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In patients at high risk for radiocontrast nephropathy LASIX can lead to a higher incidence of deterioration in renal function after receiving radiocontrast compared to high-risk patients who received only intravenous hydration prior to receiving radiocontrast.

LASIX should not be used concomitantly with ethacrynic acid because of the possibility of ototoxicityPatients receiving high doses of salicylates concomitantly with LASIXas in rheumatic diseasemay experience salicylate toxicity at lower doses because of competitive renal excretory sites.

The results of the mouse study and one of the three rabbit studies also showed an increased incidence and severity of hydronephrosisdistention of the renal pelvis andin some casesof the uretersin fetuses derived from the treated dams as compared with the incidence in fetuses from the control group.

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Cases of tinnitus and reversible or irreversible hearing impairment and deafness have been reportedReports usually indicate that LASIX ototoxicity is associated with rapid injectionsevere renal impairmentthe use of higher than recommended doseshypoproteinemia or concomitant therapy with aminoglycoside antibioticsethacrynic acidor other ototoxic drugsIf the physician elects to use high dose parenteral therapycontrolled intravenous infusion is advisablefor adultsan infusion rate not exceeding 4 mg LASIX per minute has been usedSee PRECAUTIONSDRUG INTERACTIONS

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