ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Torsemide (torasemide): Drug information

Torsemide (torasemide): Drug information
2024© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Torsemide (torasemide): Patient drug information" and "Torsemide (torasemide): Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Soaanz
Pharmacologic Category
  • Antihypertensive;
  • Diuretic, Loop
Dosing: Adult

Note: Loop diuretic approximate oral dose equivalency for patients with normal renal function: Torsemide 10 to 20 mg = bumetanide 1 mg = furosemide 40 mg (Ref).

Edema or volume overload

Edema or volume overload (alternative agent):

Note: Consider for use as a replacement if initial therapy with furosemide is not effective (eg, poor absorption of furosemide). Although loop diuretics are not recommended for initial management of hypertension, they may be used when edema persists despite use of a thiazide diuretic or instead of a thiazide diuretic in patients with severely reduced kidney function and edema (Ref). When used as a replacement for another loop diuretic, refer to the equivalencies above.

Naive to loop diuretics

Oral: Initial: 10 to 20 mg once daily; double the dose as needed (rather than administer the same dose more frequently) until diuresis occurs. The maximum effective dose varies by population; higher-than-usual doses may be required for patients with nephrotic syndrome or kidney failure; maximum effective single dose: 50 to 100 mg; maximum recommended total daily dose: 200 mg in 2 divided doses to minimize risk of ototoxicity (Ref).

Hypertension

Hypertension (alternative agent):

Note: A loop diuretic is preferred over other diuretics in patients with symptomatic heart failure or advanced chronic kidney disease, especially when hypertension is associated with edema (Ref).

Oral: Initial: 5 mg once daily; may increase to 10 mg once daily after 4 to 6 weeks if inadequate antihypertensive response (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function:

IV, Oral:

eGFR >30 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR ≤30 mL/minute/1.73 m2: Higher doses may be required to achieve desired diuretic response due to decreased secretion into the tubular fluid. However, single doses >50 to 100 mg are unlikely to result in additional diuretic effect (Ref).

Hemodialysis, intermittent (thrice weekly): Not dialyzable (Ref):

IV, Oral:

Anuric patients: There is no expected clinical benefit; use not recommended (Ref).

Patients with residual kidney function: Dose as per eGFR ≤30 mL/minute/1.73 m2 (Ref).

Peritoneal dialysis: Not dialyzable (highly protein bound) (Ref):

IV, Oral:

Anuric patients: There is no expected clinical benefit; use not recommended (Ref).

Patients with residual kidney function: Dose as per eGFR ≤30 mL/minute/1.73 m2 (Ref).

CRRT:

Note: Drug clearance is dependent on the effluent flow rate, filter type, and method of renal replacement. Recommendations are based on high-flux dialyzers and effluent flow rates of 20 to 25 mL/kg/hour (or ~1,500 to 3,000 mL/hour) unless otherwise noted.

IV, Oral: In general, use not recommended; fluid management can be more effectively managed using CRRT ultrafiltration (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration):

Note: Drug clearance is dependent on the effluent flow rate, filter type, and method of renal replacement. Close monitoring of response and adverse reactions (eg, ototoxicity) due to drug accumulation is important.

IV, Oral:

Anuric patients: There is no expected clinical benefit; use not recommended (Ref).

Patients with residual kidney function: Dose as per eGFR ≤30 mL/minute/1.73 m2 (Ref).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling; use with caution. Use is contraindicated in hepatic coma.

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions (Significant): Considerations
Acute kidney injury

Loop diuretics, including torsemide, may lead to acute kidney injury (AKI) due to fluid loss (Ref). Torsemide may be associated with less risk of AKI compared to furosemide (Ref).

Mechanism: Dose-related; related to the pharmacologic action (ie, volume depletion) (Ref).

Risk factors:

• Excessive doses (Ref)

• Concurrent administration of nephrotoxic agents (Ref)

• Older adults (Ref)

• Preexisting volume depletion (Ref)

• Reduced blood flow to the kidney or depletion of effective blood volume (eg, bilateral renal artery stenosis, cirrhosis, nephrotic syndrome, heart failure) (Ref)

Fluid/electrolyte loss

Loop diuretics, including torsemide, may lead to profound diuresis (especially if given in excessive amounts), resulting in hypovolemia and electrolyte loss. Electrolyte disturbances (eg, hypocalcemia, hypokalemia, hypomagnesemia) may predispose a patient to serious cardiac arrhythmias. Torsemide may be associated with less risk of hypokalemia than furosemide (Ref).

Mechanism: Dose-related; related to the pharmacologic action (Ref).

Risk factors:

• Excessive doses with initiation or dose adjustment (Ref)

• Reduced dietary fluid and/or electrolyte intake (Ref)

• Concurrent illness leading to excessive fluid loss (eg, diarrhea, vomiting) (Ref)

• Concomitant administration of an additional diuretic (Ref)

• Very high or very restricted dietary sodium (Ref)

Hypersensitivity reactions (delayed)

Delayed hypersensitivity reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported. A photosensitive lichenoid eruption has also been reported (Ref).

Mechanism: Delayed hypersensitivity reactions: Non–dose-related; immunologic (ie, involving a T-cell mediated drug-specific immune response) (Ref).

Onset: Delayed hypersensitivity reactions: Varied; typically occurs days to 8 weeks after drug exposure (Ref) but may occur more rapidly (usually within 1 to 4 days) upon reexposure (Ref).

Risk factors:

• Cross-reactivity: Cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides (such as torsemide) may not occur, or at the very least this potential is extremely low (Ref). Cross-reactivity due to antibody production (anaphylaxis) is unlikely to occur with antibiotic sulfonamides and nonantibiotic sulfonamides (Ref). There is limited published information regarding cross-reactivity between torsemide and other sulfonamide loop diuretics (Ref).

Ototoxicity

Loop diuretics, including torsemide, have been associated with hearing loss (deafness) and tinnitus, which are generally reversible (lasting from 30 minutes to 24 hours after administration) (Ref).

Mechanism: Dose-related; related to the pharmacologic action (ie, inhibition of a secretory isoform of the Na-K-2Cl co-transporter in the inner ear and impacts on ionic composition of cochlear fluids) (Ref).

Risk factors:

• Concurrent kidney disease (Ref)

• Excessive doses (Ref)

• Concurrent use of other ototoxic agents (eg, aminoglycosides) can lead to ototoxicity at lower doses (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%: Renal: Polyuria (7%)

Frequency not defined: Endocrine & metabolic: Hypokalemia, increased serum cholesterol, increased serum glucose, increased serum triglycerides

Postmarketing:

Dermatologic: Lichenoid eruption (Byrd 1997), pruritus, skin photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis (Reddy 2022)

Endocrine & metabolic: Hyperuricemia (Hagos 2007), vitamin B deficiency (thiamine)

Gastrointestinal: Abdominal pain, anorexia, pancreatitis (Juang 2006)

Genitourinary: Acute urinary retention

Hematologic & oncologic: Anemia, leukopenia, thrombocytopenia

Hepatic: Increased gamma-glutamyl transferase, increased serum transaminases

Nervous system: Confusion, paresthesia

Neuromuscular & skeletal: Gout (Choi 2005)

Ophthalmic: Visual impairment

Otic: Hearing loss (Bagshaw 2007), tinnitus (Bagshaw 2007)

Renal: Acute kidney injury (Liu 2021)

Contraindications

Hypersensitivity to torsemide or any component of the formulation; anuria; hepatic coma.

Warnings/Precautions

Concerns related to adverse effects:

• Hyperuricemia: Asymptomatic hyperuricemia may occur; gout may be precipitated (rarely).

• Sulfonamide (“sulfa”) allergy: The FDA-approved product labeling for many medications containing a sulfonamide chemical group includes a broad contraindication in patients with a prior allergic reaction to sulfonamides. There is a potential for cross-reactivity between members of a specific class (eg, 2 antibiotic sulfonamides). However, concerns for cross-reactivity have previously extended to all compounds containing the sulfonamide structure (SO2NH2). An expanded understanding of allergic mechanisms indicates cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or at the very least this potential is extremely low (Brackett 2004; Johnson 2005; Slatore 2004; Tornero 2004). In particular, mechanisms of cross-reaction due to antibody production (anaphylaxis) are unlikely to occur with nonantibiotic sulfonamides. T-cell-mediated (type IV) reactions (eg, maculopapular rash) are not well understood and it is not possible to completely exclude this potential based on current insights. In cases where prior reactions were severe (Stevens-Johnson syndrome/TEN), some clinicians choose to avoid exposure to these classes.

Disease-related concerns:

• Adrenal insufficiency: Avoid use of diuretics for treatment of elevated blood pressure in patients with primary adrenal insufficiency (Addison disease). Adjustment of glucocorticoid/mineralocorticoid therapy and/or use of other antihypertensive agents is preferred to treat hypertension (Bornstein 2016; Inder 2015).

• Bariatric surgery: Dehydration: Avoid diuretics in the immediate postoperative period after bariatric surgery; electrolyte disturbances and dehydration may occur. Diuretics may be resumed, if indicated, once oral fluid intake goals are met (Ziegler 2009).

• Diabetes: Use with caution in patients with diabetes; increased blood glucose levels and hyperglycemia may occur. Monitor blood glucose periodically.

• Hepatic impairment: Use with caution in patients with hepatic impairment; in patients with cirrhosis, avoid electrolyte and acid/base imbalances that may lead to hepatic encephalopathy. Administration with an aldosterone antagonist or potassium-sparing diuretic may provide additional diuretic efficacy and maintain normokalemia in patients with hepatic disease.

Special populations:

• Surgical patients: If given the morning of surgery, torsemide may render the patient volume depleted and blood pressure may be labile during general anesthesia.

Other warnings and precautions:

• Diuretic resistance: For some patients, despite high doses of loop diuretic, an adequate diuretic response cannot be attained. Diuretic resistance may be overcome by intravenous rather than oral administration, the use of two diuretics together (eg, a loop diuretic in combination with a thiazide diuretic). When multiple diuretics are used, serum electrolytes need to be monitored even more closely (ACC [Hollenberg 2019]).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Soaanz: 20 mg, 40 mg, 60 mg

Generic: 5 mg, 10 mg, 20 mg, 100 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Soaanz Oral)

20 mg (per each): $10.48

40 mg (per each): $11.24

60 mg (per each): $10.92

Tablets (Torsemide Oral)

5 mg (per each): $0.63

10 mg (per each): $0.70

20 mg (per each): $0.47 - $0.82

100 mg (per each): $3.04

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Oral: May administer with or without food.

Administration: Pediatric

Oral: Administer without regard to meals.

Use: Labeled Indications

Edema or volume overload: Treatment of edema.

Hypertension: Management of hypertension.

Medication Safety Issues
Sound-alike/look-alike issues:

Torsemide may be confused with furosemide

Demadex may be confused with Denorex

Older Adult: High-Risk Medication:

Beers Criteria: Diuretics are identified in the Beers Criteria as potentially inappropriate medications to be used with caution in patients 65 years and older due to the potential to cause or exacerbate syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatremia; monitor sodium concentration closely when initiating or adjusting the dose in older adults (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Substrate of CYP2C8 (minor), CYP2C9 (minor), OAT1/3, OATP1B1/1B3 (SLCO1B1/1B3); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Ajmaline: Sulfonamides may enhance the adverse/toxic effect of Ajmaline. Specifically, the risk for cholestasis may be increased. Risk C: Monitor therapy

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Allopurinol: Loop Diuretics may enhance the adverse/toxic effect of Allopurinol. Loop Diuretics may increase the serum concentration of Allopurinol. Specifically, Loop Diuretics may increase the concentration of Oxypurinol, an active metabolite of Allopurinol. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Amikacin Liposome (Oral Inhalation): Loop Diuretics may enhance the nephrotoxic effect of Amikacin Liposome (Oral Inhalation). Loop Diuretics may enhance the ototoxic effect of Amikacin Liposome (Oral Inhalation). Risk C: Monitor therapy

Aminoglycosides: Loop Diuretics may enhance the adverse/toxic effect of Aminoglycosides. Specifically, nephrotoxicity and ototoxicity. Risk C: Monitor therapy

Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Risk X: Avoid combination

Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Risk C: Monitor therapy

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Angiotensin II Receptor Blockers: Loop Diuretics may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Loop Diuretics may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Risk C: Monitor therapy

Angiotensin-Converting Enzyme Inhibitors: Loop Diuretics may enhance the hypotensive effect of Angiotensin-Converting Enzyme Inhibitors. Loop Diuretics may enhance the nephrotoxic effect of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor therapy

Antidiabetic Agents: Hyperglycemia-Associated Agents may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Antihypertensive Agents: Loop Diuretics may enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Arsenic Trioxide: Loop Diuretics may enhance the hypotensive effect of Arsenic Trioxide. Loop Diuretics may enhance the QTc-prolonging effect of Arsenic Trioxide. Management: When possible, avoid concurrent use of arsenic trioxide with drugs that can cause electrolyte abnormalities, such as the loop diuretics. Risk D: Consider therapy modification

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Beta2-Agonists: May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

Bilastine: Loop Diuretics may enhance the QTc-prolonging effect of Bilastine. Risk C: Monitor therapy

Bile Acid Sequestrants: May decrease the absorption of Loop Diuretics. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Canagliflozin: May enhance the hypotensive effect of Loop Diuretics. Risk C: Monitor therapy

Cardiac Glycosides: Loop Diuretics may enhance the adverse/toxic effect of Cardiac Glycosides. Specifically, cardiac glycoside toxicity may be enhanced by the hypokalemic and hypomagnesemic effect of loop diuretics. Risk C: Monitor therapy

Cefazedone: May enhance the nephrotoxic effect of Loop Diuretics. Risk C: Monitor therapy

Cefotiam: Loop Diuretics may enhance the nephrotoxic effect of Cefotiam. Risk C: Monitor therapy

Cefpirome: Loop Diuretics may enhance the nephrotoxic effect of Cefpirome. Risk C: Monitor therapy

Ceftizoxime: Loop Diuretics may enhance the nephrotoxic effect of Ceftizoxime. Risk C: Monitor therapy

Cephaloridine: Loop Diuretics may enhance the nephrotoxic effect of Cephaloridine. Loop Diuretics may increase the serum concentration of Cephaloridine. Risk X: Avoid combination

Cephalothin: Loop Diuretics may enhance the nephrotoxic effect of Cephalothin. Risk C: Monitor therapy

Cephradine: May enhance the nephrotoxic effect of Loop Diuretics. Risk C: Monitor therapy

CISplatin: Loop Diuretics may enhance the nephrotoxic effect of CISplatin. Loop Diuretics may enhance the ototoxic effect of CISplatin. Risk C: Monitor therapy

Corticosteroids (Systemic): May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

CycloSPORINE (Systemic): May enhance the adverse/toxic effect of Loop Diuretics. Specifically, the risk for hyperuricemia and gout may be increased. Risk C: Monitor therapy

CYP2C9 Inducers (Moderate): May decrease the serum concentration of Torsemide. Risk C: Monitor therapy

CYP2C9 Inhibitors (Moderate): May increase the serum concentration of Torsemide. Risk C: Monitor therapy

Desmopressin: May enhance the hyponatremic effect of Loop Diuretics. Risk X: Avoid combination

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diacerein: May enhance the therapeutic effect of Diuretics. Specifically, the risk for dehydration or hypokalemia may be increased. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Dichlorphenamide: Loop Diuretics may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Dofetilide: Loop Diuretics may enhance the QTc-prolonging effect of Dofetilide. Management: Monitor serum potassium and magnesium more closely when dofetilide is combined with loop diuretics. Electrolyte replacements will likely be required to maintain potassium and magnesium serum concentrations. Risk D: Consider therapy modification

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Empagliflozin: May enhance the hypotensive effect of Loop Diuretics. Risk C: Monitor therapy

Fexinidazole: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Management: Avoid use of fexinidazole with OAT1/3 substrates when possible. If combined, monitor for increased OAT1/3 substrate toxicities. Risk D: Consider therapy modification

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Foscarnet: Loop Diuretics may increase the serum concentration of Foscarnet. Management: When diuretics are indicated during foscarnet treatment, thiazides are recommended over loop diuretics. If patients receive loop diuretics during foscarnet treatment, monitor closely for evidence of foscarnet toxicity. Risk D: Consider therapy modification

Fosphenytoin-Phenytoin: Torsemide may enhance the adverse/toxic effect of Fosphenytoin-Phenytoin. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Iloperidone: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Iodinated Contrast Agents: Loop Diuretics may enhance the nephrotoxic effect of Iodinated Contrast Agents. Risk C: Monitor therapy

Ipragliflozin: May enhance the adverse/toxic effect of Loop Diuretics. Specifically, the risk for intravascular volume depletion may be increased. Risk C: Monitor therapy

Isocarboxazid: May enhance the hypotensive effect of Diuretics. Risk X: Avoid combination

Ivabradine: Loop Diuretics may enhance the arrhythmogenic effect of Ivabradine. Risk C: Monitor therapy

Leflunomide: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

Levosulpiride: Loop Diuretics may enhance the adverse/toxic effect of Levosulpiride. Risk X: Avoid combination

Licorice: May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

Lithium: Loop Diuretics may decrease the serum concentration of Lithium. Loop Diuretics may increase the serum concentration of Lithium. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Mecamylamine: Sulfonamides may enhance the adverse/toxic effect of Mecamylamine. Risk X: Avoid combination

Methotrexate: May diminish the therapeutic effect of Loop Diuretics. Loop Diuretics may increase the serum concentration of Methotrexate. Methotrexate may increase the serum concentration of Loop Diuretics. Risk C: Monitor therapy

Methoxsalen (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Methoxsalen (Systemic). Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Netilmicin (Ophthalmic): Loop Diuretics may enhance the nephrotoxic effect of Netilmicin (Ophthalmic). Risk X: Avoid combination

Neuromuscular-Blocking Agents: Loop Diuretics may diminish the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Loop Diuretics may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitisinone: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: May diminish the diuretic effect of Loop Diuretics. Loop Diuretics may enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. Management: Monitor for evidence of kidney injury or decreased therapeutic effects of loop diuretics with concurrent use of an NSAID. Consider avoiding concurrent use in CHF or cirrhosis. Concomitant use of bumetanide with indomethacin is not recommended. Risk D: Consider therapy modification

Nonsteroidal Anti-Inflammatory Agents (Topical): May diminish the therapeutic effect of Loop Diuretics. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Opioid Agonists: May enhance the adverse/toxic effect of Diuretics. Opioid Agonists may diminish the therapeutic effect of Diuretics. Risk C: Monitor therapy

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Diuretics may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Risk C: Monitor therapy

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Pretomanid: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Probenecid: May diminish the diuretic effect of Loop Diuretics. Probenecid may increase the serum concentration of Loop Diuretics. Risk C: Monitor therapy

Promazine: Loop Diuretics may enhance the QTc-prolonging effect of Promazine. Risk X: Avoid combination

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Reboxetine: May enhance the hypokalemic effect of Loop Diuretics. Risk C: Monitor therapy

Salicylates: May diminish the therapeutic effect of Loop Diuretics. Loop Diuretics may increase the serum concentration of Salicylates. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sodium Phosphates: Diuretics may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Taurursodiol: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk X: Avoid combination

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Teriflunomide: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Tobramycin (Oral Inhalation): Loop Diuretics may enhance the nephrotoxic effect of Tobramycin (Oral Inhalation). Loop Diuretics may enhance the ototoxic effect of Tobramycin (Oral Inhalation). Risk C: Monitor therapy

Topiramate: Loop Diuretics may enhance the hypokalemic effect of Topiramate. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Vaborbactam: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Vadadustat: May increase the serum concentration of OAT1/3 Substrates (Clinically Relevant). Risk C: Monitor therapy

Vancomycin: Loop Diuretics may enhance the nephrotoxic effect of Vancomycin. Risk C: Monitor therapy

Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Risk C: Monitor therapy

Warfarin: Torsemide may increase the serum concentration of Warfarin. Risk C: Monitor therapy

Xipamide: May enhance the adverse/toxic effect of Loop Diuretics. Specifically, the risk of hypovolemia, electrolyte disturbances, and prerenal azotemia may be increased. Risk C: Monitor therapy

Zoledronic Acid: Loop Diuretics may enhance the hypocalcemic effect of Zoledronic Acid. Risk C: Monitor therapy

Pregnancy Considerations

Adverse events have been observed in animal reproduction studies.

Breastfeeding Considerations

It is not known if torsemide is present in breast milk. Diuretics can suppress lactation.

Dietary Considerations

May cause potassium loss; potassium supplement or dietary changes may be required.

Monitoring Parameters

Kidney function; serum electrolytes; blood pressure; serum glucose; fluid intake and output.

Mechanism of Action

Inhibits reabsorption of sodium and chloride in the ascending loop of Henle and distal renal tubule, interfering with the chloride-binding cotransport system, thus causing increased excretion of water, sodium, chloride, magnesium, and calcium; does not alter GFR, renal plasma flow, or acid-base balance

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Diuresis: Within 1 hour.

Peak effect: Diuresis: 1 to 2 hours; Antihypertensive: 4 to 6 weeks (up to 12 weeks).

Duration: Diuresis: ~6 to 8 hours.

Distribution: Vd: 12 to 15 L; Cirrhosis: ~24 to 30 L.

Protein binding: >99%.

Metabolism: Hepatic (~80%) via CYP2C9 and to a minor extent, CYP2C8 and CYP2C18.

Bioavailability: ~80%.

Half-life elimination: ~3.5 hours.

Time to peak, plasma: Within 1 to 2.5 hours; delayed ~30 to 45 minutes when administered with food.

Excretion: Urine (21%).

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Renal clearance is markedly decreased in kidney failure; a smaller fraction of the administered dose is delivered to the intraluminal site of action, and the natriuretic action is reduced.

Hepatic function impairment: Volume of distribution, plasma half-life, and renal clearance are increased in patients with cirrhosis.

Heart failure: Hepatic and renal clearance are decreased. Total clearance is ~50% of that seen in healthy volunteers, and the plasma half-life and AUC are correspondingly increased.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Toras denk;
  • (AT) Austria: Torasemid hexal pharma;
  • (BD) Bangladesh: Dilast | Dytor | Luretic | Tomide | Torsid;
  • (BE) Belgium: Torasemide bexal | Torasemide sandoz | Torrem;
  • (BF) Burkina Faso: Sutrilneo | Toras denk;
  • (BG) Bulgaria: Torazidex | Torsit sr | Trifas | Trifas cor;
  • (CH) Switzerland: Toramid | Torasem | Torasemid actavis | Torasemid Helvepharm | Torasemid mepha | Torasemid Mylan | Torasemid sandoz | Torasemid Sandoz Eco | Torasemid Spirig | Torasemid spirig hc | Torasemid teva | Torasemid zentiva | Torasis | Torem;
  • (CI) Côte d'Ivoire: Sutrilneo;
  • (CN) China: Ta sai | Te su min | Tuo sai | Unat | Yi mai ge;
  • (CO) Colombia: Sutrilneo | Unat;
  • (DE) Germany: Toracard | Toradiur | Toragamma | Torasemid | Torasemid Aaa-Pharma | Torasemid abz | Torasemid Accedo | Torasemid al | Torasemid beta | Torasemid Biomo | Torasemid Corax | Torasemid Denk | Torasemid dura | Torasemid Heumann | Torasemid ratiopharm | Torasemid stada | Torasemid Volkspharma | Torasemid von ct | Torasemid-1a pharma | Torasid-gry | Torem | Torem Cor | Torem rr | Unat;
  • (DO) Dominican Republic: Britomar | Torsinex;
  • (EE) Estonia: Torasemide hexal | Torasemide teva | Trifas | Trifas cor;
  • (EG) Egypt: Cardiotimide | Examide | Onced | Retorinad | Torsamolex | Torseretic;
  • (ES) Spain: Dilutol | Dilutol hta | Isodiur | Isodiur hta | Sutril | Sutril hta | Sutril neo | Torasemida Alter | Torasemida aurobindo | Torasemida bayvit | Torasemida cinfa | Torasemida edigen | Torasemida Normon | Torasemida Pharmagenus | Torasemida ratiopharm | Torasemida sandoz | Torasemida tarbis | Torasemida teva | Torasemida UR | Torasemida Winthrop;
  • (ET) Ethiopia: Toras denk;
  • (GB) United Kingdom: Torasemide | Torasemide kent | Torem;
  • (GR) Greece: Tormis;
  • (HK) Hong Kong: Unat;
  • (HR) Croatia: Diuver | Tomid;
  • (ID) Indonesia: Toral | Unat;
  • (IE) Ireland: Torem;
  • (IN) India: Acotide | Concitor | Demator | Diurator | Dyamide | Dyloop | Dytor | Edeto | Flofre | Henletor | Ibmide | Jbtor | Lhd | Meltor | Nephtor | Nexmide | Retorlix | Semitor | Tide | Tomaris | Tor | Toracor | Torain | Torcard | Torcel | Tordac | Torget | Toride | Toriflow | Tormax | Tormid | Tornem | Torpres | Torpride | Torsed | Torsemi | Torsia | Torsid | Torsikind | Torsilong | Torsinex | Torstar | Tortas | Tortec | Torvel | Torvigress | Tosec | Vitator | Zator;
  • (IT) Italy: Diuremid | Diuresix | Toradiur | Torasemide hex | Torasemide Mgi;
  • (JO) Jordan: Sutrilneo;
  • (JP) Japan: Luprac | Torasemide ko;
  • (KE) Kenya: Diuride | Diutor | Toras denk | Torsinex;
  • (KR) Korea, Republic of: Setoram | Tora | Torad | Torcin | Torem | Torsem | Torsemide | Torsin | Tosemid;
  • (LB) Lebanon: Sutrilneo;
  • (LT) Lithuania: Torasemide hexal | Torasemide pliva | Torasemide teva | Torem | Toridium | Trifas;
  • (LU) Luxembourg: Torasemid hexal | Torrem | Unat;
  • (LV) Latvia: Torasemid teva | Torasemide hexal | Torasemide teva | Torem | Trifas | Trifas cor;
  • (MA) Morocco: Tensemide;
  • (PE) Peru: Sutrilneo;
  • (PL) Poland: Diured | Diuver | Toramide | Torsemed | Trifas | Trifas cor | Unat;
  • (PR) Puerto Rico: Demadex | Soaanz | Torsemide;
  • (PT) Portugal: Tation;
  • (RU) Russian Federation: Britomar | Diuver | Lotonel | Torasemide canon | Torasemide medisorb | Torasemide sz | Trigrim;
  • (SE) Sweden: Torasemid actavis | Torasemid bluefish | Torasemid Ebb | Torasemid orifarm | Torasemid sandoz | Torem;
  • (TH) Thailand: Unat;
  • (TR) Turkey: Sutril neo;
  • (TW) Taiwan: Torsix;
  • (UA) Ukraine: Britomar | Dioren | Diutor | Diuver | Toraren | Torasemide darnitsa | Torasemide teva | Toricard | Torsid | Trifas;
  • (UG) Uganda: Toras denk | Torsinex | Tortas;
  • (UY) Uruguay: Torem;
  • (ZA) South Africa: Risat | Torasemide biotech | Torsinat | Unat;
  • (ZM) Zambia: Tide | Toras denk;
  • (ZW) Zimbabwe: Torsid | Torsid 10 | Torsid 5
  1. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  2. Bagshaw SM, Delaney A, Haase M, Ghali WA, Bellomo R. Loop diuretics in the management of acute renal failure: a systematic review and meta-analysis. Crit Care Resusc. 2007;9(1):60-68. [PubMed 17352669]
  3. Bellón T. Mechanisms of severe cutaneous adverse reactions: recent advances. Drug Saf. 2019;42(8):973-992. doi:10.1007/s40264-019-00825-2 [PubMed 31020549]
  4. Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(2):364-389. doi:10.1210/jc.2015-1710 [PubMed 26760044]
  5. Brackett CC, Singh H, Block JH. Likelihood and mechanisms of cross-allergenicity between sulfonamide antibiotics and other drugs containing a sulfonamide functional group. Pharmacotherapy. 2004;24(7):856-870. [PubMed 15303450]
  6. Brater DC. Update in diuretic therapy: clinical pharmacology. Semin Nephrol. 2011;31(6):483-494. doi:10.1016/j.semnephrol.2011.09.003 [PubMed 22099505]
  7. Brater DC, Chennavasin P, Day B, et al. Bumetanide and furosemide. Clin Pharmacol Ther. 1983;34(2):207-213. doi:10.1038/clpt.1983.154 [PubMed 6872415]
  8. Brater DC, Ellison DH. Causes and treatment of refractory edema in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed March 1, 2022b.
  9. Brater DC, Ellison DH. Loop diuretics: dosing and major side effects. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed March 1, 2022a.
  10. Brockow K, Przybilla B, Aberer W, et al. Guideline for the diagnosis of drug hypersensitivity reactions: S2K-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Dermatological Society (DDG) in collaboration with the Association of German Allergologists (AeDA), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Contact Dermatitis Research Group (DKG), the Swiss Society for Allergy and Immunology (SGAI), the Austrian Society for Allergology and Immunology (ÖGAI), the German Academy of Allergology and Environmental Medicine (DAAU), the German Center for Documentation of Severe Skin Reactions and the German Federal Institute for Drugs and Medical Products (BfArM). Allergo J Int. 2015;24(3):94-105. doi:10.1007/s40629-015-0052-6 [PubMed 26120552]
  11. Byrd DR, Ahmed I. Photosensitive lichenoid reaction to torsemide--a loop diuretic. Mayo Clin Proc. 1997;72(10):930-931. doi:10.1016/S0025-6196(11)63363-6 [PubMed 9379695]
  12. Chobanian AV, Bakris GL, Black HR, et al, "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report," JAMA, 2003, 289(19):2560-72. [PubMed 12748199]
  13. Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Arch Intern Med. 2005;165(7):742-748. doi:10.1001/archinte.165.7.742 [PubMed 15824292]
  14. Cody RJ, Kubo SH, Pickworth KK. Diuretic treatment for the sodium retention of congestive heart failure. Arch Intern Med. 1994;154(17):1905-1914 [PubMed 8074594]
  15. Delpire E, Lu J, England R, Dull C, Thorne T. Deafness and imbalance associated with inactivation of the secretory Na-K-2Cl co-transporter. Nat Genet. 1999;22(2):192-195. doi:10.1038/9713 [PubMed 10369265]
  16. Demadex (torsemide) tablet [prescribing information]. Somerset, NJ: Meda Pharmaceuticals; February 2017.
  17. Ding D, Liu H, Qi W, et al. Ototoxic effects and mechanisms of loop diuretics. J Otol. 2016;11(4):145-156. doi:10.1016/j.joto.2016.10.001 [PubMed 29937824]
  18. Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
  19. Felker GM, Lee KL, Bull DA, et al; NHLBI Heart Failure Clinical Research Network. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med. 2011;364(9):797-805. doi:10.1056/NEJMoa1005419 [PubMed 21366472]
  20. Felker GM, Mentz RJ. Diuretics and ultrafiltration in acute decompensated heart failure. J Am Coll Cardiol. 2012;59(24):2145-2153. doi:10.1016/j.jacc.2011.10.910 [PubMed 22676934]
  21. Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi: 10.1210/jc.2015-4061. [PubMed 26934393]
  22. Greenberg A. Diuretic complications. Am J Med Sci. 2000;319(1):10-24. [PubMed 10653441]
  23. Hagos Y, Bahn A, Vormfelde SV, Brockmöller J, Burckhardt G. Torasemide transport by organic anion transporters contributes to hyperuricemia. J Am Soc Nephrol. 2007;18(12):3101-3109. doi:10.1681/ASN.2007010106 [PubMed 17978306]
  24. Hariman RJ, Bremner S, Louie EK, et al, “Dose-Response Study of Intravenous Torsemide in Congestive Heart Failure,” Am Heart J, 1994, 128(2):352-7. [PubMed 8037103]
  25. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 [PubMed 35363499]
  26. Hollenberg SM, Warner Stevenson L, Ahmad T, et al. 2019 ACC expert consensus decision pathway on risk assessment, management, and clinical trajectory of patients hospitalized with heart failure: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2019;74(15):1966-2011. doi:10.1016/j.jacc.2019.08.001 [PubMed 31526538]
  27. Ikeda K, Oshima T, Hidaka H, Takasaka T. Molecular and clinical implications of loop diuretic ototoxicity. Hear Res. 1997;107(1-2):1-8. doi:10.1016/s0378-5955(97)00009-9 [PubMed 9165341]
  28. Inder WJ, Meyer C, Hunt PJ. Management of hypertension and heart failure in patients with Addison's disease. Clin Endocrinol (Oxf). 2015;82(6):789-792. doi: 10.1111/cen.12592. [PubMed 25138826]
  29. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. [PubMed 24352797]
  30. Johnson KK, Green DL, Rife JP, Limon L. Sulfonamide cross-reactivity: fact or fiction? [published correction appears in Ann Pharmacother. 2005;39(7-8):1373]. Ann Pharmacother. 2005;39(2):290-301. [PubMed 15644481]
  31. Juang P, Page RL 2nd, Zolty R. Probable loop diuretic-induced pancreatitis in a sulfonamide-allergic patient. Ann Pharmacother. 2006;40(1):128-134. doi:10.1345/aph.1G314 [PubMed 16352777]
  32. Khan DA, Knowles SR, Shear NH. Sulfonamide hypersensitivity: fact and fiction. J Allergy Clin Immunol Pract. 2019;7(7):2116-2123. doi:10.1016/j.jaip.2019.05.034 [PubMed 31495421]
  33. Kido K, Shimizu M, Hashiguchi M. Comparing torsemide versus furosemide in patients with heart failure: a meta-analysis. J Am Pharm Assoc (2003). 2019;59(3):432-438. doi:10.1016/j.japh.2019.01.014 [PubMed 30846351]
  34. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int. 2021;99(3S):S1-S87. doi:10.1016/j.kint.2020.11.003 [PubMed 33637192]
  35. Liu C, Yan S, Wang Y, et al. Drug-induced hospital-acquired acute kidney injury in China: a multicenter cross-sectional survey. Kidney Dis (Basel). 2021;7(2):143-155. doi:10.1159/000510455 [PubMed 33824870]
  36. Malha L, Mann SJ. Loop diuretics in the treatment of hypertension. Curr Hypertens Rep. 2016;18(4):27. doi:10.1007/s11906-016-0636-7 [PubMed 26951244]
  37. Nishimura RA, Otto CM, Bonow RO, et al, 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):2440-2492. doi: 10.1161/CIR.0000000000000029. [PubMed 24589852]
  38. Oh SW, Han SY. Loop diuretics in clinical practice. Electrolyte Blood Press. 2015;13(1):17-21. doi:10.5049/EBP.2015.13.1.17 [PubMed 26240596]
  39. Palmer BF. Metabolic complications associated with use of diuretics. Semin Nephrol. 2011;31(6):542-552. doi:10.1016/j.semnephrol.2011.09.009 [PubMed 22099511]
  40. Reddy S, Aron BK, Stewart J. A life-threatening case of torsemide-induced toxic epidermal necrolysis associated with the treatment of anasarca. Cureus. 2022 Mar 6;14(3):e22895. doi:10.7759/cureus.22895 [PubMed 35399474]
  41. Refer to manufacturer's labeling.
  42. Rybak LP. Pathophysiology of furosemide ototoxicity. J Otolaryngol. 1982;11(2):127-133. [PubMed 7042998]
  43. Sica DA, Carter B, Cushman W, Hamm L. Thiazide and loop diuretics. J Clin Hypertens (Greenwich). 2011;13(9):639-643. [PubMed 21896142]
  44. Slatore CG, Tilles SA. Sulfonamide hypersensitivity. Immunol Allergy Clin North Am. 2004;24(3):477-490. [PubMed 15242722]
  45. Soaanz (torsemide) [prescribing information]. Vienna, VA: Sarfez Pharmaceuticals Inc; November 2021.
  46. Täger T, Fröhlich H, Seiz M, Katus HA, Frankenstein L. READY: relative efficacy of loop diuretics in patients with chronic systolic heart failure-a systematic review and network meta-analysis of randomised trials. Heart Fail Rev. 2019;24(4):461-472. doi:10.1007/s10741-019-09771-8 [PubMed 30874955]
  47. Tornero P, De Barrio M, Baeza ML, Herrero T. Cross-reactivity among p-amino group compounds in sulfonamide fixed drug eruption: diagnostic value of patch testing. Contact Dermatitis. 2004;51(2):57-62. [PubMed 15373844]
  48. Torsemide [prescribing information]. Pulaski, TN: AvKARE; March 2023.
  49. Vargo DL, Kramer WG, Black PK, Smith WB, Serpas T, Brater DC. Bioavailability, pharmacokinetics, and pharmacodynamics of torsemide and furosemide in patients with congestive heart failure. Clin Pharmacol Ther. 1995;57(6):601-609. [PubMed 7781259]
  50. Weber MA, Schiffrin EL, White WB, et al, Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014;16(1):14-26. [PubMed 24341872]
  51. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066 [PubMed 29133354]
  52. Wheeler DC, Becker GJ. Summary of KDIGO guideline. What do we really know about management of blood pressure in patients with chronic kidney disease? Kidney Int. 2013;83(3):377-383. [PubMed 23325075]
  53. Wu X, Zhang W, Ren H, Chen X, Xie J, Chen N. Diuretics associated acute kidney injury: clinical and pathological analysis. Ren Fail. 2014;36(7):1051-1055. doi:10.3109/0886022X.2014.917560 [PubMed 24940940]
  54. Wulf NR, Matuszewski KA. Sulfonamide cross-reactivity: is there evidence to support broad cross-allergenicity? Am J Health Syst Pharm. 2013;70(17):1483-1494. doi:10.2146/ajhp120291 [PubMed 23943179]
  55. Ziegler O, Sirveaux MA, Brunaud L, Reibel N, Quilliot D. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab. 2009;35(6, pt 2):544-557. doi: 10.1016/S1262-3636(09)73464-0. [PubMed 20152742]
Topic 10008 Version 396.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟