The continued, long-term usage of Furosemide in non-heart failure ankle oedema and hypertension might be associated with detrimental effects in those with advanced disease and poor functional status, as it may precipitate postural hypotension and pre-renal failure. While withdrawal of the drug might be advised in this setting, a gradual tapering with monitoring should be used, as these patients might be prone to the development of insidious onset chronic heart failure.

Furosemide has been recognised as a potential precipitating factor and contributor to the development of delirium in advanced cancer by virtue of its effects on electrolytes, renal hypoperfusion and dehydration. Timing of onset, history of dose uptitration, and presence of electrolyte abnormalities may act as potential clues to the diagnosis.

References

Wilcock, A., Howard, P., Stark Toller, C., Droney, J., & Charlesworth, S. (Eds.). (2025). Palliative care formulary (9th ed.). Pharmaceutical Press.

Inouye, S. K., Westendorp, R. G. J., & Saczynski, J. S. (2014). Delirium in elderly people. The Lancet, 383(9920), 911–922. https://doi.org/10.1016/S0140-6736(13)60688-1