Furosemide

Hello Amplitude 

We spoke yesterday - this one has me confused as yes, it's a diuretic, so do you stop drinking after 4pm? But I can't go against medical advice. Here's the NHS link:

Furosemide NHS.

When I was in hospital this was one option to clear my kidneys (see my profile) but the better option was for me to drink water and have a saline drip.

I am sure your team know best and I hope it works for you. Do let us know.

Best wishes - Brian.

My GP rang this morning to fill me in on what’s what with furosemide. Apparently 20mg is a light dose and it will stimulate my kidneys to remove excess fluid from my body quite quickly. She suggested I don’t go out for the first few evenings though as the effect can cause urgency and I need to understand how it’s affecting me first. Taking the tablet at 4pm should leave little excess by 10pm. I didn’t ask about drinking in the evening but can experiment with that.

I have been up in the night 3, 4, sometimes 5 times since RT finished and pass up to a litre of urine in total, which I discovered when I measured it once (out of interest…!).

Losing sleep prompted me to ask if she could help. This morning I woke at 4.30am and couldn’t get back to sleep.

Hello Amplitude 

Do keep us posted on this - there are a few of us with the night visits to the toilet, although I am lucky I go back to sleep as soon as I am back in bed.

I wish you well with the "experiment".

Kind regards - Brian.

Well, I’m now 8 days into Furosemide and yes, urgency starts between half an hour and an hour after taking it, and no, no difference yet to night time visits. Last night I measured the output and it was just over one litre, same as two weeks ago. I’m not sure if its effect builds up over time so will complete the 28-day course, which apparently finishes with a blood test. 

Hello Amplitude 

Interesting. I thought the GP might be on to something, however is 8 days long enough for change to take place.

Thanks for the update - please do keep us posted.

Kind regards-Brian.

Hi Amplitude,

I'm very interested in your post on this.

Finished my RT yesterday, not too bad overall, bowels ok but was struggling on the p-front. every 45m daytime and 3-4x during the night. 

At my sign-off with the radiologist she found that my main problem was bladder not emptying. She precribed Tamsulosin aka Flomax on the spot and am about to take my second one. 'Only' 2x last night and over an hour daytime. That's progress (kind of). She expects me to be on this for at least a couple of months. 

It does tend to lower BP, which she warned me about so some dizziness, but thinks I can reduce my Amlodipene to counteract. Talking to my GP next week.

I thought that this was the more 'standard' p-solution. I am wondering if Furosemide is your Plan A and whether you've already been down the Flomax route?

Comment appreciated.

Will keep you posted on how I get on..

David

PS...do you like red wine? Try the new varietal 'Pinot More' ;-)

Hello David. Good to hear you have completed RT without bowel issues. I had similar bladder issues which reduced during the day after a couple of weeks, but not during the night. What type of machine were you treated with?

Well, the Furosemide story so far is… After the last Zoladex injection I mentioned to the practice nurse that I was still waking 3 or 4 times, sometimes 5 times in the night for a leak. After the 4am visits sometimes getting back to sleep was an issue and I was starting to notice the effects of a lack of sleep.

She passed that on to my GP, who kindly rang me for more info. She (the GP) passed that on to the urologists for guidance. They proposed 20mg of Furosemide which would ‘leave me little urine to produce overnight’. So she then prescribed that for a month and said she would arrange a blood test and have another chat when the month was over.

I do find it a little bit confusing as the instruction from urology is to take it at 4pm. The NHS web site says take it in the morning - and try not to take it too late in the day (after 4pm) or at night, otherwise you may have to wake up to go to the toilet. Which is exactly what I’m trying to avoid… Last night I woke 3 times, the last at 4.30am and the ‘little urine’ was, in fact, quite a lot. The NHS info indicates Furosemide is an active diuretic for up to 8 hours. I’m thinking of slipping it back to say 2pm for a couple of days. See what happens.

Thanks for the advice ref Tamsulosin, please keep me updated with how you find that works and I will mention it when she calls. The list of side-effects from Furosemide is long and I’m not really keen to increase that to 40mg.

Pinot More? I think we’d all appreciate that on a 4pm prescription…!

Hi Amplitude that sounds very sensible. Maybe keep a diary and see if you can adjust the time to work for you.  Also what time you lake liquids onboard is probably relevant.  

Hi Amp,

An update on Flomax (4 days now), as promised.

Days 2&3 were 2x per night, last night was 4X. I'm not sure it's bladder not emptying (I double void when it's possible) but perhaps is OAB (over-active bladder), My review with nurse (her request) was today but she was a no-show. I've decided to keep a bladder diary for 3 days in readiness for a new appointment next week (I downloaded a freebie pro-forma from internet), might help her judge what's going on. Today (daytime) is looking like 10-12x which is not good with only 2.5l of decaf liquid, mainly am. I am trying to 'front load' my intake hoping for a better sleep tonight. Not flowing too much for the 1st 4h but ten 5x in the next 4h, I stupidly had a herbal tea last night at 9pm... I intend to stop fluid intake around 5pm. Nurse said 7pm in case urine became over-concentrated (I'd prefer to take that chance).

My SE of bad dizziness was day 1 with low BP 120/62. Since then it has shot back to my normal/high 140/80. Only slight dizziness now but could be due to my daily predisolone. No other obvious SEs.

To be continued after discussion with my nurse... (Gotta go now!) David

PS1... My wife and I celabrated end of RT with an overnight stay on Wednesday. Lovely dinner and 2 glasses of red wine and took Flo at 9.30pm instead of 6.30. Guess what...slept right through till 5.30pm... is that a way forward? Australian Shiraz = Pinot More?? or was it the large steak and chips/

PS2...I want to thank you for your diary of SEs at x weeks after RT. The best I've seen and gives me hope of when improvements might happen. Really useful.

So I’m now 10 days in to the Furosemide course and I really haven’t noticed much difference, maybe a bit more urgency in the early evening with quite a low resulting output. I’m still passing up to a litre in the night, most of that around 4-5am. The GP is ringing me on Monday to discuss results and any side-effects. That should be an interesting conversation. 

You pushed the boat out well on completion of your RT David. We celebrated with a pizza and pint of Plum Porter for me in Wetherspoons!! Thanks for the good news on Shiraz. I feel a need for an experiment coming on…