Torasemide


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO HTN 2.5-5 mg once daily. Max: 5 mg/day. Oedema 5 mg once daily, up to 20 mg once daily if needed. Max: 40 mg/day. Oedema in patients w/ hepatic cirrhosis Initial: 5-10 mg once daily, w/ an aldosterone antagonist or a K-sparing diuretic, titrate upwards till desired diuretic response. Max: 40 mg/day. IV Oedema 10-20 mg/day. Max: 200 mg/day.
Dosage Details
Intravenous
Oedema
Adult: 10-20 mg daily as IV inj slowly over 2 min. Max: 200 mg daily.

Oral
Oedema in patients with hepatic cirrhosis
Adult: Initially, 5-10 mg once daily, given together with an aldosterone antagonist or a potassium-sparing diuretic, titrated upwards until the desired diuretic response is obtained. Max: 40 mg daily.

Oral
Hypertension
Adult: 2.5-5 mg once daily. Max: 5 mg daily.

Oral
Oedema
Adult: 5 mg once daily, increased to 20 mg once daily if necessary. Max: 40 mg/day.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity to sulfonylureas, renal failure with anuria, hepatic coma and pre-coma, hypotension, cardiac arrhythmias. Pregnancy and lactation.
Special Precautions
Risk of hyperuricaemia, gout and DM. Correct electrolyte distubances and disorders of micturition before treatment. Monitor electrolyte balance, glucose, uric acid, creatinine and lipids regularly. May impair ability to drive or operate machinery.
Adverse Reactions
Electrolyte disturbances e.g. hypokalaemia, dehydration, dry mouth, headache, dizziness, hypotension, weakness, drowsiness, confusional states, loss of appetite, cramps, increased serum uric acid, glucose, lipids, urea and creatinine, increase in LFT, metabolic alkalosis, tinnitus and hearing loss.
Overdosage
Symptoms: Marked diuresis with severe dehydration and electrolytes disturbances. Somnolence, confusion, hypotension, circulatory collapse and GI disturbances. Management: Reduce or stop torasemide. There is no antidote and treatment involves simultaneous replacement of fluid and electrolytes. Haemodialysis unlikely to be useful.
Drug Interactions
Increased risk of severe hypokalaemia with amphotercin B, corticosteroids, carbenoxolone, hypokalaemia-causing medications. Increased risk of lithium toxicity. Increased potential for ototoxicity and nephrotoxicity with nephrotoxic or ototoxic medications e.g. aminoglycosides. High dose salicylates may increase the risk of salicylate toxicity. Increased risk of toxicity with digoxin. Reduced diuretic effect with NSAIDs. Increased risk of hypotension with antihypertensives.
Action
Description: Torasemide, a sulfonylurea loop diuretic, acts from within the lumen of the thick ascending portion of the loop of Henle, where it inhibits the Na+/K+/2CI--carrier system.
Onset: Diuresis: Oral: Within 1 hr; IV: Within 10 min.
Duration: Diuresis: Oral and IV: 8 hr.
Pharmacokinetics:
Absorption: Absorbed rapidly and almost completely (oral). Peak serum levels after 1-2 hr. Food decreases rate but not extent of absorption.
Distribution: Protein-binding: >99%. Apparent distribution volume: 16 L.
Metabolism: Metabolised by the cytochrome P450 isoenzyme CYP2C9. Elimination half-life: 3.5 hr.
Excretion: Excreted by urine as unchanged drug (24%) and metabolites.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Torasemide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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