Pharm

Torsemide

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Torsemide, Demadex

  • See Also
  1. Loop Diuretic
  • Indications
  1. See Loop Diuretic
  • Contraindications
  1. Povidone Hypersensitivity
  2. Anuria
  3. Hepatic coma
  • Mechanism
  1. See Loop Diuretic
  • Background
  1. Well Absorbed
    1. Oral Bioavailability 80-90% consistently, even in severe edema (contrast with Furosemide)
  2. Once daily dosing (contrast with all other Loop Diuretics)
  3. Half-Life: 3 to 4 hours (doubled in hepatic dysfunction)
  • Dosing
  • Adults
  1. Oral
    1. Start: 10-20 mg orally daily
    2. Titrate as needed by doubling dose
    3. Maximum: 200 mg/day (40 mg in Chronic Renal Failure)
    4. Duration: 12-16 hours
    5. Onset: 1 hour
  2. Intravenous Dosing (adults)
    1. Start: 10 mg IV
    2. Maximum: 100-200 mg/day
  3. Intravenous Infusion (adults)
    1. Load: 20 mg
    2. Rate: 5-20 mg/hour
  • Adverse Effects
  1. See Loop Diuretic
  • Safety
  1. Pregnancy Category B
    1. No safety information available for use in pregnancy
  2. Unknown Safety in Lactation
  • Drug Interactions
  1. Avoid with NSAIDs
  2. Metabolized by CYP2C9
    1. Avoid with potent CYP2C9 Inhibitors (decrease Torsemide clearance)
  3. Increases levels of other drugs
    1. Warfarin
    2. Phenytoin
  • Resources
  1. Torsemide Tablet (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a95cbdb-0601-47a5-9b3a-0c3b0629ceb9
  • References
  1. (2021) Presc Lett, Resource #370507, Commonly Used Diuretics
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 62-3
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia