To the Editor.
—In light of the interesting article by Drs Gerlag and van Meijel in the February 1988 issue of the Archives,1 we would like to raise the possibility that the maximum recommended daily orally administered dose of furosemide is too low and should be raised.A quick review of the medical literature concerning the use of high doses of furosemide demonstrates that its use has been beneficial in various studies other than those of Gerlag and van Meijel.2-5 These studies treated 105,2 28,3 6,4 and 365 patients (respectively) with doses of furosemide, generally over 2 g/d and up to 4 g/d (administered either intravenously or orally). In these studies, there were a total of two cases of ototoxicity observed, with one condition being permanent. No other serious side effects were reported. It is noted that the two cases of ototoxicity that did
Rotellar C, Black J, Mackow RC, Rakowski TA. The Furosemide Myth. Arch Intern Med. 1988;148(12):2693. doi:10.1001/archinte.1988.00380120125026