Torasemide

Torasemide belongs to the group of diuretics - loop diuretics.

Small doses of medicament successfully treat arterial hypertension, because it has a weak saluretic and antihypertensive effect. Higher doses of the drug have increased diuretic effects, depending on the dose used.

Oral administration of tablets leads to rapid absorption of the drug from the stomach. After 60-120 minutes the maximum concentration is observed, the bioavailability is 85%, the active substance is 99% bound to blood plasma proteins.

The maximum activity of Torasemide is observed 2-3 hours after oral administration.

Clinical and pharmacological group

Diuretic.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does Torasemide cost in pharmacies? The average price is at the level of350 rubles.

Composition and form of release

The preparation Torasemide Canon is available in the form of tablets for oral administration. Tablets of white color, round, with a risk on one side, are packed in contour mesh packages of 10 pieces (1-10 blisters in a cardboard bundle), the instruction box containing the detailed description is enclosed in the box containing the preparation.

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Each tablet of the preparation contains 5 mg or 10 mg of active active ingredient - Torasemide, as well as a number of additional auxiliaries, including lactose.

pharmachologic effect

Torasemide is a loop diuretic. The main effect of the substance is due to its connection with the conveyors of sodium, chlorine, potassium, which are located in the membrane of the ascending segment of the loop of Henle. Because of this, the absorption of sodium and water ions decreases, the pressure of the liquid inside the cells decreases. The drug is able to block the receptors of aldosterone in the myocardium, fibrosis dissolves and the function of the heart muscle improves.

The medicinal substance unlike other known diuretics causes hypokalemia to a lesser degree, it acts more durably and with greater activity. The drug well reduces blood pressure in any position of the body. It is the drug of choice for long-term treatment. Its medicinal effect is about 18 hours and the absence of very frequent urination after taking it makes life easier for patients (there are no restrictions for the normal life of people).

The diuretic effect develops 60 minutes after ingestion, its maximum amount in the body accumulates after 3 hours. The metabolism of the drug occurs in the liver with the help of enzymes of the cytochrome system. As a result of chemical reactions (hydroxylation and oxidation), the metabolites formed bind to blood plasma proteins. About 80% of the accepted dose is excreted by the kidneys (20% unchanged).

Indications for use

People with arterial hypertension indications for the use of "Torasemide" are obvious, as the rapid removal of sodium and water from the body helps reduce blood pressure. After all, just the same high blood pressure provokes hypertension.

The use of "Torasemide" in different dosages is indicated for the therapy of three diseases:

Hypertension. With her drug prescribed at the lowest dose for two months, only through this time can say whether the drug is effective or not. When the effect is inadequate, the dose is increased 4-fold.
Heart failure. It is used to eliminate swelling in the background of this disease. In the absence of positive dynamics during therapy, another means is prescribed. It makes no sense to increase dosage. It is prescribed for preventive use in order to avoid relapses of edema.
Renal failure in the chronic phase. Indication for use is the amount of urine released. At least 200 ml., At lower rates, diuretics are not prescribed.

Contraindications

Absolute:

increased central venous pressure (more than 10 mm Hg. item);
hypertrophic obstructive cardiomyopathy;
intolerance to galactose, deficiency of lactase, glucose-galactose malabsorption;
combined therapy with aminoglycosides and cephalosporins;
kidney failure in combination with anuria;
refractory hypokalemia / hyponatremia;
precoma and hepatic coma;
decompensated mitral / aortic stenosis;
hypovolemia (with or without arterial hypotension) or dehydration;
sharply expressed violations of the outflow of urine of any etiology (including unilateral urinary tract damage);
sinoatrial and atrioventricular blockade of II-III degree;
acute glomerulonephritis;
hyperuricemia;
glycoside intoxication;
the presence of an allergy to sulfonamides (sulfonylureas or sulfonamide antimicrobial agents);
age to 18 years;
pregnancy and the period of breastfeeding;
individual intolerance of the drug components.

Relative (diseases / conditions, in the presence of which the appointment of Torasemide requires caution):

hypoproteinemia;
hypokalemia / hyponatremia;
hepatorenal syndrome;
indications in the anamnesis for ventricular arrhythmia;
diarrhea;
pancreatitis;
arterial hypotension;
anemia;
gout;
stenosing arteriosclerosis of cerebral arteries;
disorders of urinary outflow (hydronephrosis, benign prostatic hyperplasia or narrowing of the urethra);
predisposition to the appearance of hyperuricemia;
acute myocardial infarction (due to increased risk of cardiogenic shock);
impaired renal / hepatic function;
diabetes mellitus (due to a decrease in glucose tolerance).

Intended use for pregnancy and lactation

During the carrying out of a child, "Torasemide" can be taken only under the strict supervision of the attending physician, who before prescribing this the drug should carefully weigh the possible benefits to the mother, as well as the potential risks to the development of the fetus.

If it is necessary to administer therapy with this drug during breastfeeding, it is necessary to interrupt it, after consultation with the treating specialist.

Dosage and route of administration

As indicated in the instructions for use Torasemid SZ taken orally 1 time / day, at any convenient (but at the same time), regardless of food intake. Tablets should be swallowed without chewing and drinking with a sufficient amount of water.

Edema Syndrome in Chronic Heart Failure:

The recommended initial dose is 10-20 mg 1 time / day. If necessary, the dose can be doubled until the desired effect is achieved.

Edema syndrome with kidney disease:

The recommended initial dose is 20 mg 1 time / day. If necessary, the dose can be doubled until the desired effect is achieved.

Edema syndrome with liver disease:

The recommended initial dose is 5-10 mg 1 time / day. If necessary, the dose can be doubled until the desired effect is achieved.

Arterial hypertension:

The initial dose is 2.5 mg (1/2 table. 5 mg) 1 time / day. In the absence of therapeutic effect for 4 weeks, the dose is increased to 5 mg 1 time / day. In the absence of an adequate reduction in blood pressure at a dose of 5 mg 1 time / day for 4-6 weeks, the dose is increased to 10 mg 1 time / day. If the use of the drug at a dose of 10 mg / day does not give the desired effect to treatment add an antihypertensive drug of another group.

In elderly patients, dose adjustment is not required.

Do not exceed the maximum single dose, which is 40 mg (no experience of use).

The drug is used for a long period or until the edema disappears.

Side effects

On the background of therapy, the following undesirable effects may occur:

metabolic alkalosis;
visual impairment;
noise in the ears, deafness (usually these effects are reversible);
itching, rashes, photosensitization;
pathological thirst, increased levels of cholesterol and triglycerides in the blood;
bleeding from the nose;
increase or decrease the number of platelets, a decrease in white blood cells and erythrocytes;
decrease in the level of potassium, sodium, chlorine in the blood;
increased levels of sugar and uric acid in the blood;
dizziness, headaches, leg muscle cramps, impaired consciousness, drowsiness, sensitivity disorder in the limbs;
increased frequency of urination, increased urine output, delay, nocturia, increased creatinine and urea levels in the bloodstream;
liquid stool, abdominal pain, bloating, nausea, vomiting, lack of appetite, inflammation of the pancreas, dyspepsia;
a decrease in the number of circulating blood, thromboembolism, severe lowering of blood pressure, deep vein thrombosis, increased and increased heart rate, extrasystole, redness of the face;
fast fatigue, impotence, hyperactivity, nervousness.

Overdose

When ingesting large doses of the drug or uncontrolled use of Torasemide Kanon tablets, the patient gradually develops signs of an overdose, which are clinically expressed by the intensification of the above-described adverse reactions, lowering blood pressure, collapse, confusion to coma.

Treatment of an overdose consists of rinsing the stomach, restoring the volume of circulating blood, normalizing the water-salt balance. There is no antidote of the drug. In case of inadvertent ingestion of a large number of tablets, the patient should be vomited, washed stomach, give to take activated charcoal and, if necessary, conduct symptomatic treatment.

special instructions

The drug should be used strictly according to the doctor's prescription.

Patients with hypersensitivity to sulfonamides and sulfonylureas may have cross-sensitivity to the preparation Torasemide-SZ.

When azotemia and oliguria occur in patients with severe progressive kidney disease, it is recommended to suspend treatment.

The choice of a dose for patients with ascites against the background of cirrhosis of the liver should be carried out under stationary conditions (violations of the water-electrolyte balance may lead to the development of the hepatic coma). This category of patients shows regular monitoring of plasma electrolytes.

In patients with diabetes mellitus or with reduced glucose tolerance, periodic monitoring of glucose concentrations in the blood and urine is required.

Patients receiving Torasemide-SZ in high doses for a long period to avoid the development of hyponatremia, metabolic alkalosis and hypokalemia, a diet with a sufficient content of table salt and the use of potassium preparations is recommended.

An increased risk of developing water-electrolyte imbalance is noted in patients with renal insufficiency. During course treatment it is necessary to periodically monitor the concentration of plasma electrolytes (including sodium, calcium, potassium, magnesium), acid-base state, residual nitrogen, creatinine, uric acid and, if necessary, carry out appropriate corrective therapy (with a higher multiplicity in patients with frequent vomiting and against parenterally injected fluids).

In patients in the unconscious state, with prostatic hyperplasia, narrowing of the ureters, diuretic control is necessary in connection with the possibility of acute urinary retention.

Interaction with other drugs

The combination of Torasemide and cardiac glycosides can increase the sensitivity of the myocardium to drugs, lead to a deficiency of magnesium and potassium. Other medication interactions of medications are indicated in the instructions for use:

The drug increases the effect of Teofillin, curare-like muscle relaxants, increases the toxic activity of salicylates, cardiotoxicity and neurotoxicity of lithium preparations.
The combination of Torasemide with non-steroidal anti-inflammatory drugs, Probenecid, mineralocorticoids leads to a weakening of its diuretic, hypotensive effect.
The drug enhances the effect of antihypertensive drugs, angiotensin converting enzyme inhibitors. To correct the problem, dose adjustment is necessary.
Combination of the drug with laxatives, glucocorticoids, mineralocorticoids can lead to potassium deficiency.
The medication reduces the result from the use of antidiabetics, weakens the vasoconstrictive effect of epinephrine and norepinephrine.
High doses of the drug potentiate the ototoxic and nephrotoxic effects of antibiotics from the aminoglycoside group (Tobramycin, Kanamycin, Gentamicin), nephrotoxic effect of cephalosporins, toxicity of platinum preparations.
Combination of the drug with Kolestyramin leads to a decrease in the absorption of the first, weakening action.

Reviews

We offer to read reviews of people who used the drug Torasemide:

Tatyana. Tablets Torasemide to me have registered the doctor, because at me weakly expressed arterial hypertensia. The drug, according to the doctor, will help me normalize the pressure and bring health back to normal. After three months of use, my pressure began to correspond to the testimony of my age. The product showed itself perfectly.
Alexander. I have kidney failure, and against her background, increased blood pressure. The doctor prescribed Torasemide tablets at a dosage of 50 mg. I drink them every day according to the instructions, do not deviate from it. I noticed that after two weeks the pressure stabilized and it began to match the norm, plus the separation of urine improved.

Analogues

Structural analogs for the active substance:

Britomar;
Diver;
Torasemide Vertex;
Torasemide Canon;
Trigrim.

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

Keep the tablets out of the reach of children in a cool place. Shelf life of the drug is 4 years from the date of production. At the end of the expiration date, the drug should not be taken orally.