Oral loop diuretic Has a half-life that is longer and is twice as long as that of furosemide; its impact on potassium excretion may be less pronounced. used to treat edema brought on by heart failure, chronic renal failure, and hepatic cirrhosis as well as hypertension
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Torsemide acts within the lumen of the thick ascending portion of the loop of Henle, where it inhibits the Na+/K+/2CI carrier system. Torsemide increases the excretion of sodium, chloride, and water in the urine but has no appreciable impact on the rate of glomerular filtration, renal plasma flow, or acid-base balance.
The initial dose of 20 mg of toremide once daily is advised for edema related to chronic renal failure. Heart failure-related edema: A starting dose of 10 mg or 20 mg of toremide once daily is advised. Torsemide 5 mg or 10 mg once daily, combined with an aldosterone antagonist or a potassium-sparing diuretic, is the recommended initial dose for edema caused by hepatic cirrhosis. Increase to 10 mg once daily if the 5 mg dose does not sufficiently lower blood pressure within 4 to 6 weeks. If the diuretic response is insufficient, gradually increase the dosage by about doubling each time until the desired diuretic response is achieved. Add another antihypertensive medication to the treatment plan if the 10 mg dose does not produce the desired results. Treatment of hypertension: A starting dose of 5 mg once daily is advised.
To make up for a missed dose, do not take a second one. On the other hand, skip the missed dose if it is almost time for your next one and carry on with your regular dosing schedule. As soon as you realize you missed a dose, take it.
Canada residents can call a provincial poison control center. While taking this medication, check your blood pressure frequently. For more information, speak with your doctor. Consult your pharmacist or local waste disposal company. In order to catch up, do not double the dose. Unless specifically instructed to do so, avoid flushing medications down the toilet or pouring them into drains. This medication should not be given to anyone else. Keep out of the bathroom. If it is near the time of the next dose, skip the missed dose. Call 911 if a person has overdosed and is exhibiting severe symptoms like fainting or breathing difficulties. As soon as you remember, take the missed dose. Keep kids and pets away from all medications. Periodically, you should undergo laboratory and/or medical tests to track your progress or look for any negative effects, including kidney tests and blood mineral levels like potassium. Learn how to check your own blood pressure at home, then inform your doctor of the results. Exercise, quitting smoking, lowering stress, and modifying your diet are all lifestyle changes that may improve how well this medication works. If not, immediately dial a poison control hotline. When the product has run its course or is no longer required, properly dispose of it. Store at room temperature away from light and moisture. Overdose symptoms can include fainting, extreme weakness, and a sharp drop in urine production. Take your next dose at the regular time. US residents can call their local poison control center at 1-800-222-1222.
Keep the medicine out of reach of children. A shield against moisture and light Store below 30 degrees Celsius.
Call your physician for advice on possible side effects. If you have: Dial your doctor right away. Typical negative effects may include: If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: hives; trouble breathing; swelling of your face, lips, tongue, or throat. Other side effects could occur; this is not a comprehensive list. Torsemide side effects (more information) Contact the FDA at 1-800-FDA-1088 to report side effects. Low magnesium levels can cause dizziness, irregular heartbeats, jitteriness, muscle cramps, muscle spasms, coughing or a feeling of choking; low potassium levels can cause leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or sudden hearing loss; kidney problems can cause little or no urination, painful or difficult urination, swelling in your feet or ankles, fatigue or shortness of breath. headache or increased urination.
To learn more, consult your physician or pharmacist. Inform your doctor right away if you take any of the following substances: probenecid (Benemid), digoxin (Digitek, Lanoxin), nonsteroidal anti-inflammatory drugs (NSAIDs) such as gentamicin, kanamycin, amikacin (Amikin), or naproxen (Aleve), nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin), naproxen (Aleve), Inform your doctor about all of the medications you take, including any prescription and over-the-counter drugs, vitamins, and herbal supplements.
Before you know how it affects you, avoid operating heavy machinery or driving a car. If any of the following apply to you: you cannot produce urine; you are allergic to torsemide or any of its ingredients; you are allergic to "sulfa" medications. Combining torsemide with other drugs that are known to cause hearing loss increases the risk of hearing loss. high blood glucose "sugar" concentrations in diabetics This medication may cause drowsiness or dizziness. If you experience hearing loss or ringing in the ears, contact your doctor right away. This medication may affect electrolytes including sodium, potassium, calcium, magnesium, and chloride. Electrolyte imbalance is one of the serious side effects of toremide. Dry mouth, thirst, weakness, lack of energy, restlessness, muscle cramps, low blood pressure, decreased urination, fast heartbeat, nausea and vomiting, worsening kidney disease, worsening gout, hearing loss are all indications of electrolyte imbalance. A blood test will be used by your doctor to determine these levels.
What is the generic for torsemide?
Torsemide oral tablet is available as the brand-name drug Demadex and as a generic drug.
Does torsemide deplete potassium?
Torsemide can cause low blood potassium, calcium, and magnesium levels. These changes can increase the risk of toxicity from digoxin (Lanoxin). Combining torsemide with other diuretics such as metolazone (Zaroxolyn), hydrochlorothiazide, or chlorthalidone (Hygroton) can exaggerate the losses of potassium and magnesium.
What is the action of torsemide?
Abstract. Torasemide (torsemide) is a high-ceiling loop diuretic which acts on the thick ascending limb of the loop of Henle to promote rapid and marked excretion of water, sodium and chloride. Like furosemide (frusemide), its major site of action is from the luminal side of the cell.
How much torsemide can I take in a day?
Adults—At first, 10 or 20 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 200 mg per day.
What is the indication of torsemide?
DEMADEX is indicated for the treatment of edema associated with heart failure, renal disease or hepatic disease.
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Pharmacokinetics Furosemide’s rapid onset of action makes it indispensable in the emergent treatment of cardiogenic pulmonary edema. In our practices, the set point for change is somewhat higher, at a furosemide dosage greater than 6 to 8 mg/kg Q 24 H. Torsemide can be initiated in this circumstance as one dose per day, replacing one dose of furosemide (at one tenth the mg dosage) and leaving other treatments (including later daily doses of furosemide) intact. Clin Pharm Therap 1995; 57(60):601-609.
Chlorthalidone reduces the kidney's ability to eliminate lithium (Eskalith, Lithobid) in the urine. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin), naproxen (Naprosyn), and nabumetone (Relafen) can reduce the effectiveness of chlorthalidone though the reason for this is not clear. Chlorthalidone can lower blood potassium and magnesium levels because both potassium and magnesium are lost in the urine.
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Administration Parenteral: Undiluted direct IV injections may be administered at a rate of 20 to 40 mg per minute; high doses (eg, ≥160 mg) should be given as a short-term infusion at a maximum rate of administration of 4 mg/minute; exceeding this rate increases the risk of ototoxicity (Brater 2019b). The maximum recommended total daily dose is 600 mg/day to avoid toxicity (Brater 2011; Brater 2019a; Brater 2019b; ACC [Hollenberg 2019]). Note: Oral bioavailability varies widely but on average is 50% of the IV dose (Brater 2011). Transitioning from IV to oral: There is substantial variability in oral bioavailability; some experts recommend giving 1 to 2 times the IV dose orally (eg, total daily IV dose of 80 mg/day should be converted to an oral dose of 80 to 160 mg/day in 1 to 2 divided doses), then monitoring urine output and adjusting oral dose as needed (Brater 2011; Brater 2019b; Kaojarern 1982; Murray 1997; Vargo 1995). Note: When IV or oral administration is not possible, the sublingual route may be used.
Setting: 19 published randomized, controlled trials (RCTs) or observational studies in the English language. Meta-analysis comparing torsemide versus furosemide in patients with heart failure. Synopsis: 19 RCTs and observational studies comparing furosemide and torsemide were analyzed to identify differences in New York Heart Association functional classification, side effects, hospitalizations for heart failure, cardiac mortality, and all-cause mortality. In addition, there were lower numbers of hospitalizations from heart failure and a lower risk of cardiac death in the torsemide arm though these differences disappeared when RCTs were analyzed alone.