Narrative review: furosemide for hypercalcemia: an unproven yet common practice.
Although primary hyperparathyroidism is the most common cause of hypercalcemia, cancer is the most common cause requiring inpatient intervention. An estimated 10% to 20% of all patients with cancer have hypercalcemia at some point in their disease trajectory, particularly in advanced disease. Aggressive saline hydration and varying doses of furosemide continue to be the standard of care for emergency management. However, a review of the evidence for the use of furosemide in the medical management of hypercalcemia yields only case reports published before the introduction of bisphosphonates, in contrast to multiple randomized, controlled trials supporting the use of bisphosphonates. The use of furosemide in the management of hypercalcemia should no longer be recommended.
LeGrand
Susan B
SB
Harry R. Horvitz Center for Palliative Medicine, Solid Tumor Oncology, Cleveland Clinic, Taussig Cancer Institute, 9500 Euclid Avenue R35, Cleveland, OH 44195, USA. legrans@ccf.org
Leskuski
Dona
D
Zama
Ivan
I
D002116:Calcitonin / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005440:Fluid Therapy; D005665:Furosemide / Q000627:therapeutic use*; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy*; D015532:Rehydration Solutions / Q000627:therapeutic use; D012965:Sodium Chloride / Q000627:therapeutic use; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use*
D004164:Diphosphonates; D015532:Rehydration Solutions; D049994:Sodium Potassium Chloride Symporter Inhibitors; D012965:Sodium Chloride; D005665:Furosemide; D002116:Calcitonin