Torasemide

Indications

Hypertension Edema

Torsem is indicated for the management of oedema of cardiac, renal and hepatic origin. It is also indicated for the management of hypertension, either as a sole therapeutic agent or in combination with other classes of antihypertensive agents.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Torasemide blocks the Na+/K+/2Cl- carrier system by interfering with the chloride binding site in the lumen of the thick ascending limb of the loop of Henle, which reduces reabsorption of sodium and chloride. This speeds up the delivery of tubular fluid and electrolytes to the distal sites where hydrogen and potassium ions are secreted, while the resulting contraction of plasma volume raises aldosterone production. The greater fluid delivery combined with high aldosterone levels promotes sodium reabsorption at the distal tubules, and because more sodium reaches the distal renal tubule, torasemide indirectly boosts potassium excretion through the sodium-potassium exchange mechanism. No effects of torasemide have been shown in other segments of the nephron. In this way, torasemide raises urinary excretion of sodium, chloride, and water without meaningfully changing glomerular filtration rate, renal plasma flow, or acid-base balance. Its blood-pressure-lowering effect comes from this diuretic action: by lowering extracellular and plasma fluid volume, it temporarily reduces blood pressure and also decreases cardiac output.

Pregnancy & Breastfeeding

Pregnancy: There have been no adequate, well-controlled studies of torasemide in pregnant women, and animal studies do not reliably predict how a drug will behave in humans. For this reason, torasemide should be used during pregnancy only when clearly needed.

Breastfeeding: It is not known whether torasemide passes into human breast milk. Since many drugs do pass into breast milk, it should be used with caution in a nursing mother.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Congestive heart failure: The usual starting oral dose is 10 mg or 20 mg once daily. If the diuretic response is not enough, the dose should be increased step by step, roughly doubling each time, until the desired diuretic response is reached. Single doses above 200 mg have not been adequately studied. Chronic renal failure: The usual starting oral dose is 20 mg once daily. If the diuretic response is not enough, the dose should be increased step by step, roughly doubling each time, until the desired diuretic response is reached. Single doses above 200 mg have not been adequately studied. Hepatic cirrhosis: The usual starting oral dose is 5 mg or 10 mg once daily, given together with an aldosterone antagonist or a potassium sparing diuretic. If the diuretic response is not enough, the dose should be increased step by step, roughly doubling each time, until the desired diuretic response is reached. Single doses above 40 mg have not been adequately studied. Long term use of any diuretic in liver disease has not been studied in adequate and well controlled trials. Hypertension: The usual starting oral dose is 2.5 to 5 mg once daily. If the 5 mg dose does not lower blood pressure enough within 4 to 6 weeks, the dose may be raised to 10 mg once daily. If the response to 10 mg is still not sufficient, another antihypertensive medicine should be added to the treatment.

Side Effects & Interactions

Side Effects

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