Adult Dosing
Edema associated with congestive heart failure
- Initial: 10-20 mg PO daily
- Titrate: double dose until response is obtained
- Max: 200 mg PO daily
Edema associated with chronic renal failure
- Initial: 20 mg PO daily
- Titrate: double dose until result seen.
- Max: 200 mg PO daily
Edema with hepatic cirrhosis
- Initial: 5-10 mg PO daily
- Titrate: double dose until response is obtained
- Max 40 mg PO daily
Hypertension
- Initial: 5 mg PO daily
- Titrate: 10 mg qd in 4-6 weeks, if insufficient response give additional antihypertensive agent
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Should be used cautiously in hepatic cirrhosis and ascites, as sudden alteration of fluid and electrolyte balance may lead to hepatic coma. Concomitantly use aldosterone antagonist or potassium-sparing drug to prevent hypokalemia and metabolic alkalosis
- Ototoxicity has been observed with torsemide. Do not administer single doses more than 200 mg as it may cause ototoxicity
- Electrolyte imbalance, hypovolemia, or prerenal azotemia has been observed in patient receiving diuretics. Monitor the patient for the symptoms like dryness of the mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, nausea, vomiting and laboratory changes. Discontinue the drug if any of these occur
- Monitor serum potassium and other electrolytes periodically in patients treated with torsemide. Patients with cirrhosis of the liver, experiencing a brisk diuresis, receiving inadequate oral intake of electrolytes and receiving concomitant therapy with corticosteroids or ACTH are at higher risk
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Hearing impairment
- Arrhythmias
- Electrolyte depletion
- History of gout
- Concomitant ototoxic agent
- Elderly patients
- Concomitant digitalis
Pregnancy Category:B
Breastfeeding: Safety unknown. Lactation might decreases because of intense diuresis ; an alternate drug may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 18 March 2011). Manufacturer advises caution.
Pricing data from www.DrugStore.com in U.S.A.
- Demadex 10 MG TABS [Bottle] (MEDA PHARMACEUTICALS)
30 mg = $43.69
90 mg = $110.37 - Torsemide 20 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
30 mg = $22.99
90 mg = $59.98 - Torsemide 10 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
30 mg = $20.99
90 mg = $59.97 - Demadex 100 MG TABS [Bottle] (MEDA PHARMACEUTICALS)
30 mg = $160.99
90 mg = $455.97 - Demadex 20 MG TABS [Bottle] (MEDA PHARMACEUTICALS)
30 mg = $57.99
90 mg = $154.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
