Torsemide (tablet): Difference between revisions

Torsemide (tablet)
	Adult Indications & Dosage
	Pediatric Indications & Dosage
	Contraindications
	Warnings & Precautions
	Adverse Reactions
	Drug Interactions
	Use in Specific Populations
	Administration & Monitoring
	Overdosage
	Pharmacology
	Clinical Studies
	How Supplied
	Images
	Patient Counseling Information
	Precautions with Alcohol
	Brand Names
	Look-Alike Names

VisualWikitext

Revision as of 06:39, 5 July 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gerald Chi

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Overview

Torsemide (tablet) is a loop diuretic that is FDA approved for the {{{indicationType}}} of edema associated with congestive heart failure, renal disease, or liver disease. Torsemide is also indicated for the treatment of hypertension alone or in combination with other antihypertensive agents. Common adverse reactions include polyuria and rhinitis.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Edema Associated with Congestive Heart Failure

Dosing Information

10–20 mg PO qd

If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied.

Edema Associated with Chronic Renal Failure

Dosing Information

20 mg PO qd

If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied.

Edema Associated with Hepatic Cirrhosis

Dosing Information

5–10 mg PO qd, administered together with an aldosterone antagonist or a potassium-sparing diuretic.

If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 40 mg have not been adequately studied.

Hypertension

Dosing Information

5mg PO qd

If the 5 mg dose does not provide adequate reduction in blood pressure within 4 to 6 weeks, the dose may be increased to 10 mg once daily. If the response to 10 mg is insufficient, an additional antihypertensive agent should be added to the treatment regimen.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Condition1

Developed by:

Class of Recommendation:

Strength of Evidence:

Dosing Information

Dosage

Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Torsemide (tablet) in adult patients.

Non–Guideline-Supported Use

Condition1

Dosing Information

Dosage

Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Torsemide (tablet) in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Condition1

Dosing Information

Dosage

Condition2

There is limited information regarding FDA-Labeled Use of Torsemide (tablet) in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition1

Developed by:

Class of Recommendation:

Strength of Evidence:

Dosing Information

Dosage

Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Torsemide (tablet) in pediatric patients.

Non–Guideline-Supported Use

Condition1

Dosing Information

Dosage

Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Torsemide (tablet) in pediatric patients.

Contraindications

Condition1

Warnings

Description

Precautions

Description

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Clinical Trial Experience of Torsemide (tablet) in the drug label.

Central Nervous System

Cardiovascular

Respiratory

Gastrointestinal

Hypersensitivity

Miscellaneous

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Torsemide (tablet) in the drug label.

Central Nervous System

Cardiovascular

Respiratory

Gastrointestinal

Hypersensitivity

Miscellaneous

Drug Interactions

Drug

Description

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

Pregnancy Category

Pregnancy Category (AUS):

Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Torsemide (tablet) in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Torsemide (tablet) during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Torsemide (tablet) with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Torsemide (tablet) with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Torsemide (tablet) with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Torsemide (tablet) with respect to specific gender populations.

Race

There is no FDA guidance on the use of Torsemide (tablet) with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Torsemide (tablet) in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Torsemide (tablet) in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Torsemide (tablet) in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Torsemide (tablet) in patients who are immunocompromised.

Administration and Monitoring

Administration

Oral

DEMADEX tablets may be given at any time in relation to a meal, as convenient. Special dosage adjustment in the elderly is not necessary.

Monitoring

Electrolytes

Periodic monitoring of serum potassium and other electrolytes is advised in patients treated with DEMADEX.

IV Compatibility

There is limited information regarding IV Compatibility of Torsemide (tablet) in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

Description

Management

Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Torsemide (tablet) in the drug label.

Pharmacology



Torsemide (tablet)
Systematic (IUPAC) name
N-[(isopropylamino)carbonyl]-4-[(3-methylphenyl)amino]pyridine-3-sulfonamide
Identifiers
CAS number	56211-40-6
ATC code	C03CA04
PubChem	41781
DrugBank	DB00214
Chemical data
Formula	Template:OrganicBox atom Template:OrganicBox atom Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox atom Template:OrganicBox Template:OrganicBox atom Template:OrganicBox Template:OrganicBox Template:OrganicBox atom Template:OrganicBox Template:OrganicBox Template:OrganicBox Template:OrganicBox
Mol. mass	348.421 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	80-90%
Protein binding	Highly bound (>99%).
Metabolism	Hepatic (80%)
Half life	3.5 hours; Cirrhosis: 7-8 hours
Excretion	?
Therapeutic considerations
Pregnancy cat.	C(US)
Legal status	[[Prescription drug\|Template:Unicode-only]](US)
Routes	Oral, IV

Mechanism of Action

Structure

File:Torsemide (tablet)01.png

This image is provided by the National Library of Medicine.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Torsemide (tablet) in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Torsemide (tablet) in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Torsemide (tablet) in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Torsemide (tablet) in the drug label.

Condition1

Description

How Supplied

DEMADEX for oral administration is available as white, scored tablets containing 5 mg, 10 mg, 20 mg, or 100 mg of torsemide. The tablets are supplied in bottles of 100 as follows:

File:Torsemide (tablet)03.png

This image is provided by the National Library of Medicine.

Each tablet is debossed on the scored side with the Boehringer Manheim logo and 102, 103, 104, or 105 (for 5 mg, 10 mg, 20 mg, or 100 mg, respectively). On the opposite side, the tablet is debossed with 5, 10, 20, or 100 to indicate the dose.

Storage

Store at 15° to 30°C (59° to 86°F).

Storage

There is limited information regarding Torsemide (tablet) Storage in the drug label.

Images

Drug Images

{{#ask: Page Name::Torsemide (tablet) |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Torsemide (tablet) |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Patient Counseling Information of Torsemide (tablet) in the drug label.

Precautions with Alcohol

Alcohol-Torsemide (tablet) interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

Demadex®^[1]

Look-Alike Drug Names

N/A^[2]

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

↑ "DEMADEX (torsemide) tablet".
↑ "http://www.ismp.org". External link in |title= (help)

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[1] "DEMADEX (torsemide) tablet".

[www.ismp.org-2] "http://www.ismp.org". External link in |title= (help)

[1]

[2]

@@ Line 50: / Line 50: @@
 :* '''10–20 mg PO qd'''
-::* If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied.
+::* If the [[diuretic]] response is inadequate, the dose should be titrated upward by approximately doubling until the desired [[diuretic]] response is obtained. Single doses higher than 200 mg have not been adequately studied.
 =====Edema Associated with Chronic Renal Failure=====
@@ Line 58: / Line 58: @@
 :* '''20 mg PO qd'''
-::* If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied.
+::* If the [[diuretic]] response is inadequate, the dose should be titrated upward by approximately doubling until the desired [[diuretic]] response is obtained. Single doses higher than 200 mg have not been adequately studied.
 =====Edema Associated with Hepatic Cirrhosis=====
@@ Line 66: / Line 66: @@
 :* '''5–10 mg PO qd''', administered together with an [[aldosterone antagonist]] or a [[potassium]]-sparing [[diuretic]].
-::* If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 40 mg have not been adequately studied.
+::* If the [[diuretic]] response is inadequate, the dose should be titrated upward by approximately doubling until the desired [[diuretic]] response is obtained. Single doses higher than 40 mg have not been adequately studied.
 =====Hypertension=====
@@ Line 74: / Line 74: @@
 :* '''5mg PO qd'''
-::* If the 5 mg dose does not provide adequate reduction in blood pressure within 4 to 6 weeks, the dose may be increased to 10 mg once daily. If the response to 10 mg is insufficient, an additional antihypertensive agent should be added to the treatment regimen.
+::* If the 5 mg dose does not provide adequate reduction in [[blood pressure]] within 4 to 6 weeks, the dose may be increased to 10 mg once daily. If the response to 10 mg is insufficient, an additional [[antihypertensive agent]] should be added to the treatment regimen.
 <!--Off-Label Use and Dosage (Adult)-->