Torasemide

Overview

Torasemide, also known as torsemide, is a diuretic medication used to treat fluid overload due to heart failure, kidney disease, and liver disease. It is a less preferred treatment for high blood pressure. It is taken by mouth or by injection into a vein.[1] WP

Common side effects include headache, increased urination, diarrhea, cough, and dizziness. Other side effects may include hearing loss and low blood potassium. Torasemide is a sulfonamide and loop diuretic. Use is not recommended in pregnancy or breastfeeding. It works by decreasing the reabsorption of sodium by the kidneys.[1][2] WP

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

Drug class

Loop diuretic WP

From the Wikipedia article's infobox.

Uses, dosage and effects

Medical uses

It is used to treat fluid overload due to heart failure. It is sometimes used to treat high blood pressure. 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. In heart failure it may be safer and more effective than furosemide. Long-term outcomes with torasemide may be better than with furosemide in patients with heart failure.[1][7–13] WP

Veterinary uses

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 with pimobendan, spironolactone, and an angiotensin-converting enzyme (ACE) inhibitor for the management of pulmonary edema (fluid build-up in lungs) in dogs with congestive heart failure caused by myxomatous mitral valve disease (MMVD).[14][15] WP

Risks and side effects

Adverse effects

No evidence of torasemide-induced ototoxicity has been demonstrated in humans.[16] WP

Loop diuretics, including torsemide, may decrease total body thiamine, 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.[17] WP

Chemistry

Formula

C16H20N4O3S PC

CAS number

56211-40-6 PC

Molar mass (g/mol)

348.4 PC

IUPAC name (computed by PubChem)

1-[[4-(3-methylanilino)-3-pyridinyl]sulfonyl]-3-propan-2-ylurea PC

SMILES

CC1=CC(=CC=C1)NC2=C(C=NC=C2)S(=O)(=O)NC(=O)NC(C)C PC

InChIKey

NGBFQHCMQULJNZ-UHFFFAOYSA-N PC

PubChem CID

41781

Harm reduction information

No harm reduction data is on file for this compound yet. That means no dose, timing or combination data from PsychonautWiki or TripSit. Please don't guess a dose from similar compounds. If you have taken it and feel unwell, contact emergency services or a poison control center.

User reports

Pop culture

No references added yet.

Sources

1. Other Torsemide Monograph for Professionals
2. Other British national formulary: BNF 76. 2018
3. Other Fischer J, Ganellin CR. Analogue-based Drug Discovery. 2006
4. Other World Health Organization. World Health Organization model list of essential medicines: 22nd list (2021). 2021
5. Other Top 300 of 2023
6. Other Torsemide Drug Usage Statistics, United States, 2014 - 2023
7. Journal / agency Abraham B, Megaly M, Sous M, Fransawyalkomos M, Saad M, Fraser R, Topf J, Goldsmith S, Simegn M, Bart B, Azzo Z, Mesiha N, Sharma R. Meta-Analysis Comparing Torsemide Versus Furosemide in Patients With Heart Failure. Am. J. Cardiol. January 2020. doi:10.1016/j.amjcard.2019.09.039 · PMID 31699358
8. Journal / agency Täger T, Fröhlich H, Seiz M, Katus HA, Frankenstein L. 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. March 2019. doi:10.1007/s10741-019-09771-8 · PMID 30874955
9. Journal / agency Miles JA, Hanumanthu BK, Patel K, Chen M, Siegel RM, Kokkinidis DG. Torsemide versus furosemide and intermediate-term outcomes in patients with heart failure: an updated meta-analysis. J Cardiovasc Med (Hagerstown). June 2019. doi:10.2459/JCM.0000000000000794 · PMID 30950982
10. Journal / agency Wargo KA, Banta WM. A comprehensive review of the loop diuretics: should furosemide be first line?. Ann Pharmacother. November 2009. doi:10.1345/aph.1M177 · PMID 19843838
11. Journal / agency Roush GC, Kaur R, Ernst ME. Diuretics: a review and update. J. Cardiovasc. Pharmacol. Ther. 2014. doi:10.1177/1074248413497257 · PMID 24243991
12. Journal / agency Buggey J, Mentz RJ, Pitt B, Eisenstein EL, Anstrom KJ, Velazquez EJ, O'Connor CM. A reappraisal of loop diuretic choice in heart failure patients. Am. Heart J. 2015. doi:10.1016/j.ahj.2014.12.009 · PMID 25728721 · PMC4346710
13. Journal / agency Ozierański K, Balsam P, Kapłon-Cieślicka A, Tymińska A, Kowalik R, Grabowski M, Peller M, Wancerz A, Marchel M, Crespo-Leiro MG, Maggioni AP, Drożdż J, Filipiak KJ, Opolski G. 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. February 2019. doi:10.1007/s10557-018-6843-5 · PMID 30649675
14. Journal / agency FDA Conditionally Approves First Torsemide Animal Drug for Dogs. 10 May 2024
15. Journal / agency FDA Roundup: May 14, 2024. 14 May 2024
16. Journal / agency Dunn CJ, Fitton A, Brogden RN. Torasemide. An update of its pharmacological properties and therapeutic efficacy. Drugs. January 1995. doi:10.2165/00003495-199549010-00009 · PMID 7705212
17. Journal / agency Kattoor AJ, Goel A, Mehta JL. Thiamine Therapy for Heart Failure: a Promise or Fiction?. Cardiovasc Drugs Ther. August 2018. doi:10.1007/s10557-018-6808-8 · PMID 30022355

Text and values on this page are quoted from Wikipedia (CC BY-SA 4.0), PubChem (public domain). Each value links to the exact revision it came from.