Generic Name: Torsemide.

Trade Name    : Examide.

Drug Class      : Loop Diuretics.

Forms of The Drug

  • Tablet: 5mg – 10mg – 20mg – 60mg – 100mg.

Mechanism of Action

The mechanism of action of torsemide is similar to that of other loop diuretics and primarily involves its effects on the renal system. Torsemide acts on the ascending limb of the loop of Henle in the kidneys, where sodium, chloride, and water are reabsorbed from the filtrate. It inhibits the Na-K-2Cl cotransporter, which is responsible for the reabsorption of sodium, potassium, and chloride ions from the tubular fluid into the renal tubular cells. By blocking the Na-K-2Cl cotransporter, torsemide prevents the reabsorption of sodium and chloride ions, leading to an increased concentration of these ions in the tubular fluid. This high concentration creates an osmotic gradient that hinders the reabsorption of water. As a result, more water and electrolytes are excreted in the urine, promoting diuresis and reducing fluid retention.

Like other loop diuretics, torsemide also has vasodilatory effects. It causes relaxation and dilation of the blood vessels, particularly the arteries, which reduces peripheral vascular resistance and lowers blood pressure. It is worth noting that torsemide is considered to have a longer duration of action compared to other loop diuretics. This means that it can maintain its diuretic effect for a longer period, requiring fewer doses throughout the day.

Indications

  1. Edema.
  2. Congestive heart failure (CHF).
  3. Hypertension.
  4. Renal impairment.
  5. Ascites.
  6. Pulmonary edema.

Contraindications

  1. Allergy or hypersensitivity.
  2. Anuria.
  3. Severe electrolyte imbalances.
  4. Hepatic coma.
  5. Anencephaly.
  6. Severe dehydration.
  7. Pregnancy.

Side Effects

  1. Excessive urination (7%).
  2. Headache (7%).
  3. Electrolyte imbalance (2-4%).
  4. Dizziness (3%).
  5. Rhinitis (3%).
  6. Constipation (2%).
  7. Cough (2%).
  8. Diarrhea (2%).
  9. Dyspepsia (2%).
  10. Nausea (2%).
  11. Insomnia (1%).
  12. Nervousness (1%).

Drug Interaction

  1. Other drugs that can interact with it.
  2. Other diuretics such as thiazides or potassium-sparing diuretics.
  3. Aminoglycoside antibiotics e.g., gentamicin, tobramycin.
  4. Lithium.
  5. NSAIDs, including ibuprofen and naproxen.
  6. Corticosteroids, such as prednisone or dexamethasone.
  7. Digoxin.
  8. Antihypertensive medications, such as beta-blockers or ACE inhibitors.
  9. Ototoxic medications, such as cisplatin or certain antibiotics.

Precautions

  1. Pregnancy: Category B.
  2. Lactation: Torsemide, a loop diuretic medication, is known to be excreted into breast milk. Therefore, caution is advised when considering the use of torsemide during lactation. While it is generally considered compatible with breastfeeding.

Leave a Reply

Your email address will not be published. Required fields are marked *