Torasemide is used on its own or together with other medicines to keep your blood pressure under control.
It is also used to treat water retention caused by heart failure, kidney, or liver disease. Water retention may be noticed as swelling of the feet, ankles, lower leg and hands, or shortness of breath. For this reason, it is commonly known as a "water pill."
Take Torasemide exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
You may need to pass urine more often while being treated with this medicine. Take it early in the day, preferably in the morning, to avoid waking up frequently at night to go to the toilet.
Torasemide must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Do not take Torasemide if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to Torasemide or sulfonylureas (medicine for diabetes).
Alert your doctor if you have the following conditions:
- not able to pass urine
- severe liver disease
as Torasemide may not be suitable for you.
Inform your doctor if you have the following conditions:
- difficulty in passing urine
- prostate enlargement
- high level of uric acid in the blood
- heart disease
- kidney disease
- mild to moderate liver disease
Let your doctor know if you are pregnant or breastfeeding.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
What lifestyle changes can I make to improve my blood pressure?
- Routine tests (e.g. kidney function, cholesterol, sugar, uric acid, electrolyte levels, complete blood count) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure during treatment.
- Regular monitoring of volume status may also be needed.
Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.
If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.
Torasemide may cause dizziness. If affected, do not drive, or take part in any activity in which you need to be alert.
Other side effects include any of the following: nausea, vomiting, indigestion, diarrhoea, constipation, upper stomach pain, dry mouth, sore throat, headache, weakness, tiredness, loss of appetite, high blood sugar, high cholesterol level, muscle weakness/pain, joint pain, confusion, "pins and needles", nervousness, cough, colds, skin rash, low blood pressure.
You may need to pass urine more often while you are being treated with Torasemide. As your body adjusts to the medicine, this urination effect should also decrease.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- dryness of the mouth, thirst, drowsiness, restlessness, weakness, muscle pain/cramps, muscle weakness, low blood pressure, low urine output, fast heartbeat, nausea and vomiting
- severe joint pain, joint stiffness, swelling and redness
- hearing problems such as loss of hearing, ringing or buzzing sounds in the ear
Torasemide may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- certain antibiotics e.g. aminoglycosides, cephalosporins
- other water pills e.g. ethacrynic acid, spironolactone
- cisplatin (medicine for cancer)
- digoxin (medicine for heart disease)
- medicine for constipation
- anti-inflammatory medicines e.g. bethamethasone, aspirin, indomethacin
- medicine for high blood pressure e.g. enalapril
- medicines for diabetes
- theophylline (asthma medicine)
- muscle relaxants containing a plant extract called curare
- lithium (medicine for mood disorders)
- medicine for gout e.g. probenecid
This list does not include all medicines that may interact with Torasemide.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Cut down on your salt intake. This may help lower your blood pressure and improve your overall health. Discuss with your doctor or dietitian about ways to cut down on your salt intake.
Your doctor may give you potassium supplements while you are being treated with Torasemide. Alternatively, your doctor may tell you to eat more foods that are rich in potassium, such as orange juice, bananas, or prunes.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.