torasemide


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Related to torasemide: Torsemide, spironolactone

torsemide (torasemide (UK))

Demadex, Torem (UK)

Pharmacologic class: Loop diuretic

Therapeutic class: Diuretic, antihypertensive

Pregnancy risk category B

Action

Inhibits sodium and chloride reabsorption from ascending loop of Henle and distal renal tubule; increases renal excretion of water, sodium, chloride, magnesium, calcium, and hydrogen. Also may exert renal and peripheral vasodilatory effects. Net effect is natriuretic diuresis.

Availability

Injection: 10 mg/ml

Tablets: 5 mg, 10 mg, 20 mg, 100 mg

Indications and dosages

Heart failure

Adults: 10 to 20 mg P.O. or I.V. daily. If response inadequate, double dosage until desired response occurs. Don't exceed 200 mg as a single dose.

Hypertension

Adults: 5 mg P.O. daily. May increase to 10 mg daily after 4 to 6 weeks; if drug still isn't effective, additional antihypertensives may be prescribed.

Chronic renal failure

Adults: 20 mg P.O. or I.V. daily. If response inadequate, double dosage until desired response occurs. Don't exceed 200 mg as a single dose.

Hepatic cirrhosis

Adults: 5 or 10 mg P.O. or I.V. daily, given with aldosterone antagonist or potassium-sparing diuretic. If response inadequate, double dosage. Don't exceed 40 mg as a single dose.

Contraindications

• Hypersensitivity to drug, thiazides, or sulfonylureas

• Anuria

Precautions

Use cautiously in:

• severe hepatic disease accompanied by cirrhosis or ascites, preexisting uncorrected electrolyte imbalances, diabetes mellitus, worsening azotemia

• elderly patients

• pregnant or breastfeeding patients

• children younger than age 18.

Administration

• Give I.V. by direct injection over at least 2 minutes or by continuous I.V. infusion.

• Flush I.V. line with normal saline solution before and after administering.

Adverse reactions

CNS: dizziness, headache, asthenia, insomnia, nervousness, syncope

CV: hypotension, ECG changes, chest pain, volume depletion, atrial fibrillation, ventricular tachycardia, shunt thrombosis

EENT: rhinitis, sore throat

GI: nausea, diarrhea, vomiting, constipation, dyspepsia, anorexia, rectal bleeding, GI hemorrhage

GU: excessive urination

Metabolic: hyperglycemia, hyperuricemia, hypokalemia

Musculoskeletal: joint pain, myalgia

Respiratory: increased cough

Skin: rash

Other: edema

Interactions

Drug-drug. Aminoglycosides, cisplatin: increased risk of ototoxicity

Amphotericin B, corticosteroids, mezlocillin, piperacillin, potassium-wasting diuretics, stimulant laxatives: additive hypokalemia

Antihypertensives, nitrates: additive hypotension

Lithium: increased lithium blood level and toxicity

Neuromuscular blockers: prolonged neuromuscular blockade

Nonsteroidal anti-inflammatory drugs, probenecid: inhibited diuretic response

Sulfonylureas: decreased glucose tolerance, hyperglycemia in patients with previously well-controlled diabetes

Drug-diagnostic tests. Glucose, uric

acid: increased levels

Potassium: decreased level

Drug-herbs. Dandelion: interference with diuresis

Ephedra (ma huang): reduced hypotensive effect of torsemide

Geranium, ginseng: increased risk of diuretic resistance

Licorice: rapid potassium loss

Drug-behaviors. Acute alcohol ingestion: additive hypotension

Patient monitoring

• Monitor vital signs, especially for hypotension.

• Assess ECG for arrhythmias and other changes.

• Monitor weight and fluid intake and output to assess drug efficacy.

• Monitor electrolyte levels, particularly potassium. Stay alert for signs and symptoms of hypokalemia.

• Assess hearing for signs and symptoms of ototoxicity.

• Monitor blood glucose level carefully in diabetic patient.

Patient teaching

• Advise patient to take in morning with or without food.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure drop.

• Tell patient to monitor weight and report sudden increases.

• Instruct diabetic patient to monitor blood glucose level carefully.

• Caution patient to avoid alcohol during drug therapy.

• Advise patient to consult prescriber before using herbs.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.

torasemide

A LOOP DIURETIC drug used to treat high blood pressure (HYPERTENSION) or oedema from any cause. A brand name is Torem.
References in periodicals archive ?
Comparison of the effect on ambulatory blood pressure of awakening versus bedtime administration of torasemide in essential hypertension.
The exception was his contribution to the development of torasemide. He remained an independent voice to the end, quite uncorrupted by financial inducements.
700 c08da01 verapamil hydrochloride tb.40 mg 200 c01da08 isosorbite dinitrate spray 15 c01da02 glyceryl trinitrate 50 mg 50 ml 100 c03ca04 torasemide 10 mg.
His additional short-term follow-up remained uneventful, with treatment with clopidogrel, aspirin, metoprolol, atorvastatin, ramipril, torasemide, and pantoprazole.
Lot no - atc code - atc description 1 - a04aa02 - granisetron 2 - a05aa02 - ursodeoxycholic acid 3 - a05aa02 - ursodeoxycholic acid 4 - b01ac04 - clopidogrel 5 - c02ca04 - doxazosin 6 - c03ca04 - torasemide 7 - c03da04 - eplerenone 8 - c07ab02 - metoprolol 9 - c07ab02 - metoprolol 10 - c07ab07 - bisoprolol 11 - c08ca02 - felodipine 12 - c09ba02 - enalapril and diuretics 13 - c09ca03 - valsartan 14 - c09ca06 - candesartan 15 - c09da03 - valsartan and diuretics 16 - c09da06 - candesartan and diuretics 17 - c10aa03 - pravastatin 18 - c10ac01 - colestyramine 19 - c10ax06 - omega-3 fatty acids incl.
Limited Tenders are invited for Procurement Of Torasemide 10Mg T.
Tenders are invited for Torasemide Or Torsemide U.S.P.
Tenders are invited for Torasemide 20 Mg Plus Spironolactone 50 Mg Tab