Torsemide is indicated for the treatment of-

• Edema associated with congestive heart failure, renal disease, or hepatic disease. Use of torsemide has been found to be effective for the treatment of edema associated with chronic renal failure. Chronic use of any diuretic in hepatic disease has not been studied in adequate and well-controlled trials.
• Torsemide is indicated for the treatment of Hypertension alone or in combination with other antihypertensive agents.

Edema

Hypertension (Hight Blood Pressure)

Congestive Heart Failure
The usual initial dose is 10 mg or 20 mg of once-daily oral Torsemide. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained.

Chronic Renal Failure
The usual initial dose of Torsemide is 20 mg of once-daily oral Torsemide.

Hepatic Cirrhosis
The usual initial dose is 5 mg or 10 mg of once-daily oral Torsemide, administered together with an aldosterone antagonist or a potassium-sparing diuretic.

Hypertension
The usual initial dose is 5 mg once daily. 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.

In each of the above cases, the dosage may be up-titrated.

Side effects commonly associated with torsemide are-

• Metabolic alkalosis
• Fluid and electrolyte imbalance
• Headache
• Dizziness
• Anorexia
• Nausea
• Vomiting
• Muscle spasms
• Asthenia

Headache

Dizziness

Asthenia

Nausea

• Torsemide should be used with caution in patients with hepatic disease with cirrhosis and ascites, since sudden alterations of fluid and electrolyte balance may precipitate hepatic coma.
• Tinnitus and hearing loss (usually reversible) have been observed after rapid intravenous injection of other loop diuretics and have also been observed after oral Torsemide.
• Patients receiving diuretics should be observed for clinical evidence of electrolyte imbalance, hypovolemia, or prerenal azotemia.