Top 21 on furosemide healthtap healthtap healthtap. Feb 28, 2017 torsemide is cleared from the circulation by both hepatic metabolism approximately 80% of total clearance and excretion into the urine approximately 20% of total clearance in patients with normal renal function. Torsemide and bumetanide are 10100x more expensive. Learn about drug interactions between furosemide inj and torsemide iv and use the rxlist drug interaction checker to check drug combinations. Diuretic drugs are used almost universally in patients with congestive heart failure, most frequently the potent loop diuretics.
The summary of the study outcomes is illustrated in figure 2. This retrospective observational study aimed to assess the impact of switching. Feb 01, 2016 torsemide treated patients had lower ejection fraction and blood pressure and higher creatinine and natriuretic peptide level compared with furosemide. The plasma torsemide concentrations rose rapidly after ir to peak within 1 hour, but the peak was delayed to. It is much stronger than other diuretics used for high blood pressure control. The recommended starting torsemide dosage for controlling high blood pressure is 5 mg once daily. It is a diuretic used in the treatment of congestive heart failure.
In the treatment of more advanced stages of heart failure diuretics may fail to control salt and water retention. Torsemide demadex is a diuretic water pill used to treat edema due to kidney disease, liver disease, and congestive heart failure. Metaanalysis comparing torsemide versus furosemide in patients. The oral bioavailability of bumetanide and torsemide typically exceeds 80%, whereas that of furosemide is substantially lower, at approximately 50% see table 2. Torsemide is a potent loop diuretic with better pharmacokinetic and pharmacodynamic profiles compared with furosemide. Potassium, sodium and magnesium can be lost in excess with the use of furosemide and must be closely monitored. Because torsemide is extensively bound to plasma protein 99%, very little enters tubular urine via glomerular filtration.
You may not have noticed but the majority of endstage heart failure patients arent generally the ones with good insurance coverage. Torsemide is thought to be slightly more potent on a per milligram basis than furosemide, but this isnt thought to be evidence for better outcomes in treating patients. Comparing torsemide versus furosemide in patients with heart. Loop diuretics including furosemide and torsemide are prescribed for the treatment of symptomatic heart failure hf 1, 2. Longterm efficacy of torsemide compared with frusemide in. The present invention provides bumetanide, furosemide, piretanide, azosemide, and torsemide analogs and compositions comprising such analogs. Metaanalysis comparing torsemide versus furosemide in. Comparison of the urine acidification tests of torsemide vs. Compare lasix vs torsemide comprehensive analysis by. The effectiveness of switching furosemide to torsemide versus optimizing the furosemide dose following adhf has not yet been evaluated.
Torsemide versus furosemide in heart failure patients. However, torsemide longterm effects and complications have not been sufficiently investigated. In patients with heart failure hf, torsemide demonstrated decreased mortality compared with furosemide in 1 study 2. Torsemide versus furosemide in patients with acute heart. Torsemide versus furosemide in patients with acute heart failure.
It has a role as a xenobiotic, an environmental contaminant and a loop diuretic. Intravenous diuretics are considered to be more potent than oral doses and are used in advanced heart failure. Torsemide versus furosemide after continuous renal. Comparison of the urine acidification tests of torsemide. Warning lasix furosemide is a potent diuretic which, if. If torsemide is administered through an iv line, flush the iv line with 0. Furosemide, sold under the brand name lasix among others, is a medication used to treat fluid buildup due to heart failure, liver scarring, or kidney disease. Although the t 12 of furosemide is short, its duration of action is longer when administered orally, as its gastrointestinal absorption may be slower than its elimination t 12. Torsemide is a novel diuretic that promotes renal excretion of sodium, chloride, and water by targeting the thick ascending loop of henle, similar to furosemide. Torsemide treated patients had lower ejection fraction and blood pressure and higher creatinine and natriuretic peptide level compared with furosemide. Torsemide and furosemide work the same way and most guidelines do not recommend one drug over the other. Capitals indicate lifethreatening, underlines indicate most frequent. Lasix furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Wed like to understand how you use our websites in order to improve them.
However, urine ph after the administration of torsemide was significantly lower than after that of furosemide p. To provide compositions and methods for the treatment andor prophylaxis of diseases, disorders, and conditions that involve the nakclcotransporter. It is most frequently used in patients who are fluid overloaded such as in congestive heart failure. Loop diuretics are recommended by clinical practice guidelines to treat volume overload in acute decompensated heart failure adhf. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen. Although torsemides oral bioavailability and halflife theoretically render it a more efficient diuretic than furosemide, the clinical outcomes of torsemide compared with furosemide. Torsemide is cleared from the circulation by both hepatic metabolism approximately 80% of total clearance and excretion into the urine approximately 20% of total clearance in patients with normal renal function. It also confers an antialdosterone effect, similar to spironolactone. Torsemide was associated with significantly more improvement of functional status compared with furosemide 72. Figure 1 presents the percentage of hf patients discharged on furosemide vs.
Lasix furosemide will cause the body to excrete potassium while spironolactone will cause the body to retain potassium. Torsemide versus furosemide after acute decompensated heart failure. Should torsemide be loop diuretic of choice in systolic hf. Review drug interactions, dosing, and pregnancy and breastfeeding safety information. Although torsemides oral bioavailability and halflife theoretically render it a more efficient diuretic than furosemide, the clinical outcomes of torsemide compared with furosemide remain unclear. Doctors give trusted answers on uses, effects, sideeffects, and cautions. Renal torsemide excretion followed a similar time course figure 3b. Pooled analysis and sensitivity analyses of the odds of improvement in functional status with torsemide vs furosemide in chronic heart failure. Drug interactions with furosemide inj and torsemide iv. Torsemide, a novel and more potent diuretic than furosemide, may improve management of advanced congestive heart failure in dogs and cats. Ten healthy participants were crossed over between 20 mg of oral immediate. Twoway anova was done to compare the mean change in diuretic dose from admission to discharge between the two groups.
These diuretics are sometimes given together, but they are not. Article pdf available in european journal of internal medicine 57. Furosemide is used to reduce extra fluid in the body edema caused by conditions such as heart failure, liver disease, and kidney disease. Current hf guidelines indicate that loop diuretics are a central treatment for the management of volume overload 3. Therefore, careful medical supervision is required and dose and dose schedule must be adjusted to the individual patients needs. Compared with furosemide, torsemide has increased bioavailability and a longer halflife 4, yet furosemide remains the most commonly used loop.
May 28, 2019 the chi square test was used to compare categorical variables between the two groups optimized furosemide vs. Comparing torsemide to furosemide torsemide and furosemide work the same way and most guidelines do not recommend one drug over the other. Torsemide versus furosemide after acute decompensated. When taken by mouth, it typically begins working within an hour, while. In residency i had to keep medicaidself pay patients in the hospital for up to an extra week while we waited for approval for bumex and demadex scripts. Sodium and fluid excretion with torsemide in healthy. Chronic heart failure, edema and high blood pressure. Compare lasix vs torsemide comprehensive analysis by treato.
Torsemide use began to increase in 2006 and rose to approximately 30% of loop diuretic use in 2010. Of these, 4580 patients had an echocardiogram prior to discharge and were discharged on either torsemide or furosemide. Mechanisms and management of diuretic resistance in. Torasemide, also known as torsemide, is a medication used to treat fluid overload due to heart failure, kidney disease, and liver disease and high blood pressure. While torsemides oral bioavailability and half life theoretically render it a more efficacious drug than furosemide, the clinical outcomes of torsemide compared with. It can be taken by injection into a vein or by mouth. It is taken by mouth or by injection into a vein common side effects include headache, increased urination, diarrhea, cough, and dizziness. It is much stronger than other diuretics used for high blood pressure. Cvb6 torsemide and furosemide in the treatment of the edema. Despite their unproven effect on survival, their indisputable efficacy in relieving congestive symptoms makes them first line therapy for most patients. Compared with furosemide treated patients, torsemide treated patients were less likely to need readmission for heart failure 39 32% vs. However, urine ph after the administration of torsemide was significantly lower than after that of furosemide p torsemide, in addition, has a longer halflife than both furosemide and bumetanide. It also confers an antialdosterone effect, similar to. I would take it in the morning, it makes you tinkle a.
It may also be used for the treatment of high blood pressure. Comparing torsemide versus furosemide in patients with. Comparing furosemide to torsemide pharmacistanswers. Common side effects include headache, increased urination, diarrhea, cough. Fortysix patients were randomized in two groups to receive torsemide 20 mgday n 22 or frusemide 40 mgday n. Torsemidetreated patients had lower ejection fraction and blood pressure and higher creatinine and natriuretic peptide level compared with furosemide. In the treatment of more advanced stages of heart failure diuretics may fail to control. Side effects can include headache, diarrhea, runny nose, dizziness, and cough. Weight loss was also significantly greater in the 20 mg torsemide group vs the 40 mg furosemide group at weeks 4 and 6 2. Torsemide furosemide is used to reduce extra fluid in the body edema caused by conditions such as heart failure, liver disease, and kidney disease. Furosemide is initially administered at a dose ranging from 20 to 40 mg or up to 2. Torsemide was associated with similar outcomes on unadjusted analysis and nominally lower events on adjusted analysis 30day mortalityhf hospitalization odds ratio 0. Studies comparing torsemide and furosemide have shown conflicting results. Torsemide use began to increase in 2006 and rose to approximately 30%.
Clinical pharmacology in diuretic use american society of. Dec 04, 2016 torsemide, a novel and more potent diuretic than furosemide, may improve management of advanced congestive heart failure in dogs and cats. Drugs az pill identifier supplements symptom checker diseases dictionary media. Leastprescribed loop diuretic may be most helpful for heart. As part of a prospective, randomised, nonblind study, we assessed the effects of torasemide and furosemide on readmission to hospital in 193 patients treated for chf at a us urban public healthcare system. Both are diuretics, but they work in very different ways. May 28, 2019 since torsemide is a more potent loop diuretic with higher bioavailability and less erratic absorption in patients with hf that retains its pharmacodynamic effects regardless of the hf severity compared to furosemide 4, 5, 10, it was hypothesized that changing furosemide to torsemide would result in more favorable clinical outcomes than. Twentynine critically ill patients admitted to an intensive care unit at a university teaching. Clinical pharmacology in diuretic use american society. Torsemide versus furosemide after acute decompensated heart. Of 4,580 patients, 86% n3,955 received furosemide and 14% n625 received torsemide. The aim was to compare the efficacy and safety of torsemide versus frusemide in cirrhotic patients with uncomplicated ascites. Compared with furosemide, torsemide has increased bioavailability and a longer halflife, yet furosemide remains the most commonly used loop diuretic.
Compared with furosemide, torsemide has increased bioavailability and a longer halflife 4, yet furosemide remains the. To compare the efficacy and safety of torsemide versus furosemide in patients with heart failure hf. To compare the direct healthcare costs of patients with congestive heart failure chf prescribed torasemide torsemide or furosemide frusemide. Jp2011231094a bumetanide, furosemide, piretanide, azosemide. May 14, 20 loop diuretics are commonly prescribed to heart failure patients because they help reduce fluid buildup in the body, a common problem facing these individuals. Furosemide is a chlorobenzoic acid that is 4chlorobenzoic acid substituted by a furan2ylmethylamino and a sulfamoyl group at position 2 and 5 respectively. Sodium and fluid excretion with torsemide in healthy subjects. But a recent study shows that of the three major types of loop diuretics, the one that may be the most effective is also the least prescribed. It is a less preferred treatment for high blood pressure. With further sensitivity analysis, including rcts only or studies where the medication was initiated in the outpatient setting only, torsemide. In this study, the effects of torsemide versus furosemide on renal function in cardiac surgery patients recovering from arf after continuous renal replacement therapy crrt were studied. The use of torsemide versus furosemide in patients with heart. Loop diuretics including furosemide and torsemide are prescribed for the.