Avoid concomitant use of Torsemide and aminoglycoside antibiotics, if possible.Coadministration of Torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment.Torsemide can increase the risk of renal toxicity related to administration of radiocontrast agents.Concomitant use with Torsemide may increase risk of hypokalemia.There are no available data on use of Torsemide in pregnant women and the risk of major birth defects or miscarriage. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Fetal and maternal toxicity (decrease in average body weight, increase in fetal resorption and delayed fetal ossification) occurred in rabbits and rats given doses 4 (rabbits) and 5 (rats) times larger. Blood Urea Nitrogen (BUN), Creatinine and Uric Acid:The 20 mg tablet is supplied as a white to off-white, round, standard biconvex, beveled edge tablet, scored on one side and debossed with product identification “54 017” on the other side.We comply with the HONcode standard for trustworthy health information - No specific age-related differences in effectiveness or safety were observed between younger patients and elderly patients.In single-dose studies in patients with non-anuric renal failure, high doses of Torsemide (20 mg to 200 mg) caused marked increases in water and sodium excretion.

Torasemide appears to be a useful alternative to furosemide in these patients, providing potent and long-lasting diuresis while being relatively potassium and calcium sparing. To prevent hypokalemia and metabolic alkalosis, an aldosterone antagonist or potassium-sparing drug should be used concomitantly with torsemide.Tinnitus and hearing loss (usually reversible) have been observed after rapid intravenous injection of other loop diuretics and have also been observed after oral torsemide. Peak plasma time: PO, 1 hr. When patients in a study of acute renal failure received total daily doses of 520 mg to 1,200 mg of Torsemide, 19% experienced seizures. Consider suspending or discontinuing Torsemide [To prevent hypokalemia and metabolic alkalosis, use an aldosterone antagonist or potassium-sparing drug with Torsemide in patients with hepatic disease.When given with aldosterone antagonists, Torsemide also caused increases in sodium and fluid excretion in patients with edema or ascites due to hepatic cirrhosis.

However, further long term trials in larger groups of patients are needed to delineate the place of torasemide in therapy fully, both as a single agent and in combination with other currently accepted drug regimens.
Unable to load your delegates due to an error 2001;19(6):679-703. doi: 10.2165/00019053-200119060-00006.Drug Saf. The changes subsided during chronic therapy.

Drug Saf.

Single doses higher than 200 mg have not been adequately studied.The usual initial dose is 5 mg or 10 mg of once-daily oral torsemide, administered together with an aldosterone antagonist or a potassium-sparing diuretic. 2016 Dec;11(4):145-156. doi: 10.1016/j.joto.2016.10.001. Patients who received 10 mg to 20 mg of daily torsemide in these studies achieved significantly greater reductions in weight and edema than did patients who received placebo.In single-dose studies in patients with nonanuric renal failure, high doses of torsemide (20 mg to 200 mg) caused marked increases in water and sodium excretion. Reactions Possibly or Probably Drug-Related United States Placebo-Controlled Studies Incidence (Percentages of Patients)To report SUSPECTED ADVERSE REACTIONS, contact TEVA USA, PHARMACOVIGILANCE at tel: 1-888-838-2872 X6351 or drug.safety@tevausa.com; or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. On a body-weight basis, these doses are 27 to 96 times a human dose of 20 mg; on a body-surface-area basis, they are 5 to 8 times this dose. Diuretic activity thus correlates better with the rate of drug excretion in the urine than with the concentration in the blood.Torsemide increases the urinary excretion of sodium, chloride, and water, but it does not significantly alter glomerular filtration rate, renal plasma flow, or acid-base balance.The bioavailability of torsemide tablets is approximately 80%, with little intersubject variation; the 90% confidence interval is 75% to 89%. A diuretic response in renal failure may still be achieved if patients are given higher doses.
Systolic and diastolic supine and standing blood pressures are all reduced. No changes were clinically significant nor were clinically relevant changes noted in glucose metabolism, cholesterol or triglyceride levels or in haematological values. Monitor diuretic effect and blood pressure when used in combination with CYP2C9 inhibitor or inducer. Adverse drug interactions have not been observed, and special dosage adjustment has not been necessary.Torsemide tablets are indicated for the treatment of edema associated with congestive heart failure, renal disease, or hepatic disease. In patients with congestive heart failure, torsemide has been administered together with digitalis glycosides, ACE inhibitors, and organic nitrates. Springer 1996 Feb;14(2):104-20. doi: 10.2165/00002018-199614020-00005.Drugs. However, total plasma clearance and elimination half-life remain unchanged.With oral dosing, the onset of diuresis occurs within 1 hour and the peak effect occurs during the first or second hour and diuresis lasts about 6 to 8 hours. The physiologic effect of torsemide is by means of Increased Diuresis at Loop of Henle.