Torsemide Pharmacology


About Torsemide
Pyridine-sulfonylurea class Loop Diuretic, Antihypertensive,in CHF, Diuretic.
Mechanism of Action of Torsemide
Torsemide is a high ceiling loop diuretic which exerts it`s diuretic action by acting at site-2(thick ascending loop of Henle). It binds to Na+K+2Cl- symporter and inhibits Na+K+2Cl- co transport in luminal membrane of thick ascending loop of Henle. It inhibits sodium and chloride re absorption and promotes excretion of sodium, water, chloride, potassium, calcium, and magnesium. Torsemide does not significantly alter glomerular filtration rate, renal plasma flow, or acid base balance.
Torsemide increase local prostaglandin synthesis and increases systemic venous capacitance and decreases left ventricular filling pressure. This causes relief in left ventricular failure and pulmonary edema. It causes renal and peripheral vasodilatation and decrease in peripheral resistance.

Pharmacokinets of Torsemide
Absorption: It is rapidly absorbed after oral administration (bioavailability is 80%) and little undergoes first pass metabolism.
Distribution: It is widely distributed in the body in protein bound form.
Metabolism: Torsemide undergoes metabolism in the liver and forms both active and inactive metabolites.
Excretion: Drug and its metabolites are excreted mainly in the urine

Onset of Action for Torsemide
1 hour
Duration of Action for Torsemide
6 - 8 hours
Half Life of Torsemide
3.5 hours
Side Effects of Torsemide
1. Excessive urination
2. Altered electrolyte balance
3. Diarrhoea
4. Constipation
5. Dizziness
6. Headache
7. Rhinitis
8. Asthenia
9. ECG Abnormality
10. Increased cough
11. Nausea
12. Arthralgia
13. Dyspepsia
14. Sore Throat
15. Myalgia
16. Chest Pain
17. Insomnia
18. Edema
19. Nervousness
20. Ototoxicity
Contra-indications of Torsemide
1. Hypersensitivity to Torsemide and other sulfonylurea derivatives
2. Patient with anuria
Special Precautions while taking Torsemide
1. Monitor fluid and electrolyte balance
Pregnancy Related Information
Use with caution
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
NEONATES : Contraindicated
Indications for Torsemide
1. Diuretics
2. Hypertension
3. Heart failure
Interactions for Torsemide
Anticoagulants: Activity of anticoagulants may be enhanced.
Aminoglycoside antibiotics: Frusemide increases potential for ototoxicity.
Cisplatin: Frusemide increases potential for ototoxicity.
Digitalis glycosides: Diuretics induced potassium loss may precipitate digitalis toxicity, increased frequency of cardiac arrhythmias.
NSAIDs: Effect of frusemide reduced.
Lithium: Therapeutic and toxic effects of lithium increased.
Metolazone: Profound diuresis and greater than predicted electrolyte loss related to the ability of metolazone to block proximal tubular sodium reabsorption useful in patients refractory to frusemide.
Non-depolarizing muscle relaxants: Action of succinylcholine & tubocurarine potentiated by low doses reversed by high doses.
Food: Efficacy reduced when administered with food.
Propranolol: Plasma propranolol level may be increased.
Clofibrate: Increased diuretic responses.
Hydantoins: May decrease the diuretic effects.
Typical Dosage for Torsemide
As diuretic
1. In heart failure: 10 - 20 mg once daily if sufficient therapeutic response is not obtained then increases the dose until response is obtained up to 200 mg/ day.
2. In chronic renal failure: 20 mg once daily if sufficient therapeutic response is not obtained then increases the dose until response is obtained up to 200 mg/ day.
3. In hepatic cirrhosis: 5 - 10 mg once daily with potassium sparing antagonist if sufficient therapeutic response is not obtained then increases the dose until response is obtained up to 40 mg/ day.
Intravenous: Same as oral dose
Hypertension: 5 mg / day if needed dose can be gradually increased to 10mg

Children: Not recommended
Schedule of Torsemide
Storage Requirements for Torsemide
Store in a cool dry place. Protect from heat and light. Keep out of the reach of children.
Effects of Missed Dosage of Torsemide
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Torsemide
Give supportive measures and symptomatic treatment. Treatment involves fluid and electrolyte replacement.

Home Delivery for Torsemide in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including torsemide.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for torsemide and other medicines and health products. Home delivery services for torsemide may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take torsemide only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for torsemide before they complete the sale. You can get this information while placing the order for torsemide with the pharmacy.

Torsemide is a generic medicine name and there are several brands available for it. Some of the brands for torsemide might be better known than torsemide itself. If the pharmacy that's willing to deliver medicines to your home doesn't have torsemide in stock, you can ask for one of the branded alternatives for torsemide.