Torsemide

What is Torsemide

Torsemide is an oral and IV loop diuretic, the most active of a new series of anilinopyridine sulfonylurea derivatives.

On a weight to weight basis torsemide is twice as potent as furosemide, and provides a longer duration of action at lower urinary concentrations.

This allows for a 24-hour dosage interval and avoids the paradoxical antidiuresis seen with furosemide. Torsemide doses of 10—20 mg are roughly equivalent to 40 mg furosemide and 1 mg bumetanide.

Limited data suggest torsemide exhibits less pronounced effects on the excretion of calcium, magnesium, and potassium than furosemide however, at higher doses, these distinctions may be insignificant.

Torsemide is effective in the treatment of mild to moderate essential hypertension, and in the reduction of edema associated with congestive heart failure, renal disease and hepatic cirrhosis. Torsemide received approval from the FDA on August 23, 1993.

Brand Name

Demadex

Indications

  1. ascites
  2. edema
  3. hypertension

Side Effects

  1. angina
  2. angioedema
  3. anxiety
  4. arthralgia
  5. asthenia
  6. atrial fibrillation
  7. azotemia
  8. constipation
  9. cough
  10. diarrhea
  11. dizziness
  12. dyspepsia
  13. edema
  14. GI bleeding
  15. gout
  16. headache
  17. hearing loss
  18. hypercholesterolemia
  19. hyperglycemia
  20. hypertriglyceridemia
  21. hyperuricemia
  22. hypokalemia
  23. hypovolemia
  24. insomnia
  25. leukopenia
  26. myalgia
  27. nausea
  28. oliguria
  29. orthostatic hypotension
  30. pancreatitis
  31. pharyngitis
  32. polyuria
  33. rash
  34. rhinitis
  35. Stevens-Johnson syndrome
  36. syncope
  37. thrombocytopenia
  38. thrombosis
  39. tinnitus
  40. toxic epidermal necrolysis
  41. ventricular tachycardia
  42. vomiting
  43. xerostomia

Monitoring Parameters

  • audiometry
  • blood glucose
  • serum creatinine/BUN
  • serum electrolytes
  • weight

Contraindications

  • acute myocardial infarction
  • anuria
  • breast-feeding
  • children
  • diabetes mellitus
  • electrolyte imbalance
  • geriatric
  • gout
  • hearing impairment
  • hepatic disease
  • hyperglycemia
  • hyperuricemia
  • hypochloremia
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hypovolemia
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • sulfonamide hypersensitivity
  • sulfonylurea hypersensitivity
  • sympathectomy
  • syncope
  • thiazide diuretic hypersensitivity
  • ventricular arrhythmias

Interactions

  • Acarbose
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
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