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Torasemide

From Wikipedia, the free encyclopedia
Diuretic medication

Pharmaceutical compound
Torasemide
Clinical data
Trade namesDemadex, Tortas, Wator
Other namesTorsemide, Torsemide (USANUS)
AHFS/Drugs.comMonograph
MedlinePlusa601212
License data
Routes of
administration
By mouth,intraveneous
Drug classLoop diuretic
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability80-90%
Protein bindingHighly bound (>99%).
MetabolismLiver (80%)
Eliminationhalf-life3.5 hours;Cirrhosis: 7-8 hours
Identifiers
  • N-[(isopropylamino)carbonyl]-4-[(3-methylphenyl)amino]pyridine-3-sulfonamide
CAS Number
PubChemCID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard(EPA)
ECHA InfoCard100.164.924Edit this at Wikidata
Chemical and physical data
FormulaC16H20N4O3S
Molar mass348.42 g·mol−1
3D model (JSmol)
  • CC(C)NC(=O)NS(=O)(=O)c1cnccc1Nc2cc(C)ccc2
  • InChI=1S/C16H20N4O3S/c1-11(2)18-16(21)20-24(22,23)15-10-17-8-7-14(15)19-13-6-4-5-12(3)9-13/h4-11H,1-3H3,(H,17,19)(H2,18,20,21) checkY
  • Key:NGBFQHCMQULJNZ-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Torasemide, also known astorsemide, is a diuretic medication used to treatfluid overload due toheart failure,kidney disease, andliver disease. It is a less preferred treatment for high blood pressure.[1] It is taken by mouth or byinjection into a vein.[1]

Common side effects include headache, increased urination, diarrhea, cough, and dizziness.[1] Other side effects may includehearing loss andlow blood potassium.[1] Torasemide is asulfonamide andloop diuretic.[1] Use is not recommended inpregnancy orbreastfeeding.[2] It works by decreasing the reabsorption ofsodium by thekidneys.[1]

Torasemide was patented in 1974 and came into medical use in 1993.[3] It is on theWorld Health Organization's List of Essential Medicines.[4] It is available as ageneric medication.[2] In 2023, it was the 193rd most commonly prescribed medication in the United States, with more than 2 million prescriptions.[5][6]

Medical uses

[edit]

It is used to treatfluid overload due toheart failure. It is sometimes used to treathigh blood pressure.[1] Compared with furosemide, torasemide is associated with a lower risk of rehospitalization for heart failure and with improvement in New York Heart Association functional class, reflected by a reduction in NYHA class severity.[7][8][9] In heart failure it may be safer and more effective thanfurosemide.[10][11][12] Long-term outcomes with torasemide may be better than with furosemide in patients with heart failure.[13]

Adverse effects

[edit]

No evidence of torasemide-inducedototoxicity has been demonstrated in humans.[14]

Loop diuretics, including torsemide, may decrease total bodythiamine, 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.[15]

Chemistry

[edit]

Compared with other loop diuretics, torasemide has a more prolongeddiuretic effect than equipotent doses offurosemide and relatively decreasedpotassium loss.[16]

Names

[edit]
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Torasemide is the recommended name of the drug (rINN) according to the (INN), which is the drug naming system coordinated by theWorld 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).

Veterinary uses

[edit]

In May 2024, the US FDA conditionally approved the first torsemide animal medication for dogs. UpCard-CA1 (torsemide oral solution) was conditionally approved for use with concurrent therapy withpimobendan,spironolactone, and anangiotensin-converting enzyme (ACE) inhibitor for the management ofpulmonary edema (fluid build-up in lungs) in dogs with congestive heart failure caused bymyxomatous mitral valve disease (MMVD).[17][18]

References

[edit]
  1. ^abcdefg"Torsemide Monograph for Professionals".Drugs.com. American Society of Health-System Pharmacists. Retrieved18 March 2019.
  2. ^abBritish national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 227–228.ISBN 978-0-85711-338-2.
  3. ^Fischer J, Ganellin CR (2006).Analogue-based Drug Discovery. John Wiley & Sons. p. 458.ISBN 978-3-527-60749-5.
  4. ^World Health Organization (2021).World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization.hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  5. ^"Top 300 of 2023".ClinCalc.Archived from the original on 12 August 2025. Retrieved12 August 2025.
  6. ^"Torsemide Drug Usage Statistics, United States, 2013 - 2023".ClinCalc. Retrieved20 August 2025.
  7. ^Abraham B, Megaly M, Sous M, Fransawyalkomos M, Saad M, Fraser R, et al. (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.S2CID 207937875.
  8. ^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.
  9. ^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.
  10. ^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.
  11. ^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.S2CID 21204143.
  12. ^Buggey J, Mentz RJ, Pitt B, Eisenstein EL, Anstrom KJ, Velazquez EJ, et al. (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.
  13. ^Ozierański K, Balsam P, Kapłon-Cieślicka A, Tymińska A, Kowalik R, Grabowski M, et al. (February 2019). "Comparative Analysis of Long-Term Outcomes of Torasemide and Furosemide in Heart Failure Patients in Heart Failure Registries of the European Society of Cardiology".Cardiovascular Drugs and Therapy.33 (1):77–86.doi:10.1007/s10557-018-6843-5.hdl:2183/22704.PMID 30649675.S2CID 58014640.
  14. ^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.S2CID 261404564.
  15. ^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.
  16. ^Christopher J. Dunn (1995)."Torasemide: An Update of its Pharmacological Properties and Therapeutic Efficacy".Drugs.49 (1):121–142.doi:10.2165/00003495-199549010-00009.PMID 7705212. Retrieved8 March 2024.
  17. ^"FDA Conditionally Approves First Torsemide Animal Drug for Dogs".U.S. Food and Drug Administration (Press release). 10 May 2024. Archived fromthe original on 15 May 2024. Retrieved15 May 2024.Public Domain This article incorporates text from this source, which is in thepublic domain.
  18. ^"FDA Roundup: May 14, 2024".U.S. Food and Drug Administration (Press release). 14 May 2024. Retrieved15 May 2024.Public Domain This article incorporates text from this source, which is in thepublic domain.
Sulfonamides
(andetacrynic acid)
CA inhibitors (atPT)
Loop (Na-K-Cl atAL)
Thiazides (Na-Cl atDCT,
Calcium-sparing)
Thiazide-likes (primarilyDCT)
Potassium-sparing (atCD)
ESC blockers
Aldosterone antagonists
Osmotic diuretics (PT,DL)
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