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- What is torsemide, and how does it work?
- What are the uses for torsemide?
- What are torsemide side effects?
- What dosages are available for torsemide, and how do I take it?
- Which drugs or supplements interact with torsemide?
- Is torsemide safe to use during pregnancy or while breastfeeding?
- What else should I know about torsemide?
What is torsemide, and how does it work?
Torsemide (Demadex) is a potent drug that's a diuretic (water pill). This medicine 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 by the kidneys.
Torsemide is in a class of diuretic drugs called "loop" diuretics, which also includes the drugs furosemide (Lasix) and bumetanide (Bumex). Torsemide 10-20 mg is approximately equivalent to 1 mg of bumetanide and 40 mg of furosemide. The potent diuretic effect of torsemide 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.
What brand names are available for torsemide?
Demadex is the brand name for this medication in the U.S.
Is torsemide available as a generic drug?
Yes, it's available as a generic drug.
Do I need a prescription for torsemide?
Yes, your medical doctor or health care professional will need to write you a prescription for the medication.
What are the uses for torsemide?
Torsemide is prescribed by doctors to treat several diseases and conditions.
- Torsemide (Demadex) is used for the medical treatment of edema (water retention) due to congestive heart failure, kidney disease, chronic kidney failure, or liver disease.
- Torsemide also is used alone or combined with other antihypertensive medications for the treatment of high blood pressure (hypertension).
Who shouldn't take torsemide?
- Patients shouldn't take torsemide if they are allergic to it or to sulfonylureas to which it is related.
- Don't take torsemide if you aren't able to urinate.
- Patients with liver disease with cirrhosis and ascites should use this drug with caution because sudden changes in fluid and electrolyte balance can cause hepatic coma.
What are torsemide side effects?
- Dry mouth
- Reduced kidney function
- Heart arrhythmias
- Muscle aches and pains
Possible side effects of this medication reported often include:
- Excessive urination
- Runny nose
- ECG abnormality
- Joint pain
- Stomach upset
- Sore throat
- Muscle pain
Possible serious side effects and adverse effects include:
- Atrial fibrillation
- Chest pain
- Gastrointestinal bleeding
- High blood sugar (hyperglycemia)
- Increased uric acid (hyperuricemia)
- Low blood potassium (hypokalemia)
- Low blood pressure (hypotension)
- Dehydration (symptoms listed previously)
- Shunt thrombosis
- Rectal bleeding
- Ventricular tachycardia
- Serious skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Allergic reactions
- Reduced number of white blood cells and platelets
Demadex can cause dehydration and loss of potassium and other electrolytes. Low potassium levels (hypokalemia) can cause abnormal heartbeats especially in people with heart disease or those taking the medicine digoxin (Lanoxin). Levels of potassium and other electrolytes should be monitored during medical treatment with this medicine.
What dosages are available for torsemide, and how do I take it?
- Torsimide (Demadex) comes in tablets of 5, 10, 20, and 100 mg. The 10 mg/ml injectable solution has been discontinued.
- Patients can take the tablets at any time without regard to meals. (You can take it on an empty stomach.)
- For the treatment for patients with 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 once daily.
- The dose for treating high blood pressure is 2.5 to 10 mg orally once daily.
- 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.
Which drugs or supplements interact with torsemide?
Several medicines may cause interactions with torsemide.
- 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.
- Indomethacin (Indocin) can reduce the diuretic and blood pressure-lowering effects of other loop diuretics (for example furosemide) and it probably can do the same with torsemide. Other nonsteroidal anti-inflammatory drugs -- for example, ibuprofen (Motrin) and naproxen (Naprosyn) -- may interact similarly.
- 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.
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Is torsemide safe to use during pregnancy or while breastfeeding?
What else should I know about torsemide?
Storage and FDA approval
- Keep this drug stored at room temperature, 15 C to 30 C (59 F to 86 F).
- The FDA approved torsemide in August 1993.
There have been no human experiences with overdoses of this medication. Signs and symptoms of overdose may include:
- Low blood pressure (hypotension)
- Hypokalemia (low potassium levels)
- Hypochloremic alkalosis
If you think someone has taken an overdose of this drug call 911 or the poison control center at 1-800-222-1222.
Torsemide (Demadex) is a prescription drug used to treat water retention from congestive heart failure, kidney disease, liver disease, and chronic kidney failure. Review side effects, drug interactions, dosage, storage, and pregnancy and breastfeeding safety information prior to taking this medication.
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Second Source WebMD Medical Reference
Liver (Anatomy and Function)
The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depends on the cause.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin (jaundice), itching, and fatigue. The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Heart Attack (Myocardial Infarction)
A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include: weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Fatty Liver (NASH)
Nonalcoholic fatty liver disease or NASH occurs due to the accumulation of abnormal amounts of fat within the liver. Fatty liver most likely caused by obesity and diabetes. Symptoms of fatty liver disease are primarily the complications of cirrhosis of the liver; and may include mental changes, liver cancer, the accumulation of fluid in the body (ascites, edema), and gastrointestinal bleeding. Treatment for fatty liver includes avoiding certain foods and alcohol. Exercise, weight loss, bariatric surgery, and liver transplantation are treatments for fatty liver disease.
Congestive Heart Failure (CHF) Symptoms, Treatment, and Life Expectancy
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Lung Anatomy (Structure and Function)
The lungs are primarily responsible for the exchange of oxygen and carbon dioxide between the air we breathe and the blood. Eliminating carbon dioxide from the blood is important, because as it builds up in the blood, headaches, drowsiness, coma, and eventually death may occur. The air we breathe in (inhalation) is warmed, humidified, and cleaned by the nose and the lungs.
Kidney (Renal) Failure
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones.Treatment options included diet, medications, or dialysis.
Edema is the swelling of tissues as a result of excess water accumulation. Peripheral edema occurs in the feet and legs. There are two types of edema, non-pitting edema and pitting edema. Causes of pitting edema is caused by systemic diseases (most commonly involving the heart, liver, and kidneys), and medications. Local conditions that cause edema are thrombophlebitis and varicose veins. Edema or swelling of the legs, feet, ankles, and face are common during pregnancy. Idiopathic edema is edema in which the cause is not known. Pitting edema is scored on pitting edema measurement scales. Edema is generally treated with medication.
Tylenol Liver Damage
Tylenol liver damage (acetaminophen) can occur from accidentally ingesting too much acetaminophen, or intentionally. Signs and symptoms of acetaminophen-induced liver damage may include: nauseau, vomiting, kidney failure, bleeding disorders, coma, and death. Acetaminophen is a drug contained in over 200 OTC and prescription medications from NyQuil to Vicodin. Avoiding unintentional overdoses include reading medication labels, write down the dosages of medications you are taking, do not drink excessive alcohol while taking acetaminophen. In severe cases, a liver transplant may be necessary.
Hypertensive Kidney Disease
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats. There are two types of congestive heart failure, systolic or left-sided heart failure; and diastolic or right-sided heart failure. Treatment, prognosis, and life-expectancy for a person with congestive heart failure depends upon the stage of the disease.
Drug-Induced Liver Disease
Drug-induced liver diseases are diseases of the liver that are caused by: physician-prescribed medications, OTC medications, vitamins, hormones, herbs, illicit (recreational) drugs, and environmental toxins. Read about the signs and symptoms of drug-induced liver disease like hepatitis (inflammation of the liver cells), liver disease treatment, and types.
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Febrile seizures, or convulsions caused by fever, can be frightening in small children or infants. However, in general, febrile seizures are harmless. Febrile seizure is not epilepsy. It is estimated that one in every 25 children will have at least one febrile seizure. It is important to know what to do to help your child if he/she has a febrile seizure. Some of the features of a febrile seizure include: losing consciousness, shaking, moving limbs on both sides of the body, lasts 1-2 minutes. Less commonly, a febrile seizure may only affect one side of the body.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Liver cancer is cancer of the liver cells (hepatocellular carcinoma) or of the ducts in the liver (cholangiocarcinoma). Liver cancer often arises due to liver damage, cirrhosis (scarring) caused by alcohol use/abuse, hepatitis B, or hepatitis C. Liver cancer may not cause any symptoms. Liver cancer is diagnosed with blood tests, imaging tests, and a liver biopsy. Treatment for liver cancer may include surgery, ablation, embolization, radiation, chemotherapy, and targeted therapy.
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