Torsinex injection (Torsemide)

• Composition :
  Each 2 ml vial contains Torsemide 10 mg/ml.
• Indications :
  Diuretic.
• Pharmacodynamics :
  Torsemide acts from within the lumen of the thick ascending portion of the loop of Henle, inhibits the Na+/K+/2Cl–-carrier system, increases the urinary excretion of sodium, chloride, and water.
• Dosage and administration :
  For edema associated with heart failure initial dose is 10 mg or 20 mg once daily, for hypertension- the recommended initial dose is 5 mg once daily. After 4-6 weeks, increase to 10 mg once daily, if needed.
• Contraindications :
  Hypersensitivity to Torsemide and in patients with anuria, and hepatic coma.
• Precautions and warnings :
  Torsemide should be used with caution in patients with hepatic disease with cirrhosis and ascites. Tinnitus and hearing loss (usually reversible) have been observed after rapid intravenous injection. Patients receiving diuretics should be observed for clinical evidence of electrolyte imbalance, hypovolemia, or prerenal azotemia.
• Use in pregnancy, lactation & pediatrics :
  Pregnancy Category B. There are no adequate and well-controlled studies established for safety and efficacy in pregnancy, lactation and pediatrics. It is not known whether torsemide is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when torsemide is administered to a nursing woman. Safety and effectiveness in pediatric patients have not been established.
• Drug interactions :
  Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and torsemide has been associated with the development of acute renal failure. Monitor lithium level as the levels increase on concomitant administration, caution should be excised when are co-administered with indomethacin. Concomitant use of torsemide with aminoglycoside, ACE inhibitors, corticosteroids and ACTH is not recommended.
• Adverse reactions :
  Excessive urination, metabolic alkalosis, fluid and electrolyte imbalance. (e.g. hypovolemia, hyponatremia).
• Therapy Area :
  Diuretics