Dosing & Uses
Dosage Forms & Strengths
tablet
- 5mg (generic)
- 10mg (generic)
- 20mg (Soaanz, generic)
- 60mg (Soaanz, generic)
- 100mg
Edema
Soaanz and generic
Indicated for treatment of edema associated with heart failure or renal disease
10-20 mg PO qDay initially; may increase dose by doubling until desired diuretic effect is achieved
Doses >200 mg have not been adequately studied
Hepatic Cirrhosis
Indicated for treatment of edema associated with hepatic disease
5-10 mg PO qDay initially with aldosterone antagonist or potassium-sparing diuretic; may increase dose by doubling until desired diuretic effect achieved
Doses >40 mg have not been adequately studied
Hypertension
2.5-5 mg/day PO initially; increased to 10 mg/day PO in 4-6 weeks PRN
Consider adding another antihypertensive agent if 10-mg dose is insufficient
Dosage Modifications
Renal impairment
- No dosage adjustments provided in prescribing information
- Higher doses may be required to achieve diuretic effect
Hepatic impairment
- No dosage adjustments provided in prescribing information
- Use with caution
- Contraindicated in hepatic coma
Dosing Considerations
Use for fluid retention refractory to thiazides or with impaired renal function
Overdose management
- Normal saline may be used for volume replacement
- Dopamine or norepinephrine may be used to treat hypotension
- If dysrhythmia due to decreased potassium or magnesium is suspected, replace aggressively
- Discontinue treatment if no symptoms are apparent after 6 hours
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (9)
- amikacin
torsemide, amikacin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- gentamicin
torsemide, gentamicin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- ivosidenib
ivosidenib will decrease the level or effect of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2C9 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.
- lofexidine
lofexidine, torsemide. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
- neomycin PO
torsemide, neomycin PO. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- paromomycin
torsemide, paromomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- squill
torsemide increases toxicity of squill by Other (see comment). Avoid or Use Alternate Drug. Comment: Potassium depletion may enhance toxicity of squill.
- streptomycin
torsemide, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
- tobramycin
torsemide, tobramycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.
Monitor Closely (156)
- acebutolol
acebutolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aceclofenac
aceclofenac increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- acemetacin
acemetacin increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- albuterol
albuterol and torsemide both decrease serum potassium. Use Caution/Monitor.
- aldesleukin
aldesleukin increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- alpelisib
alpelisib will decrease the level or effect of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.
- amifostine
amifostine, torsemide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.
- amiloride
amiloride increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- apalutamide
apalutamide will decrease the level or effect of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.
- arformoterol
arformoterol and torsemide both decrease serum potassium. Use Caution/Monitor.
- aspirin
aspirin increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aspirin rectal
aspirin rectal increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atenolol
atenolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- avanafil
avanafil increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- beclomethasone, inhaled
beclomethasone, inhaled increases toxicity of torsemide by increasing elimination. Use Caution/Monitor. Corticosteroids may increase the hypkalemic effects of loop diuretics.
- benazepril
benazepril, torsemide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- bendroflumethiazide
torsemide and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.
- betaxolol
betaxolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bisoprolol
bisoprolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bretylium
torsemide, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- bumetanide
bumetanide and torsemide both decrease serum potassium. Use Caution/Monitor.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection decreases effects of torsemide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Opioids can reduce diuretic efficacy by inducing antidiuretic hormone release.
- candesartan
candesartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cannabidiol
cannabidiol will increase the level or effect of torsemide by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.
- captopril
captopril, torsemide. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency. Monitor blood pressure and renal function.
- carbenoxolone
torsemide and carbenoxolone both decrease serum potassium. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.
- carvedilol
carvedilol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celecoxib
celecoxib increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celiprolol
celiprolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorothiazide
torsemide and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- chlorthalidone
torsemide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- citalopram
torsemide, citalopram. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.
- cornsilk
cornsilk increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).
- cyclopenthiazide
torsemide and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.
- deflazacort
torsemide and deflazacort both decrease serum potassium. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and torsemide both decrease serum potassium. Use Caution/Monitor.
- diclofenac
diclofenac increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diflunisal
diflunisal increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- digoxin
digoxin increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
torsemide increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Hypokalemia increases digoxin effects. - dobutamine
dobutamine and torsemide both decrease serum potassium. Use Caution/Monitor.
- dopexamine
dopexamine and torsemide both decrease serum potassium. Use Caution/Monitor.
- drospirenone
drospirenone increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Elvitegravir is a moderate CYP2C9 inducer.
- empagliflozin
empagliflozin, torsemide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of empagliflozin with diuretics results in increased urine volume and frequency of voids, which might enhance the potential for volume depletion.
- enalapril
enalapril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- ephedrine
ephedrine and torsemide both decrease serum potassium. Use Caution/Monitor.
- epinephrine
epinephrine and torsemide both decrease serum potassium. Use Caution/Monitor.
- epinephrine racemic
epinephrine racemic and torsemide both decrease serum potassium. Use Caution/Monitor.
- eprosartan
eprosartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- esmolol
esmolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ethacrynic acid
ethacrynic acid and torsemide both decrease serum potassium. Use Caution/Monitor.
- etodolac
etodolac increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fenoprofen
fenoprofen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fentanyl
fentanyl decreases effects of torsemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- fentanyl intranasal
fentanyl intranasal decreases effects of torsemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- fentanyl transdermal
fentanyl transdermal decreases effects of torsemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- fentanyl transmucosal
fentanyl transmucosal decreases effects of torsemide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- flurbiprofen
flurbiprofen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- formoterol
formoterol and torsemide both decrease serum potassium. Use Caution/Monitor.
- fosinopril
fosinopril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- furosemide
furosemide and torsemide both decrease serum potassium. Use Caution/Monitor.
- gentamicin
torsemide and gentamicin both decrease serum potassium. Use Caution/Monitor.
- hydrochlorothiazide
torsemide and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.
- ibuprofen
ibuprofen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen IV
ibuprofen IV increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- imidapril
imidapril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- indacaterol, inhaled
torsemide, indacaterol, inhaled. serum potassium. Use Caution/Monitor. Combination may increase risk of hypokalemia.
indacaterol, inhaled, torsemide. Other (see comment). Use Caution/Monitor. Comment: Caution is advised in the coadministration of indacaterol neohaler with non-potassium-sparing diuretics. - indapamide
torsemide and indapamide both decrease serum potassium. Use Caution/Monitor.
- indomethacin
indomethacin increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- insulin degludec
torsemide decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.
- insulin degludec/insulin aspart
torsemide decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.
- insulin inhaled
torsemide decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.
- irbesartan
irbesartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- isoproterenol
isoproterenol and torsemide both decrease serum potassium. Use Caution/Monitor.
- juniper
juniper, torsemide. Other (see comment). Use Caution/Monitor. Comment: Juniper may potentiate or interfere with diuretic therapy. Juniper has diuretic effects, but may cause kidney damage at large doses.
- ketoprofen
ketoprofen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac
ketorolac increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac intranasal
ketorolac intranasal increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- labetalol
labetalol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levalbuterol
levalbuterol and torsemide both decrease serum potassium. Use Caution/Monitor.
- levodopa
levodopa increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- lily of the valley
torsemide increases toxicity of lily of the valley by Other (see comment). Use Caution/Monitor. Comment: Increased risk of cardiac toxicity due to K+ depletion.
- lisinopril
lisinopril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- lornoxicam
lornoxicam increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- losartan
losartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lumacaftor/ivacaftor
lumacaftor/ivacaftor, torsemide. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C9 substrates. .
- lurasidone
lurasidone increases effects of torsemide by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.
- maitake
maitake increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).
- maraviroc
maraviroc, torsemide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- mavacamten
torsemide will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose.
- meclofenamate
meclofenamate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mefenamic acid
mefenamic acid increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meloxicam
meloxicam increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaproterenol
metaproterenol and torsemide both decrease serum potassium. Use Caution/Monitor.
- metformin
torsemide decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.
- methyclothiazide
torsemide and methyclothiazide both decrease serum potassium. Use Caution/Monitor.
- metolazone
torsemide and metolazone both decrease serum potassium. Use Caution/Monitor.
- metoprolol
metoprolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- moexipril
moexipril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- mometasone inhaled
mometasone inhaled increases toxicity of torsemide by Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may increase hypokalemic effect of loop diuretics.
- nabumetone
nabumetone increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nadolol
nadolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- naproxen
naproxen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nebivolol
nebivolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nitisinone
nitisinone will increase the level or effect of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.
- nitroglycerin rectal
nitroglycerin rectal, torsemide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .
- norepinephrine
norepinephrine and torsemide both decrease serum potassium. Use Caution/Monitor.
- oliceridine
oliceridine decreases effects of torsemide by Other (see comment). Use Caution/Monitor. Comment: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. Monitor for signs of diminished diuresis and/or effects on blood pressure and increase dosage of the diuretic as needed. .
- olmesartan
olmesartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- olodaterol inhaled
torsemide and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.
- oxaprozin
oxaprozin increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
parecoxib increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- peginterferon alfa 2b
peginterferon alfa 2b decreases levels of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. When patients are administered peginterferon alpha-2b with CYP2C9 substrates, the therapeutic effect of these drugs may be altered. .
- penbutolol
penbutolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- perindopril
perindopril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- pindolol
pindolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pirbuterol
pirbuterol and torsemide both decrease serum potassium. Use Caution/Monitor.
- piroxicam
piroxicam increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- potassium acid phosphate
potassium acid phosphate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium chloride
potassium chloride increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium citrate
potassium citrate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- propranolol
propranolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quinapril
quinapril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- ramipril
ramipril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- rucaparib
rucaparib will increase the level or effect of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.
- sacubitril/valsartan
sacubitril/valsartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salicylates (non-asa)
salicylates (non-asa) increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salmeterol
salmeterol and torsemide both decrease serum potassium. Use Caution/Monitor.
- salsalate
salsalate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of torsemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
torsemide and sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of torsemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sotalol
sotalol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sparsentan
sparsentan will decrease the level or effect of torsemide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C9 inducer) decreases exposure of CYP2C9 substrates and reduces efficacy related to these substrates.
- spironolactone
spironolactone increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- succinylcholine
succinylcholine increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sulfasalazine
sulfasalazine increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sulindac
sulindac increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tadalafil
tadalafil increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- telmisartan
telmisartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- terbutaline
terbutaline and torsemide both decrease serum potassium. Use Caution/Monitor.
- timolol
timolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tobramycin inhaled
tobramycin inhaled, torsemide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent use if possible; theorized mechanisms include rapid injection of loop diuretics, existing renal impairment, or volume depletion leading to increased aminoglycoside concentration within the nephron.
- tolfenamic acid
tolfenamic acid increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolmetin
tolmetin increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolvaptan
tolvaptan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trandolapril
trandolapril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.
- triamterene
triamterene increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- trientine
torsemide decreases levels of trientine by increasing renal clearance. Use Caution/Monitor.
- umeclidinium bromide/vilanterol inhaled
umeclidinium bromide/vilanterol inhaled and torsemide both decrease serum potassium. Modify Therapy/Monitor Closely. Electrocardiographic changes and/or hypokalemia associated with non?potassium-sparing diuretics may worsen with concomitant beta-agonists, particularly if recommended dose is exceeded
- valsartan
valsartan increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- vilanterol/fluticasone furoate inhaled
vilanterol/fluticasone furoate inhaled and torsemide both decrease serum potassium. Modify Therapy/Monitor Closely. Beta-agonists may acutely worsen ECG changes and/or hypokalemia resulting from non-potassium-sparing diuretics
- xipamide
xipamide increases effects of torsemide by pharmacodynamic synergism. Use Caution/Monitor.
Minor (72)
- agrimony
agrimony increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- albuterol
albuterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- arformoterol
arformoterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- birch
birch increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- bitter melon
bitter melon, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- brimonidine
brimonidine increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- budesonide
budesonide, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- calcium acetate
torsemide decreases levels of calcium acetate by increasing renal clearance. Minor/Significance Unknown.
- calcium carbonate
torsemide decreases levels of calcium carbonate by increasing renal clearance. Minor/Significance Unknown.
- calcium chloride
torsemide decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.
- calcium citrate
torsemide decreases levels of calcium citrate by increasing renal clearance. Minor/Significance Unknown.
- calcium gluconate
torsemide decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.
- carbenoxolone
torsemide, carbenoxolone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.
- clopidogrel
clopidogrel increases levels of torsemide by decreasing metabolism. Minor/Significance Unknown.
- corticotropin
corticotropin, torsemide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.
- cortisone
cortisone, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- cosyntropin
cosyntropin, torsemide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.
- deflazacort
deflazacort, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- dexamethasone
dexamethasone, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- dobutamine
dobutamine, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- dopexamine
dopexamine, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- duloxetine
torsemide, duloxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- ephedrine
ephedrine, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epinephrine
epinephrine, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epinephrine racemic
epinephrine racemic, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epoprostenol
epoprostenol increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
- escitalopram
torsemide, escitalopram. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- fludrocortisone
fludrocortisone, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- fluoxetine
torsemide, fluoxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- fo-ti
fo-ti increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia (theoretical).
- folic acid
torsemide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- formoterol
formoterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- forskolin
forskolin increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- goldenrod
goldenrod increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrocortisone
hydrocortisone, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- isoproterenol
isoproterenol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- L-methylfolate
torsemide decreases levels of L-methylfolate by increasing renal clearance. Minor/Significance Unknown.
- levalbuterol
levalbuterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- levomilnacipran
torsemide, levomilnacipran. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- magnesium chloride
torsemide decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.
- magnesium citrate
torsemide decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.
- magnesium hydroxide
torsemide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium oxide
torsemide decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium sulfate
torsemide decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.
- metaproterenol
metaproterenol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- methylprednisolone
methylprednisolone, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- milnacipran
torsemide, milnacipran. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- minoxidil
torsemide increases effects of minoxidil by pharmacodynamic synergism. Minor/Significance Unknown.
- nefazodone
torsemide, nefazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- noni juice
noni juice increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- norepinephrine
norepinephrine, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- octacosanol
octacosanol increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- paroxetine
torsemide, paroxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- patiromer
patiromer, torsemide. cation binding in GI tract. Minor/Significance Unknown. No observed clinically important interaction. No separation of dosing required.
- pirbuterol
pirbuterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- prednisolone
prednisolone, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- prednisone
prednisone, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- reishi
reishi increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- salmeterol
salmeterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- sertraline
torsemide, sertraline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- shepherd's purse
shepherd's purse, torsemide. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- sulfadiazine
torsemide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfamethoxazole
torsemide increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfisoxazole
torsemide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
- terbutaline
terbutaline, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
torsemide, terbutaline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects. - thiamine
torsemide decreases levels of thiamine by increasing renal clearance. Minor/Significance Unknown.
- tizanidine
tizanidine increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- trazodone
torsemide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- treprostinil
treprostinil increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- venlafaxine
torsemide, venlafaxine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.
- zoledronic acid
torsemide, zoledronic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypocalcemia.
Adverse Effects
1-10%
Excessive urination (7%)
Headache (7%)
Electrolyte imbalance (2-4%)
Dizziness (3%)
Rhinitis (3%)
Constipation (2%)
Cough (2%)
Diarrhea (2%)
Dyspepsia (2%)
Nausea (2%)
Insomnia (1%)
Nervousness (1%)
Postmarketing Reports
Gastrointestinal system: Pancreatitis, abdominal pain
Nervous System: Paresthesia, confusion, visual impairment, loss of appetite
Hematologic: Leucopenia, thrombocytopenia, anemia
Hepatobiliary: Increase in liver transaminases, gamma-glutamyltransferase
Metabolism: Thiamine (vitamin B1) deficiency
Skin/hypersensitivity: Stevens-Johnson syndrome, toxic epidermal necrolysis, photosensitivity reaction, pruritus
Urogenital: Acute urinary retention
Warnings
Contraindications
Hypersensitivity to torsemide or to povidone
Anuria
Hepatic coma
Cautions
Use with caution in diabetes mellitus, fluid or electrolyte imbalance (hypokalemia, hyponatremia), hyperglycemia, hyperlipidemia, hyperuricemia or gout, severe liver disease with cirrhosis and ascites
Use with caution in cirrhosis; avoid changes in fluid and electrolyte balance and acid-base status, which may lead to hepatic encephalopathy
Monitor fluid status and renal function to prevent azotemia, oliguria, and reversible increases in blood urea nitrogen (BUN) and creatinine
Excessive diuresis may cause potentially symptomatic dehydration, blood volume reduction and hypotension and worsening renal function, including acute renal failure particularly in salt-depleted patients or those taking renin-angiotensin aldosterone inhibitors; worsening of renal function can also occur with concomitant use of nephrotoxic drugs (e.g., aminoglycosides, cisplatin, and NSAIDs); monitor volume status and renal function periodically
Can cause potentially symptomatic hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia, and hypochloremic alkalosis; therapy can cause an increase in blood glucose levels and hyperglycemia; asymptomatic hyperuricemia can occur, and gout may rarely be precipitated; monitor serum electrolytes and blood glucose periodically
Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics; higher than recommended doses, severe renal impairment, and hypoproteinemia, appear to increase the risk of ototoxicity
Drug interaction overview
- CYP2C9 substrate; CYP2C9 inhibitor
-
Nonsteroidal Anti-inflammatory Drugs (NSAIDS)
- Coadministration of NSAIDS and torsemide has been associated with acute renal failure; diuretic effects of torsemide may be reduced by NSAIDS
- Because torsemide and salicylates compete for renal tubule secretion, patients treated with high-dose salicylates may experience salicylate toxicity when torsemide is coadministered
-
CYP2C9 inhibitors
- Monitor diuretic effect and blood pressure (BP); adjust dose, if necessary
- CYP2C9 inhibitors (eg, amiodarone, fluconazole, miconazole, oxandrolone) can decrease torsemide clearance and increase torsemide plasma concentrations
-
CYP2C9 inducers
- Monitor diuretic effect and blood pressure (BP); adjust dose, if necessary
- CYP2C9 inhibitors (eg, amiodarone, fluconazole, miconazole, oxandrolone) can increase torsemide clearance and decrease torsemide plasma concentrations
-
Sensitive CYP2C9 substrates
- Monitor patients and adjust dosages if necessary
- Torsemide may affect the efficacy and safety of sensitive CYP2C9 substrates (eg, celecoxib), or of substrates with a narrow therapeutic range (eg, warfarin, phenytoin)
-
Cholestyramine
- Administer torsemide at 1 hr before or 4-6 hr after cholestyramine
- Not studied in humans
- Cholestyramine decreased the absorption of oral torsemide in animals
-
Organic anion drugs
- Monitor diuretic effect and BP
- Organic anion drugs (eg, probenecid) that undergo significant renal tubular secretion may potentially reduce the secretion of torsemide into the proximal tubule, which decreases diuretic activity of torsemide
-
Lithium
- Monitor lithium levels
- Torsemide reduces renal clearance of lithium, increase risk of lithium toxicity
-
Renin-angiotensin inhibitors
- Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment
-
Radiocontrast agents
- Torsemide may increase nephrotoxicity related to administration of radiocontrast agents
-
Corticosteroids and ACTH
- Torsemide may increase risk of hypokalemia
Pregnancy & Lactation
Pregnancy
No data are available on use in pregnant females and risk of major birth defects or miscarriage
Animal data
- In pregnant rats and rabbits administered 50x and 6.8x the human dose, decreases in body weight, decreased fetal resorption, and delayed ossification was observed
Lactation
There are no data regarding presence of torsemide in human milk or effects of on breastfed children
Diuretics can suppress lactation
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Sulfonylurea diuretic; loop diuretic acting at Na-K-2Cl reabsorptive pump at ascending loop of Henle; interferes with chloride-binding cotransport system, causing increased excretion of water, sodium, chlorine, magnesium, and calcium
Absorption
Bioavailability: 80%
Onset: 1 hr
Duration of diuresis: 6-8 hr (generic)
Peak plasma time: 2.5 hr (Soaanz); 1 hr (generic)
Peak of antihypertensive effect: 4-6 weeks
Food effects
- Administered with a high-fat, high-calorie meal H5
- Delayed peak plasma time: ~45 min (Soaanz); ~30 min (generic)
- Increased peak plasma concentration: 100% (Soaanz)
- Increased AUC: 48% (Soaanz)
Distribution
Protein bound: >99%
Vd: 12-15 L (doubled in cirrhosis)
Metabolism
Metabolized in liver by CYP2C9 (major), CYP2C8 (minor), CYP2C18 (minor)
Metabolites: M1 (active), M3 (active), M5 (inactive)
Elimination
Half-life: 3.5 hr
Dialyzable: Hemodialysis, no
Renal clearance: 0.38-0.78 L/hr
Excretion: Urine (21% [torsemide]; 12% [M1]; 2% [M3]; 34% [M5])
Administration
Oral Administration
Administer without regard to meals
Storage
Store between 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| torsemide oral - | 10 mg tablet |  | |
| torsemide oral - | 20 mg tablet |  | |
| torsemide oral - | 20 mg tablet |  | |
| torsemide oral - | 20 mg tablet |  | |
| torsemide oral - | 100 mg tablet |  | |
| torsemide oral - | 10 mg tablet |  | |
| torsemide oral - | 10 mg tablet |  | |
| torsemide oral - | 5 mg tablet |  | |
| torsemide oral - | 100 mg tablet |  | |
| torsemide oral - | 20 mg tablet |  | |
| torsemide oral - | 5 mg tablet |  | |
| torsemide oral - | 100 mg tablet |  | |
| torsemide oral - | 5 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
torsemide oral
TORSEMIDE - ORAL
(TOR-seh-mide)
COMMON BRAND NAME(S): Demadex, Soaanz
USES: Torsemide is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen.This drug is also used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.Torsemide is a "water pill" (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt.
HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually once daily. It is best to avoid taking this medication within 4 hours of your bedtime to prevent having to get up to urinate.Dosage is based on your medical condition and response to treatment. Do not increase your dose or take it more often than directed.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day as directed. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick. Generally, it may take 4 to 6 weeks, and sometimes up to 12 weeks, before the full blood pressure-lowering effect is seen. Do not stop taking this medication without consulting your doctor.If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take torsemide at least 1 hour before or at least 4 to 6 hours after these medications.Tell your doctor if your condition does not improve or if it worsens. If you are taking this medication to control high blood pressure, tell your doctor if your blood pressure readings remain high or increase.
SIDE EFFECTS: Dizziness or headache may occur as your body adjusts to the medication. If either of these effects lasts or gets worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may cause dehydration and electrolyte imbalance. Tell your doctor right away if you have any of these unlikely but serious side effects: muscle cramps, weakness, unusual tiredness, confusion, severe dizziness, fainting, drowsiness, unusual dry mouth/thirst, nausea, vomiting, fast/irregular heartbeat.Tell your doctor right away if you have any serious side effects, including: signs of kidney problems (such as change in the amount of urine), numbness/tingling/pain/redness/swelling of the arms/legs, hearing changes (such as ringing in the ears, temporary or permanent decreased hearing/deafness).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking torsemide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, inability to make urine, gout.If you have diabetes, torsemide may rarely affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Torsemide may reduce the potassium level in your blood. Your doctor may instruct you to add potassium-rich foods to your diet (such as bananas, orange juice) or prescribe potassium supplements to prevent potassium loss. Ask your doctor for more details.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Severe sweating, diarrhea, or vomiting can increase the risk of dehydration. Report prolonged diarrhea or vomiting to your doctor. Follow your doctor's instructions about the amount of fluids you can drink.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the effects of this drug, especially dizziness and water/mineral loss.During pregnancy, this drug should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also the How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: desmopressin, lithium.Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fainting, severe weakness, a severe decrease in the amount of urine.
NOTES: Do not share this medication with others.Lifestyle changes that may help this medication work better include exercising, stopping smoking, reducing stress, and changing your diet. Consult your doctor for more details.Lab and/or medical tests (such as kidney function, blood mineral levels such as potassium) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised May 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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