Overview
Torasemide is a loop diuretic used to treat edema associated with congestive heart failure, renal disease, and hepatic cirrhosis. It works by inhibiting sodium-potassium-chloride cotransport in the ascending loop of Henle, promoting diuresis and reducing fluid retention.
Mechanism of Action
Inhibits the Na+/K+/2Cl- cotransporter in the thick ascending limb of the loop of Henle, reducing sodium and chloride reabsorption and increasing water excretion.
Indications
- Edema due to congestive heart failure
- Edema due to renal impairment
- Edema due to hepatic cirrhosis
- Hypertension (in some formulations)
Dosage
For edema: 5-20 mg once daily, adjusted based on response. For hypertension: 2.5-5 mg once daily. Maximum dose typically 40 mg/day, but may be higher under medical supervision.
Contraindications
- Anuria
- Hypersensitivity to torasemide or sulfonamides
- Severe electrolyte depletion
- Hepatic coma
Side Effects
- Headache
- Dizziness
- Polyuria
- Hypokalemia
- Hyponatremia
- Hypotension
- Muscle cramps
- Gastrointestinal disturbances
- Increased blood glucose
- Hyperuricemia
Interactions
- Lithium (increased lithium toxicity)
- Other antihypertensives (additive effects)
- NSAIDs (reduced diuretic effect)
- Digoxin (hypokalemia may increase digoxin toxicity)
- Aminoglycosides (increased risk of ototoxicity)
- Probenecid (reduces torasemide effect)