Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Torsemide can cause low blood potassium, calcium, and
magnesium levels. These changes can increase the risk of toxicity from digoxin
(Lanoxin). Combining torsemide with other diuretics such as metolazone
(Zaroxolyn), hydrochlorothiazide, or chlorthalidone (Hygroton) can exaggerate
the losses of potassium and magnesium.
The body's ability to eliminate lithium (Lithobid, Eskalith) may decrease in
patients receiving torsemide. Therefore, careful monitoring of lithium levels in
blood is recommended when torsemide and lithium are taken together in order to
prevent increases in lithium levels and lithium toxicity.
Concomitant use of torsemide and aminoglycosides may increase the risk of
hearing impairment since both agents can affect hearing.
Probenecid decreases the diuretic effect of torsemide by reducing secretion
of torsemide into the kidney tubules.
PREGNANCY AND BREASTFEEDING SAFETY: ;Safe use of torsemide by pregnant women
has not been established. It is not known whether torsemide is excreted in human
STORAGE: Torsemide should be stored at room temperature,15 C to 30 C (59 F to
Torsemide tablets may be given at any time without regard to meals.
For treatment of heart failure the initial dose is 10 to 20 mg by mouth or
injection once daily. The dose may be doubled until the desired diuretic effect
is achieved. The maximum dose is 200 mg daily.
Chronic kidney failure is treated with 20 to 200 mg orally or by injection
Liver cirrhosis is treated with 5 to 40 mg orally or by injection once daily.
It is combined with aldosterone antagonists or potassium-sparing diuretics.
DRUG CLASS AND MECHANISM:
Torsemide is a potent diuretic (water pill) that
causes a profound increase in urine output (diuresis) by preventing the kidney
from retaining water.
Specifically, it blocks the reabsorption back into the
blood of sodium and water that has been filtered out of the blood in the
It is in a class of diuretics called "loop" diuretics which also
includes furosemide (Lasix) and bumetanide (Bumex).
Torsemide 10-20 mg is
approximately equivalent to 1 mg of bumetanide and 40 mg of furosemide.
potent diuretic effect of bumetanide can cause the loss of large amounts of body
water leading to dehydration as well as the loss of electrolytes (for example,
sodium, potassium, magnesium, and calcium).
Therefore, careful medical
supervision is necessary during treatment.