Furosemide is an antihypertensive loop diuretic drug. The main indications are for edema and hypertension with an off-label use for hypercalcemia. The general dosing range is between 40-120 mg per day with a max of 600 mg per day. The mechanism of action is it interferes with the chloride-binding co-transport system causing a natriuretic effect. It inhibits sodium and chloride resorption in the ascending Loop of Henle and the proximal and distal renal tubules. The onset of action for diuresis is around 30-60 minutes with symptomatic improvement of acute pulmonary edema occurs within 15-20 minutes. Caution should be observed in patients with electrolyte imbalances, the elderly, premature neonates, patients with gout, lupus, and diabetes. There is a black box warning for fluid and electrolyte loss if excessive amounts are used. When considering the drug interactions one should consider that furosemide is an OAT1 and OAT3 substrate, it may cause hypocalcemia, hypokalemia, hyponatremia, ototoxicity, and others. 

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