Torasemide

May be taken with or without food.

Hypersensitivity to sulfonamide derived drugs. Anuria; hepatic coma and pre-coma.

Patient with difficulty in micturition including prostatic hypertrophy, hyperuricaemia, gout, diabetes mellitus, cardiac arrhytmias (e.g. sino-atrial-block, 2nd or 3rd degree atrioventricular block). Patient with CV disease (particularly those receiving cardiac glycosides); liver cirrhosis and ascites (IV). Patient undergoing surgery; avoid use in the immediate postoperative period after bariatric surgery. Not recommended for the initial treatment of hypertension. Not for use in the treatment of hypertension in patients with Addison's disease. Renal and hepatic impairment. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor serum electrolytes, renal function, uric acid, serum glucose, lipids, CBC, blood pressure, volume status and diuretic effect periodically.

Significant: Fluid loss, dehydration, electrolyte abnormalities (e.g. hypokalaemia, hyponatraemia, hypomagnesaemia, hypocalcaemia, hypochloraemic alkalosis), hyperuricaemia, increased blood glucose levels, hyperglycaemia; nephrotoxicity, oliguria, azotaemia, reversible increase in BUN and creatinine; tinnitus and hearing loss (reversible). Rarely, gout. Gastrointestinal disorders: Nausea, vomiting, dyspepsia, diarrhoea, constipation, anorexia, abdominal pain. General disorders and administration site conditions: Asthenia, fatigue. Immune system disorders: Serious skin reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis). Investigations: Increased blood uric acid, blood glucose, and lipids (including triglycerides, cholesterol). Metabolism and nutrition disorders: Metabolic alkalosis, hyperlipidaemia. Musculoskeletal and connective tissue disorders: Muscle spasms. Nervous system disorders: Headache, dizziness, nervousness. Renal and urinary disorders: Polyuria.

May enhance the adverse/toxic (nephrotoxicity/ototoxicity) effect of aminoglycosides. May increase the nephrotoxic effect of cephalosporins and cisplatin. May increase serum concentrations and the cardio-and neurotoxic effect of lithium. May increase the hypokalaemic effect of corticosteroids and laxatives. May enhance the hypotensive effect of ACE inhibitors. May diminish the therapeutic efficacy of antidiabetic agents. May potentiate the therapeutic effect of theophylline and curare-containing muscle relaxants. May increase the risk of salicylate toxicity. Decreased renal clearance of spironolactone. NSAIDs (e.g. indomethacin) and probenecid may decrease the therapeutic efficacy of torasemide. May decrease the arterial responsiveness to pressor agents (e.g. epinepherine, norephinephrine).

Diuretics

C03CA04 - torasemide ; Belongs to the class of high-ceiling sulfonamide diuretics.