● It has been found to be effective for the treatment of edema associated with chronic renal failure. It is a loop diuretic a water pill that prevents body from absorbing too much salt.These oral tablet is used to treat high blood pressure.
● It’s also used to treat edema a fluid retention due to conditions such as heart, liver, or kidney disease.
Indications:
Torsemide tablets are also indicated for the treatment of high blood pressure also known as hypertension alone or in combination with other antihypertensive agents.
Mechanism of Action:
Torsemide increases the urinary excretion of sodium, chloride, and water, but it does not significantly alter glomerular filtration rate, acid-base balance renal plasma flow.It is in a class of medications called diuretics a water pills . It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.
It selectively blocks the active sodium and chloride reabsorption in the thick ascending loop of Henle promoting rapid excretion of water, sodium and chloride. This action is a result of binding of the diuretic to a chloride ion-binding site of the transport molecule
Pharmacokinetics Properties:
Torsemide is metabolized by the hepatic cytochrome P450 enzyme system. About 73% is excreted through liver metabolism and rest of 27% is excreted in urine. Renal failure reduces torsemide renal clearance, but the plasma elimination half-life is unchanged. It has three times longer half-life than frusemide about 3 hours vs. 0.8 hours.Independent of the rate of administration of torsemide, diuresis lasts about 6-8 hours and is 3 times longer than frusemide.
ELEMINATION: Torsemide is mainly eliminated hepatically (73%), while frusemide is excreted renally (83%). This prevents the accumulation of torsemide in patients with renal insufficiency.
Volume of distribution and plasma clearance and half-life are not altered despite the fall in renal clearance , due to renal failure with the use of torsemide.It causes less loss of potassium. This may be accounted by the fact that torsemide in contrast to frusemide is devoid of a proximal tubular site of action . It is twice as potent compared to frusemide by IV route. Torsemide demonstrates longer natriuretic activity.
Side Effects:
● frequent urination
● headache
● cough,sore throat
● hearing loss,ringing in your ears
● upset stomach,constipation
● diarrhea
● Fast, unexplained weight loss
● Trouble breathing or swallowing
● Blisters or peeling skin
● Hives, skin rash, or itching
● Vomiting blood
● Dehydration
Contraindications:
● Sulfonamide, sulfonylurea hypersensitivity, thiazide diuretic hypersensitivity.
● Hepatic disease
● hypovolemia, sympathectomy
● Electrolyte imbalance, hypokalemia, ventricular arrhythmias.
● Acute myocardial infarction
● Anuria