Demadex (torsemide)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Torsemide is a sulfonamide, loop-type diuretic and antihypertensive agent.
Torsemide is a sulfonamide-type, loop diuretic.
The American Society of Health-System Pharmacists, Inc. represents that the information provided in the accompanying monograph was formulated with a reasonable standard of care, and in conformity with professional standards in the field. Readers are advised that decisions regarding use of drugs are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and that the information contained in the monograph is provided for informational purposes only. The manufacturer's labeling should be consulted for more detailed information.
The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information contained in the monograph is not a substitute for medical care.
USES: Torsemide is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen. This drug is also used to treat high blood pressure.
Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Torsemide is a "water pill" (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt.
Generic name: torsemide
Pronunciation: (TOR-seh-mide)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Demadex
Indications
The following indications are listed for Demadex:
- Edema
- Edema Due To Hepatic Cirrhosis
- Hypertension
- Peripheral Edema Due To Chronic Heart Failure
- Pulmonary Edema Due To Chronic Heart Failure
- Renal Disease With Edema
Also known as: Edema Associated With Hepatic Cirrhosis, Edema Associated With Renal Insufficiency, Edematous Sodium Retaining Conditions, Elevated Blood Pressure, Essential Hypertension, Hyperpiesia, Hyperpiesis, Hypertensive Disorder, Peripheral Edema Due To Chf, Peripheral Edema Due To Congestive Heart Failure, Pulmonary Edema Due To Congestive Heart Failure, Systemic Arterial Hypertension.
Dosing
The manufacturers state that since oral and IV doses of torsemide are therapeutically equivalent, torsemide dosage is identical for oral or IV administration.
For the management of fluid retention (e.g., edema) associated with heart failure, experts state that diuretics should be administered at a dosage sufficient to achieve optimal volume status and relieve congestion without inducing an excessively rapid reduction in intravascular volume, which could result in hypotension, renal dysfunction, or both.
Safety and efficacy of torsemide in children have not been established.
For the management of edema in patients with chronic renal failure, the usual initial adult oral or IV dosage of torsemide is 20 mg daily, given as a single dose. If the diuretic response is inadequate, dosage may be titrated upward by doubling the dose until desired response is attained. However, the manufacturers state that single doses exceeding 200 mg or chronic use in patients with renal impairment have not been adequately studied.
For the management of edema in patients with hepatic cirrhosis, torsemide is administered concomitantly with an aldosterone antagonist or a potassium-sparing diuretic; the usual initial adult oral or IV dosage of torsemide is 5-10 mg daily, given as a single dose. If the diuretic response to this initial dosage is inadequate, dosage may be titrated upward by doubling the dose until the desired response is attained. Single doses exceeding 40 mg have not been adequately studied in patients with hepatic cirrhosis.
Torsemide usually is administered orally. Food decreases the rate but not the extent of GI absorption, and the manufacturers state that the drug may be administered without regard to meals.
Torsemide also may be given by IV injection when a rapid onset of diuresis is desired or when oral therapy is not practical. IV injections of torsemide should be administered slowly over 2 minutes (''bolus''); alternatively, the drug may be administered as a continuous IV infusion.
If torsemide injection is administered through an IV line, it is recommended that the IV line be flushed with 0.9% sodium chloride injection before and after the drug is administered. Because the pH of torsemide injection exceeds 8.3, flushing is necessary to avoid potential incompatibilities that may result from differences in pH.
For administration of torsemide as a continuous IV infusion, 200 mg of the drug may be diluted in 250 mL of 5% dextrose or 0.9% sodium chloride injection or in 500 mL of 0.45% sodium chloride injection; alternatively, 50 mg of torsemide may be diluted in 500 mL of 5% dextrose, 0.9% sodium chloride injection, or 0.45% sodium chloride injection. Following dilution in these solutions in plastic containers, the drug is stable for up to 24 hours at room temperature.
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Drug interactions
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There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
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There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
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There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
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ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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