section name header

Pronunciation

TORE-se-mide

Classifications

Therapeutic Classification: antihypertensives

Pharmacologic Classification: loop diuretics

Indications

REMS

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: 80% absorbed after oral administration.

Distribution: Widely distributed to tissues.

Protein Binding: ge.gif99%.

Metabolism/Excretion: Primarily metabolized by the liver via the CYP2C9 isoenzyme, with minor metabolism via the CYP2C8 and CYP2C18 isoenzymes. 80% metabolized by liver, 20% excreted in urine.

Half-life: 3.5 hr.

Time/Action Profile

(diuretic effect)

ROUTEONSETPEAKDURATION
POwithin 60 min60–120 min6–8 hr

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension.

Derm: photosensitivity, rash, STEVENS-JOHNSON SYNDROME (SJS), TOXIC EPIDERMAL NECROLYSIS (TEN).

EENT: hearing loss, tinnitus.

Endo: hyperglycemia.

F and E: dehydration, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, hypocalcemia.

GI: constipation, diarrhea, dry mouth, dyspepsia, nausea, vomiting.

GU: acute renal failure, excessive urination, renal impairment.

Metab: hyperuricemia.

MS: arthralgia, muscle cramps, myalgia.

Neuro: dizziness, headache, nervousness.

Interactions

Drug-Drug:

Route/Dosage

Heart Failure

Chronic Renal Failure

Hepatic Cirrhosis

Hypertension

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Demadex, Soaanz