Brand names include: Lasix, Frusax, Uremide

What is it & what are it’s uses?

Furosemide is prescription medication that is used for the treatment of hypertension (high blood pressure), heart failure, kidney disease and fluid retention1. It can be used alone or in combination with other anti-hypertensive medications1. It can be prescribed as an oral tablet or intravenously2.

How does it work?

It is classified as a loop diuretic which works by increasing urine production to reduce blood pressure and fluid retention. It works at the level of the renal tubules in the kidneys where it inhibits reabsorption of sodium and chloride which increases water secretion via urine1.

What are the side effects and risks?

Adverse effects associated with the prescribed use of Furosemide are1:

  • Pancreatitis
  • Liver disease
  • Acute kidney injury
  • Diarrhoea
  • Constipation
  • Loss of appetite
  • Nausea and vomiting
  • Numbness or tingling
  • Headache
  • Dizziness
  • Blurred vision
  • Allergic reaction

Additionally, if Furosemide is abused and used at higher doses1:

  • Dehydration
  • Electrolyte imbalance
  • Low blood pressure

This substance meets at least two of the following three criteria, as determined by the World Anti-Doping Agency (WADA):

  • It has the potential to enhance or does enhance sports performance.
  • It poses an actual or potential health risk to the athlete.
  • It violates the spirit of sport (as defined in The Code).

The Prohibited List is updated yearly after consultation with scientific, medical, and anti-doping experts to ensure that it aligns with the latest medical and scientific evidence and doping trends.

As a diuretic, Furosemide is banned for two reasons:

  1. It can be used to reduce weight amongst athletes. In sports where weight is a factor in competing or where having a lower weight may create an advantage (boxing, weightlifting, skating etc.)3. 
  2. As Furosemide causes increased urine production it can be used to flush the system of other Prohibited Substances prior to a doping control test3.

What if an athlete has been prescribed furosemide to treatment a medical condition?

If an athlete has been prescribed Furosemide or another diuretic by a medical practitioner for treatment of a medical condition, they may be eligible for a Therapeutic Use Exemption (TUE).

The TUE application should include:

  • A completed TUE application form signed by the treating medical practitioner and athlete.
  • Detailed clinical letter(s) from treating medical practitioner and specialist(s) that includes:
    • The diagnosis including the athlete’s medical history, examination and diagnostic test results
    • Outcome of trials of alternative medications, and
    • Current treatment, including medication/s, dose and route of administration 
    • More information for prescribing practitioners can be found at the WADA Checklist for TUE Application [PDF 80KB].

References

1 Khan TM, Patel R, Siddiqui AH. Furosemide. National Library of Medicine. National Centre of Biotechnology Information. May 2023.

2 Pharmaceutical Benefits Scheme (PBS) | PBS Medicine Search

3 Cadwallader AB, de la Torre X, Tieri A et al. The Abuse of diuretics as performance-enhancing drugs and masking agents in sport doping: pharmacology, toxicology and analysis. Br J Pharmacol 2010;161(1):1-16.

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