title: Special Comments - Neonatal Intensive Care Drug Manual
text: Loop diuretics are preferred for initial treatment of heart failure as they have a greater effect on sodium excretion compared to distal diuretics.2
  Potassium deficits can be corrected by the short-term use of potassium supplements.
  Concomitant administration of a potassium-retaining agent such as spironolactone can prevent potassium depletion in most infants taking a loop diuretic.
  Alternate day dosing may be considered to reduce the risk of electrolyte and mineral abnormalities.
  Plasma t½ of furosemide is 7.7–26.8 hours in neonates. It is longer in immature infants (mean t½ > 20 hours).22 The t½ is prolonged by renal and hepatic insufficiency.
  Blood concentrations exceeding 0.05 mg/mL may be associated with ototoxicity.
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