Torsemide

Mechanism of Action

• It predominantly inhibits salt and chloride reabsorption in the loop of Henle and renal tubules.
• Water is retained in the region of the proximal tubule and descending limb of Henle's loop because it cannot be reaborbed.
• Increases the pace at which electrolytes, particularly sodium, chloride, and potassium, are excreted by the kidney.

Indication

• Management of edema, hypertension.
• CHF, Hepatic Cirrhosis

Dose

• CHF, Chronic Kidney Failure
  • Adult: PO/IV 10-20mg od, may increase up to  200 mg/day as needed
• Hepatic Cirrhosis
  •  Adult: PO/IV 5-10mg od administered with an aldosterone antagonist or potassium- sparing diuretic, may increase up to 40 mg/day as needed
• Hypertension
  • Adult: PO/IV 5mg od, may increase to 10 mg/day if no response after 4-6 wk

Side effect

• Headache, dizziness, fatigue, insomnia, orthostatic hypotension, chest pain, ECG abnormality, Hypokalemia, hyponatremia, hyperuricemia, nausea, diarrhea, rash, pruritus, muscle cramps, rhinitis.

Contraindication

• Hypersensitivity to torsemide sulfonamides, anuria, acute MI, hepatic coma.