHARMACOKINETICS IN THE PREMATURE NEWBORN. Pediatr Res 12 (Suppl 4), 407 (1978). https://doi.org/10.1203/00006450-197804001-00268
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DOI: https://doi.org/10.1203/00006450-197804001-00268
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