Torsemide

Generic name: Torsemide

Drug class: Loop diuretic

Dosage form: Oral tablet

Root of administration: Oral

Dose: For edema associated with heart failure, renal disease, or hepatic disease: initial dose is 10–20 mg once daily, which can be increased as needed up to a maximum of 200 mg/day. For hypertension: initial dose is 5 mg once daily, which can be increased to 10 mg once daily after 4–6 weeks, up to a maximum of 10 mg/day.

Mechanism of action: Torsemide inhibits the Na+/K+/2Cl− symporter in the thick ascending limb of the loop of Henle, leading to decreased reabsorption of sodium and chloride ions. This results in increased excretion of water, sodium, chloride, magnesium, and calcium, thereby reducing fluid retention and lowering blood pressure.

Drug usage cases:

• Edema associated with heart failure
• Edema associated with chronic renal failure
• Edema associated with hepatic cirrhosis
• Hypertension

Drug contraindications:

• Hypersensitivity to torsemide or sulfonylureas
• Anuria
• Hepatic coma
• Severe electrolyte depletion until corrected

Side effects:

• Hypotension
• Hypokalemia
• Hyponatremia
• Hypomagnesemia
• Hypocalcemia
• Hypochloremic alkalosis
• Dehydration
• Hearing loss
• Ringing in ears
• Gastrointestinal disturbances (e.g., nausea, vomiting, diarrhea)
• Headache
• Dizziness
• Fatigue
• Skin rash

Warnings:

• Monitor electrolytes regularly during treatment
• Use caution in patients with renal impairment
• May cause orthostatic hypotension; advise patients to rise slowly from sitting or lying positions
• Use with caution in patients with a history of gout
• Alcohol may enhance the hypotensive effect; avoid alcohol consumption during treatment

Use during pregnancy or breastfeeding: Torsemide is not recommended during pregnancy or breastfeeding due to potential risks to the fetus or nursing infant.