Torsinex Plus Tablets ( Torsemide +Spironolactone )
Each tablet contains Torsemide 10mg + Spironolactone 25mg.
Indicated for the treatment of edema associated with congestive heart failure and liver cirrhosis and hypokalemia.
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. Spironolactone is an aldosterone antagonist, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule. Spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained.
One tablet once daily.
Torsemide is contraindicated in patients with known hypersensitivity to Torsemide or to povidone and in anuria, and hepatic coma. Spironolactone- is contraindicated for patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, or hyperkalemia.
Torsemide -Hypotension and worsening renal function, electrolyte and metabolic abnormalities & ototoxicity. Spironolactone- Potassium supplementation, severe heart failure and fluid or electrolyte imbalance
It is contraindicated in pregnancy. Spironolactone metabolite appears in human breast milk so caution should be exercised. Safety and effectiveness in pediatric patients have not been established.
Torsemide-Monitoring of lithium level is needed, NSAID & CYP2C9 inhibitor should be used with caution when co-administered with torsemide. Concomitant use of torsemide with aminoglycoside, ACE inhibitors, corticosteroids and ACTH is not recommended.
The most common adverse reaction with Torsemide is excessive urination, dizziness, and hyperglycemia. Spironolactone- Gynecomastia, Gastric bleeding, ulceration, gastritis, diarrhea, nausea, vomiting, hypersensitivity, hyperkalemia, headache, drowsiness and lethargy.