Lasix — furosemide

Furosemide belongs to a class of drugs known as loop diuretics, which cause the body to excrete water as well as potassium, sodium, magnesium, calcium, and chloride. They are used most commonly to treat edema and high blood pressure. Like other agents of this type, furosemide works by inhibiting the Na-K-2Cl symporter in the thick ascending loop of Henle, which is a carrier protein that pulls sodium, potassium, and chloride inside cells. This mode of action is independent of any inhibition towards aldosterone. Loop diuretics are among the strongest diuretics available, and can have an extremely dramatic effect on fluid and electrolyte levels in the body. Potassium levels need to be closely watched in particular, and patients may require a prescription potassium supplement. If the proper levels of potassium and other electrolytes are not maintained, serious heart complications may develop. Mistakes in potassium dosage have equally serious consequences; so it is of note that furosemide can be a particularly risky item to use without proper medical supervision.

Athletes and bodybuilders use diuretics for a couple of specific purposes, and usually for only brief periods. Competitive athletes in sports with weight class restrictions may use these drugs to drop water weight, in an effort to make adjustments in their weight class standings. Since the weigh-in procedure is often a day or days before a competition, one can drop their bodyweight considerably with diuretics, and be back to normal within hours after drug cessation and rehydration. This may provide a strong competitive advantage, allowing the athlete to compete at a heavier weight than his or her category would dictate. This advantage is only offset to some degree by the now near universal nature of some form of “dropping weight” practice in these sports. Bodybuilders may rely heavily on diuretics when preparing for a contest. Here, a drug like furosemide can efficiently lower subcutaneous water concentrations, helping to produce a more defined (“ripped”) look common to competitive bodybuilding.

Brand name Lasix, Furosemide

Furosemide History

Furosemide was developed during the early 1960s. Much of the initial research on this diuretic was conducted in Europe, mainly Germany and Italy. The drug proved to be quite successful, however, and within a matter of years gained worldwide attention and acceptance as a treatment for edema and high blood pressure. Over the years, furosemide preparations have become among the most popular medications in their area of medicine. Single- and multi-ingredient preparations making use of this diuretic can presently be found in virtually all corners of the world. The most recognized brand name is Lasix, presently sold in the U.S. and many other nations under the Sanofi Aventis label. The actual number of different brand and generic forms of furosemide would be difficult to calculate and list, but would probably measure in the hundreds.

How is Furosemide Supplied

Furosemide is most commonly supplied in oral tablets of 20 mg, 40 mg, and 80 mg, and injectable solutions containing 10 mg/ml.

Structural Characteristics of Furosemide

Furosemide is an anthranilic acid derived loop diuretic. It has the chemical designation 4- chloro-N-furfuryl-5- sulfamoylanthranilic acid.

Furosemide Warnings (Dehydration, Death)

Furosemide is a highly potent diuretic, which can profoundly increase water excretion (diuresis) and lead to electrolyte depletion. The misuse of diuretic drug(s) like furosemide for physique- or performance-enhancing purposes is characterized as a high-risk practice. Diuretics may produce a life-threatening level of dehydration and electrolyte imbalance when administered without proper medical supervision. Many deaths have been associated with the misuse of these drugs.

Furosemide Side Effects

Furosemide use may be associated with electrolyte imbalance. This may include the depletion of potassium (hypokalemia), sodium (hyponatremia), magnesium (hypomagnesemia), and calcium (hypocalcemia), as well as hypochloremic alkalosis, an increase in blood bicarbonate due to significant chloride loss. Signs of electrolyte imbalance include dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pain, muscle cramping, seizures, reduced urine volume, low blood pressure, and gastrointestinal disturbances. Other side effects may include pancreatitis, jaundice, anorexia, oral and stomach irritation, cramping, diarrhea, constipation, nausea, vomiting, hearing loss, numbness or tingling of the extremities, vertigo, dizziness, headache, blurred vision or other visual disturbances, anemia, decreased white cell or blood platelet count, dermatitis, rash, skin itching and sensitivity to light, low blood pressure, high blood sugar levels (hyperglycemia), muscle spasm, weakness, restlessness, urinary bladder spasm, fever, blood clot, and excess uric acid in the blood (hyperuricemia). Additionally, some rare side effects characterized as hypersensitivity reactions have been reported including inflammation of blood vessels, kidney inflammation, and inflammation of blood vessels or lymph ducts (angiitis).

Furosemide Administration

When used medically to treat edema, it is often given orally in a dose of 20 mg to 80 mg per day, which is taken in one single application. For the treatment of hypertension, it is generally recommended to administer 80 mg per day, which is given in two separate 40 mg applications spaced 12 hours apart.

Athletes and bodybuilders typically use this drug (offlabel) for very brief periods (several days) of water adjustment. The dosage and method of administration is tailored to the individual, dependent on the desired goals and condition of the athlete. Oral tablets are the most common form of administration. The athlete will usually start with a low dose, and increase the amount slightly on subsequent days. The main focus is to calculate the optimal dosage, as well as to determine the best intake schedule, in relation to a show or competition. The initial dosage is usually 20 mg to 40 mg, and the maximum daily intake rarely exceeds 80 mg. In order to minimize the side effects associated with this drug, it is generally used for no longer than 4-5 days.

Note that since furosemide has such a strong effect on electrolyte levels, it is generally considered much safer to add a potassium sparing agent like Aldactone (spironolactone) than it is to keep increasing the amount of furosemide used. Combination diuretics like this are widely produced as prescription medicines for this reason. The use of 50 mg Aldactone and 20 mg furosemide is a common starting point, and is believed to have a roughly similar diuretic effect to 40 mg of furosemide, but without the same level of potassium loss. This dosage may be adjusted on subsequent days in order to determine the optimal amount and intake schedule, but should rarely exceed 100 mg/40 mg per day. It is important to remember that these drugs can be active for many hours. It can become difficult to control the dehydrating effect with an overlapping schedule, therefore one should be careful not to administer diuretics on multiple occasions during the same day.

Injectable furosemide solutions are considered to be significantly more powerful forms of the drug milligram for milligram. Furosemide solutions can be administered intramuscularly or intravenously, depending on the individual needs of the patient. The IV method is much more rapid acting, and produces significantly higher peak blood levels of the drug. Given that the action of furosemide can be noticed in a matter of seconds or minutes when given by injection, the effect is actually easier to judge and control with this method of use, at least under normal conditions. Since the injection is much more powerful than the oral, however, is important to emphasize that the dosage must be considerably reduced in comparison. Intramuscular injection is most common with bodybuilders and athletes, and is usually given at a dosage of 10-20 mg. Doses in excess of 40 mg per day are rarely used in the bodybuilding/athletic population.

Furosemide Availability

Furosemide is widely available, and is manufactured and sold under many different brand names, in many countries. No version of Lasix (or any other diuretic) is currently being counterfeited on any large scale. Although it is doubtful these will circulate, make sure to never purchase the drug in 500 mg tablets. These are used only in severe medical conditions, and contain a dosage that would likely prove fatal to a healthy person.

Bodybuilders reference

Lasix is probably one of the most dangerous drugs some pre-contest bodybuilders used. Even the IFBB tests for diuretics, and that is saying something.

Lasix was used to excrete excess water during the last day or two before a show. This was said to be especially effective with subcutaneous water (under the skin) so a "ripped to the bone, dry, and hard" look was achieved. Lasix was also used by some to lose weight for weight class oriented sports.

Loop diuretics work by increasing the excretion of electrolytes (sodium, chloride, potassium) which the body normally uses to maintain intra cellular and extracellular water. Monitoring of the re-absorption of potassium, sodium, and chloride ions during use should have been a must, but few did so. Lasix can and has caused death.

As to dosages, it depended upon the effect achieved. Normally 20-40-mg was taken and (over a periods of 2-4 hours) the bodybuilder evaluates the results. This was followed once or twice more at 4 hour intervals if more water loss was necessary. Too much water loss makes the body appear flat with no vascularity and makes it impossible to pump-up before walking out onto the stage. The effects of Lasix begin within about an hour of administration and continue for 6-8 hours. Once "the look" was achieved, it was unnecessary to ingest more to maintain "the look".

Lasix is very strong and was reported to cause diarrhea, dehydration, dizziness, muscle cramps, circulatory disorders, vomiting, circulatory collapse, fainting, and cardiac arrest. It was considered far more safe to start with 20-mg and repeat every 4 hours than to use higher dosages for a shorter period of tome. Over 40-mg per dosage increased side effects dramatically!

Most serious noted comment:
NEVER USE A 250 or 500MG TAB!!!!

Anabolic Steroid Guide reference

Lasix is not a hormone compound but a diuretic. It belongs to the group of saluretics and to be exact is a loop diuretic. Its effect consists of distinctly increased excretion of sodium, chloride, potassium, and water. A very important characteristic which must be absolutely monitored with loop diuretics is the reabsorbtion of potassium ions, sodium ions, and chloride ions. This causes a considerable disturbance of the electrolyte household. Due to its intense effect on water excretion Lasix is used for treatment of edema~ and high blood pressure. Bodybuilders use Lasix shortly before a compe-tition to excrete excessive, mostly subcutaneous, water so that they appear hard, defined, and ripped to the bone when in the limelight. The effect of tablets begins within an hour and continues for 3-4 hours. Depending on how much water is still in the athlete's body he must have more or less frequent access to a restroom. This can cause a considerable weight loss within a very short time. For this reason, athletes often use Lasix to lose weight and to compete in a lower weight class. Athletes usually prefer the oral form of the compound. Bodybuilders occasionally use the injectable and intravenous version the morning of the competition since it becomes immedi-ately effective when the athlete, due to a more or less strongly remaining water film, begins to panic. This, however, can also pro-duce the opposite effect. That is, the muscles become small and flat; the athlete loses vascularity, and has no pump during warm-up when during a very short time too much water and minerals are lost. It is thus possible that some pro or top amateur shortly before the beginning of a competition as a last countermeasure is seen with a bag of glucose solution being injected intravenously so that the blood volume rises again. In order to compensate for the potassium loss many athletes take potassium chloride tablets. This, however, involves a certain risk since an overdose of potassium can cause cardiac arrest. In our experience, Lasix is taken in the last two days before a competition.

The amount of the dosage, the duration of application, and the intervals of intake usually depend on the diuretic effect or the athlete's shape. Bodybuilders usually take a half or whole 40 mg tablet and wait to see what happens. Some repeat this procedure once or twice in an interval of a few hours. Lasix is the strongest diuretic and the most dangerous compound in bodybuilders' arsenal of medicine. Side effects can include circulatory disturbances, dizziness, dehy-dration, muscle cramps, vomiting, circulatory collapse, diarrhea, and fainting. In extreme cases cardiac arrest is possible. Extreme caution is advised when athletes who are already substantially drained and dehydrated continue their loop diuretic treatment with a "make it or die atti-tude," or even continue the intake altogether with a completely reduced liquid intake. ATTENTION: The 500 mg tablet version must not be used under any circumstances by persons with a normal kidney function. Loop diuretics are prescription drugs and are only available in pharmacies. The compound Lasix by Hoechst Company, for example, is sold in packages containing 20 tablets of 40 mg each and costs about $10.

Newbies Research Guide reference

Lasix is not a hormone compound but a diuretic. It belongs to the group of saluretics and to be exact is a loop diuretic. Its effect consists of distinctly increased excretion of sodium, chloride, potassium, and water. A very important characteristic which must be absolutely monitored with loop diuretics is the reabsorbtion of potassium ions, sodium ions, and chloride ions. This causes a considerable disturbance of the electrolyte household. Due to its intense ef fect on water excretion Lasix is used for treatment of edemas and high blood pressure. Bodybuilders use Lasix shortly before a competition to excrete excessive, mostly subcutaneous, water so that they appear hard, defined, and ripped to the bone when in the limelight. The effect of tablets begins within an hour and continues for 3-4 hours. Depending on how much water is still in the athlete’s body he must have more or less frequent access to a restroom. This can cause a considerable weight loss within a very short time. For this reason, athletes often use Lasix to lose weight and to compete in a lower weight class. Athletes usually prefer the oral form of the compound. Bodybuilders occasionally use the injectable and intravenous version the morning of the competition since it becomes immediately effective when the athlete, due to a more or less strongly remaining water ifim, begins to panic. This, however can also produce the opposite effect. That is, the muscles become small and flat; the athlete loses vascularity, and has no pump during warm-up when during a very short time too much water and minerals are lost. It is thus possible that some pro or top amateur shortly before the beginning of a competition as a last countermeasure is seen with a bag of glucose solution being injected intravenously so that the blood volume rises again. In order to compensate for the potassium loss many athletes take potassium chloride tablets. This, however, involves a certain risk since an overdose of potassium can cause cardiac arrest. In our experience, Lasix is taken in the last two days before a competition. The amount of the dosage, the duration of application, and the intervals of intake usually depend on the diuretic effect or the athlete’s shape. Bodybuilders usually take a half or whole 40 mg tablet and wait to see what happens. Some repeat this procedure once or twice in an interval of a few hours. Lasix is the strongest diuretic and the most dangerous compound in bodybuilders’ arsenal of medicme. Side effects can include circulatory disturbances, dizziness, dehydration, muscle cramps, vomiting, circulatory collapse, diarrhea, and fainting. In extreme cases cardiac arrest is possible. This also seems to have been the cause of death for Austrian bodybuilder Heinz Salimayer, who passed away during the 1980’s, and for Mohammed Benaziza, who died in October ~ 992. Extreme caution is advised when athletes who are already substantially drained and dehydrated continue their loop diuretic treatment with a “make it or die attitude,” or even continue the
intake altogether with a completely reduced liquid intake. ATTENTION: The 500 mg tablet version must not be used under any circumstances by persons with a normal kidney function. Loop diuretics are prescription drugs and are only available in pharmacies. The compound Lasix by Hoechst Company, for example, is sold in packages containing 20 tablets of 40 mg each and costs about $10.

References

Wlliam Llewellyn (2011) - Anabolics
L. Rea (2002) - Chemical Muscle Enhancement Bodybuilders Desk Reference
Anabolic Steroid Guide
Newbies Research Guide

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