Tomide

Indications

Torasemide (torsemide) is a loop diuretic, often called a water tablet. It is used to reduce swelling (oedema) caused by heart failure, kidney disease or liver disease, and to treat high blood pressure.

How It Works

Torasemide acts on a part of the kidney called the loop of Henle and stops it from taking back salt (sodium and chloride). The extra salt is passed out in the urine and takes water with it, which reduces fluid build-up and lowers blood pressure.

Dosage and Administration

Usual adult doses: for oedema, 5 mg once a day, increased if needed to 10 to 20 mg once a day, or as prescribed (higher doses are sometimes used in kidney failure under specialist care); for high blood pressure, 2.5 to 5 mg once a day. Take it in the morning, with or without food, so you do not need to pass urine at night. Injections are given by a doctor or nurse.

Interactions

It may increase the risk of low potassium with Corticosteroids, laxatives and Amphotericin B, which raises the risk of side effects with Digoxin. It can raise Lithium levels. NSAIDs such as Ibuprofen may reduce its effect and harm the kidneys. Use with Aminoglycosides can increase hearing and kidney damage. Other blood pressure medicines add to its effect. Tell your doctor about all medicines you take.

Contraindications

• Allergy to torasemide or to sulfonylureas
• Kidney failure with no urine production
• Hepatic coma or pre-coma
• Low blood pressure or low blood volume (dehydration)
• Severe low sodium or potassium that has not been corrected

Side Effects

Common effects include passing more urine, dizziness, headache, tiredness, thirst, muscle cramps, stomach upset, and changes in blood salts (low potassium, sodium or magnesium). It may raise blood sugar and uric acid (risk of gout).

Get urgent medical help for fainting, severe dizziness, a very fast or irregular heartbeat, severe muscle weakness or cramps, confusion, ringing in the ears or hearing loss, very little urine, or a serious skin or allergic reaction.

Pregnancy and Lactation

Use in pregnancy only if your doctor advises, as it can reduce blood flow to the baby. It is not known if it passes into breast milk and it may reduce milk supply; ask your doctor before using it while breastfeeding.

Precautions and Warnings

Your doctor will check blood pressure, kidney function and blood salts. Tell your doctor about diabetes, gout, an enlarged prostate or problems passing urine. Get up slowly from sitting or lying. Drink fluids as advised, and take extra care in hot weather or if you have vomiting or diarrhoea.

Overdose

Overdose causes heavy urine loss, dehydration, very low blood pressure, salt imbalance, confusion and collapse. Seek emergency help.

Therapeutic Class

Loop diuretic

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.