Torasemide

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Torasemide
Torasemide.svg
Torasemide bas.png
Clinical data
Trade names Demadex, Tortas, Wator, others
Other namesTorsemide
AHFS/Drugs.com Monograph
MedlinePlus a601212
License data
Pregnancy
category
  • US:C (Risk not ruled out)
    Routes of
    administration
    By mouth, IV
    Drug class Loop diuretic
    ATC code
    Legal status
    Legal status
    Pharmacokinetic data
    Bioavailability 80-90%
    Protein binding Highly bound (>99%).
    Metabolism Hepatic (80%)
    Elimination half-life 3.5 hours; Cirrhosis: 7-8 hours
    Identifiers
    CAS Number
    PubChem CID
    IUPHAR/BPS
    DrugBank
    ChemSpider
    UNII
    KEGG
    ChEBI
    ChEMBL
    CompTox Dashboard (EPA)
    ECHA InfoCard 100.164.924 OOjs UI icon edit-ltr-progressive.svg
    Chemical and physical data
    Formula C16H20N4O3S
    Molar mass 348.42 g·mol−1
    3D model (JSmol)
     X mark.svgNYes check.svgY  (what is this?)    (verify)

    Torasemide, also known as torsemide, is a diuretic medication used to treat fluid overload due to heart failure, kidney disease, and liver disease and high blood pressure. [1] It is a less preferred treatment for high blood pressure. [1] It is taken by mouth or by injection into a vein. [1]

    Contents

    Common side effects include headache, increased urination, diarrhea, cough, and dizziness. [1] Other side effects may include hearing loss and low blood potassium. [1] Torasemide is a sulfonamide and loop diuretic. [1] Use is not recommended in pregnancy or breastfeeding. [2] It works by decreasing the reabsorption of sodium by the kidneys. [1]

    Torasemide was patented in 1974 and came into medical use in 1993. [3] It is available as a generic medication. [2] In 2017, it was the 264th most commonly prescribed medication in the United States, with more than one million prescriptions. [4] [5]

    Medical uses

    It is used to treat fluid overload due to heart failure and high blood pressure. [1] Compared with furosemide, torasemide is associated with a lower risk of rehospitalization for heart failure and an improvement in New York Heart Association class of heart failure. [6] [7] [8] In heart failure it may be safer and more effective than furosemide. [9] [10] [11]

    Adverse effects

    No evidence of torasemide-induced ototoxicity has been demonstrated in humans. [12]

    Loop diuretics, including torsemide, may decrease total body thiamine, particularly in people with poor thiamine intake, and this depletion may worsen heart failure. It is therefore reasonable to either also give thiamine supplements or to check blood thiamine levels in those being treated with chronic loop diuretics. [13]

    Chemistry

    Compared with other loop diuretics, torasemide has a more prolonged diuretic effect than equipotent doses of furosemide and relatively decreased potassium loss.

    Names

    Torasemide is the recommended name of the drug (rINN) according to the (INN), which is the drug naming system coordinated by the World Health Organization. Torsemide is the official name of the drug according to the (USAN), which is the drug naming system coordinated by the USAN Council, which is co-sponsored by the American Medical Association (AMA), the United States Pharmacopeial Convention (USP), and the American Pharmacists Association (APhA).

    Related Research Articles

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    Furosemide, sold under the brand name Lasix among others, is a loop diuretic medication used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It may also be used for the treatment of high blood pressure. It can be taken by injection into a vein or by mouth. When taken by mouth, it typically begins working within an hour, while intravenously, it typically begins working within five minutes.

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    Hydrochlorothiazide

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    Nifedipine

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    Loop diuretic

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    Bumetanide

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    Chlortalidone Chemical compound

    Chlortalidone, also known as chlorthalidone, is a diuretic medication used to treat high blood pressure, swelling including that due to heart failure, liver failure, and nephrotic syndrome, diabetes insipidus, and renal tubular acidosis. In high blood pressure it is a preferred initial treatment. It is also used to prevent calcium-based kidney stones. It is taken by mouth. Effects generally begin within three hours and last for up to three days.

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    Benazepril

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    Bisoprolol

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    Metolazone

    Metolazone is a thiazide-like diuretic marketed under the brand names Zytanix, Metoz, Zaroxolyn, and Mykrox. It is primarily used to treat congestive heart failure and high blood pressure. Metolazone indirectly decreases the amount of water reabsorbed into the bloodstream by the kidney, so that blood volume decreases and urine volume increases. This lowers blood pressure and prevents excess fluid accumulation in heart failure. Metolazone is sometimes used together with loop diuretics such as furosemide or bumetanide, but these highly effective combinations can lead to dehydration and electrolyte abnormalities.

    Eplerenone

    Eplerenone, sold under the brand name Inspra, is a steroidal antimineralocorticoid of the spirolactone group that is used as an adjunct in the management of chronic heart failure and high blood pressure, particularly for patients with resistant hypertension due to elevated aldosterone. Classed as a selective aldosterone receptor antagonist (SARA), it is similar to the diuretic spironolactone, though it is much more selective for the mineralocorticoid receptor in comparison, and is specifically marketed for reducing cardiovascular risk in patients following myocardial infarction. Eplerenone is a potassium-sparing diuretic, meaning that it helps the body get rid of water but still keep potassium.

    Nebivolol

    Nebivolol is a beta blocker used to treat high blood pressure and heart failure. As with other β-blockers, it is generally a less preferred treatment for high blood pressure. It may be used by itself or with other blood pressure medication. It is taken by mouth.

    Pimobendan

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    Acute decompensated heart failure

    Acute decompensated heart failure (ADHF) is a sudden worsening of the signs and symptoms of heart failure, which typically includes difficulty breathing (dyspnea), leg or feet swelling, and fatigue. ADHF is a common and potentially serious cause of acute respiratory distress. The condition is caused by severe congestion of multiple organs by fluid that is inadequately circulated by the failing heart. An attack of decompensation can be caused by underlying medical illness, such as myocardial infarction, an abnormal heart rhythm, infection, or thyroid disease.

    Diuretic Substance that promotes the production of urine

    A diuretic is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way. Alternatively, an antidiuretic, such as vasopressin, is an agent or drug which reduces the excretion of water in urine.

    References

    1. 1 2 3 4 5 6 7 8 "Torsemide Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 18 March 2019.
    2. 1 2 British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 227–228. ISBN   9780857113382.
    3. Fischer, Jnos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 458. ISBN   9783527607495.
    4. "The Top 300 of 2020". ClinCalc. Retrieved 11 April 2020.
    5. "Torsemide - Drug Usage Statistics". ClinCalc. Retrieved 11 April 2020.
    6. Abraham B, Megaly M, Sous M, Fransawyalkomos M, Saad M, Fraser R, Topf J, Goldsmith S, Simegn M, Bart B, Azzo Z, Mesiha N, Sharma R (January 2020). "Meta-Analysis Comparing Torsemide Versus Furosemide in Patients With Heart Failure". Am. J. Cardiol. 125 (1): 92–99. doi: 10.1016/j.amjcard.2019.09.039 . PMID   31699358.
    7. Täger T, Fröhlich H, Seiz M, Katus HA, Frankenstein L (March 2019). "READY: relative efficacy of loop diuretics in patients with chronic systolic heart failure-a systematic review and network meta-analysis of randomised trials". Heart Fail Rev. 24 (4): 461–472. doi:10.1007/s10741-019-09771-8. PMID   30874955. S2CID   77394851.
    8. Miles JA, Hanumanthu BK, Patel K, Chen M, Siegel RM, Kokkinidis DG (June 2019). "Torsemide versus furosemide and intermediate-term outcomes in patients with heart failure: an updated meta-analysis". J Cardiovasc Med (Hagerstown). 20 (6): 379–388. doi:10.2459/JCM.0000000000000794. PMID   30950982. S2CID   96436158.
    9. Wargo KA, Banta WM (November 2009). "A comprehensive review of the loop diuretics: should furosemide be first line?". Ann Pharmacother. 43 (11): 1836–47. doi:10.1345/aph.1M177. PMID   19843838. S2CID   43339236.
    10. Roush GC, Kaur R, Ernst ME (2014). "Diuretics: a review and update". J. Cardiovasc. Pharmacol. Ther. 19 (1): 5–13. doi:10.1177/1074248413497257. PMID   24243991.
    11. Buggey J, Mentz RJ, Pitt B, Eisenstein EL, Anstrom KJ, Velazquez EJ, O'Connor CM (2015). "A reappraisal of loop diuretic choice in heart failure patients". Am. Heart J. 169 (3): 323–33. doi:10.1016/j.ahj.2014.12.009. PMC   4346710 . PMID   25728721.
    12. Dunn CJ, Fitton A, Brogden RN (January 1995). "Torasemide. An update of its pharmacological properties and therapeutic efficacy". Drugs. 49 (1): 121–42. doi:10.2165/00003495-199549010-00009. PMID   7705212.
    13. Kattoor AJ, Goel A, Mehta JL (August 2018). "Thiamine Therapy for Heart Failure: a Promise or Fiction?". Cardiovasc Drugs Ther. 32 (4): 313–317. doi: 10.1007/s10557-018-6808-8 . PMID   30022355.