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HomeExclusiveIs Torsemide Hard On The Kidneys

Is Torsemide Hard On The Kidneys

Carcinogenesis Mutagenesis Impairment Of Fertility

Diuretic (Part 02)= Parts and Functions of Nephron (HINDI) By Solution Pharmacy

No overall increase in tumor incidence was found when Torsemide was given to rats and mice throughout their lives at doses up to 9 mg/kg/day and 32 mg/kg/day . On a body-weight basis, these doses are 27 to 96 times a human dose of 20 mg on a body-surface-area basis, they are 5 to 8 times this dose. In the rat study, the high-dose female group demonstrated renal tubular injury, interstitial inflammation, and a statistically significant increase in renal adenomas and carcinomas. The tumor incidence in this group was, however, not much higher than the incidence sometimes seen in historical controls. Similar signs of chronic non-neoplastic renal injury have been reported in high-dose animal studies of other diuretics such as furosemide and hydrochlorothiazide.

No mutagenic activity was detected in any of a variety of in vivo and in vitro tests of Torsemide and its major human metabolite. The tests included the Ames test in bacteria , tests for chromosome aberrations and sister-chromatid exchanges in human lymphocytes, tests for various nuclear anomalies in cells found in hamster and murine bone marrow, tests for unscheduled DNA synthesis in mice and rats, and others.

In doses up to 25 mg/kg/day , Torsemide had no adverse effect on the reproductive performance of male or female rats.

What Is This Medicine

TORSEMIDE is a diuretic. It helps you make more urine and to lose salt and excess water from your body. This medicine is used to treat high blood pressure, and edema or swelling from heart, kidney, or liver disease.

This medicine may be used for other purposes ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME: Demadex

Can You Take Torsemide Twice A Day

Guidelines from American College of Cardiology/American Heart Association recommend furosemide and bumetanide starting daily or twice daily and torsemide starting daily. Similar guidelines are available from the European Society of Cardiology. Note that higher doses may be useful in acute decompensated heart failure.

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Pharmacist Tips For Torsemide

Torsemide can be taken with or without food.

You may feel mild dizziness for the first few days after starting torsemide or if your dose increases. This should get better over time as your body adjusts to your new blood pressure. Take your time standing up to avoid dizziness or fainting from low blood pressure. Tell your provider if your dizziness doesn’t go away.

Since this medication is a water pill, it can cause you to urinate more often. It’s best to take torsemide in the morning or afternoon to avoid waking up in the middle of the night to go to the bathroom.

Torsemide is a very potent water pill. When you first start torsemide, you might be more likely to have electrolyte imbalances. Tell your provider right away if you have any weakness, muscle pain or cramps, dizziness, fast heartbeat, or vomiting.

Torsemide can raise the risk of gout attacks. Tell your healthcare provider if you’ve had gout attacks in the past or currently have gout, so that they can monitor your condition closely.

People with allergies to other sulfa-containing medications can have a reaction to torsemide. Avoid using this medication if you’ve had a severe reaction to sulfa medications before. Get medical help right away if you notice a rash, hives, trouble breathing, or swelling around your face or neck.

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How Do You Convert Furosemide To Torsemide

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4.5/5Torsemidebumetanidefurosemidetorsemide

Subsequently, one may also ask, can you take furosemide with Torsemide?

Interactions between your drugsNo interactions were found between Lasix and torsemide.

Also Know, is torsemide more effective than furosemide? Compared to furosemide, torsemide has a longer half-life, longer duration of action, and a higher and less variable bioavailability. Compared to furosemide, torsemide significantly reduced total heart failure readmissions , I 2 = 0%.

Then, how does torsemide compared to Lasix?

Torsemide and Lasix are effective loop diuretics used for symptomatic treatment of heart failure. They both increase urine output to decrease fluid accumulation in the body. Torsemide is considered to have a longer duration of action compared to Lasix. It is eliminated from the body at a slower rate of 3.5 hours.

Is there an alternative to furosemide?

There are other diuretics that work in a similar way to furosemide. There are 3 different types of diuretic: loop diuretics , thiazide diuretics and potassium-sparing diuretics. Potassium-sparing diuretics, such as spironolactone and eplerenone, can be used to treat heart failure.

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Furosemide & Torsemide: Effects On Renal Function

All diuretics can have a negative effect on renal perfusion if they produce excessive diuresis, resulting in prerenal azotemia and contributing to renal failure in:

  • Older dogs
  • Dogs with underlying kidney disease
  • Dogs with multipronged off-loading therapy in the treatment of CHF.

Serum creatinine, phosphorus, and blood urea nitrogen concentrations all rise with the use of furosemide or torsemide, in both normal dogs and those with heart disease, and in those with and without CHF.11-13,15

In a study by Peddle and colleagues, BUN, serum creatinine, and phosphorus were increased to a significantly greater degree with torsemide than with furosemide in dogs with heart failure, although the values remained within the normal reference range.11

For these reasons, the lowest effective dosage of furosemide and/or torsemide should be sought and use of these drugs should be coupled with careful monitoring of renal function. However, we believe that changes in drugs or dosages based simply on serum creatinine concentration should not be made unless levels increase at least 35%.

Most often, the loop diuretic will be temporarily discontinued or have its dosage reduced first, with the ACE inhibitor being manipulated last.

High Furosemide Dosage May Harm Kidneys

    DALLASHalving the dosage of furosemide in patients with stable class II/III systolic heart failure and impaired renal function may improve glomerular filtration rate , according to data from a pilot study presented at the Heart Associations Scientific Sessions 2013.

    Furosemide and other loop diuretics are mainstays in the medical management of heart failure. Although they have a class I indication, the level of evidence is C, which suggests that loop diuretics have not been extensively studied, said Paul McKie, MD, the studys lead investigator. Preliminary data have shown that aggressive loop diuretics may adversely activate neurohumoral pathways and ultimately impair renal blood flow and decrease GFR, he said. GFR is an important prognostic marker for cardiovascular morbidity and mortality in heart failure.

    Thirty-two patients were enrolled in the National Institutes of Health-sponsored study, 19 with normal GFR and 13 with reduced GFR .

    Patients were monitored for at least three weeks prior to enrollment to ensure clinical stability on a stable dosage of furosemide. After three weeks, they underwent a comprehensive baseline assessment that included measurements of GFR and renal plasma flow, hemodynamic assessments, and assessment of functional capacity. After baseline assessment, individuals decreased their furosemide dosage by half. After three weeks they underwent the same assessments as at baseline.

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    Is Torsemide Or Lasix More Effective

    A recent meta-analysis compared torsemide and Lasix in patients with congestive heart failure . This review encompassed nineteen studies and almost 20,000 patients. The results found that torsemide use was associated with a lower rate of hospitalization for CHF. Torsemide is also associated with a significantly higher number of patients achieving functional improvement in status as compared to furosemide. Functional improvement was defined as improving from class III/IV to class I/II as defined by the New York Heart Association . Torsemide use was also associated with a lower risk of cardiac mortality.

    A retrospective, cohort study published by the American College of Cardiology found that patients with heart failure who were hospitalized without prior use of a diuretic had lower mortality and re-hospitalization rates when discharged on a loop diuretic.

    The pharmacokinetics and pharmacodynamics, or how the drugs function in the body, of torsemide and Lasix are different. Torsemide has a high bioavailability of about 80% after taking a dose orally. Lasix absorption is much less predictable, and the presence of food may delay the response. Torsemide is twice as potent as furosemide on a milligram to milligram comparison.

    Which Is Better Lasix Or Torsemide

    Drinking This Much Water Will Poison You

    4.4/5TorsemideLasixTorsemideLasix

    Likewise, people ask, is torsemide better than Lasix?

    Compared to furosemide, torsemide has a longer half-life, longer duration of action, and a higher and less variable bioavailability. Compared to furosemide, torsemide significantly reduced total heart failure readmissions , I 2 = 0%.

    Beside above, can you take furosemide with Torsemide? Interactions between your drugsNo interactions were found between Lasix and torsemide.

    Hereof, what diuretic is stronger than Lasix?

    Bumex

    Is torsemide hard on the kidneys?

    Torsemide is used to help treat fluid retention and swelling that is caused by congestive heart failure, liver disease, kidney disease. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure.

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    The Need To Monitor Kidney Function With Certain Drugs

    Experts have suggested that after the initial assessment of kidney function, physicians should consider regular monitoring after starting or increasing the dosage of drugs associated with nephrotoxicity, especially those used chronically in patients with multiple risk factors for impaired kidney function, Dr. Naughton noted. If there is any sign of kidney harm, the provider should review the medications you are taking in order to identify which one is causing the problem.

    If multiple medications are present and the patient is clinically stable, physicians should start by discontinuing the drug most recently added to the patients medication regimen. Once that has been taken care of, further harm to the kidneys may be minimized by keeping blood pressure stable, staying hydrated, and temporarily avoiding the use of other medications that may cause nephrotoxicity.

    These safety tips can ensure you get the care you need while keeping your kidneys safe. That way, they can tend to essential functions like keeping things flowing .Originally published May 11, 2017

    How Should I Take Torsemide

    Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

    Torsemide oral is taken by mouth.

    Torsemide injection is given as an infusion into a vein. A healthcare provider may teach you how to properly use the medication by yourself. Torsemide injection is given either as a slow infusion over 2 minutes, or as a continuous infusion.

    If you have cirrhosis or other liver problems, you may receive your first injection in a hospital or clinic setting to quickly treat any serious side effects.

    Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don’t understand all instructions.

    Prepare an injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

    You may take torsemide with or without food.

    Your blood pressure will need to be checked often, and you may need other medical tests. Your blood and urine may both be tested if you have been vomiting or are dehydrated.

    Some things can cause your blood pressure to get too low. This includes vomiting, diarrhea, or heavy sweating. Call your doctor if you are sick with vomiting or diarrhea.

    Store at room temperature away from moisture and heat.

    • Save up to 80% on your prescriptions.
    • Accepted at over 65,000 pharmacies.

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    Is Torsemide Stronger Than Lasix

    4.7/5Torsemidefurosemidetorsemideon it here

    Compared to furosemide, torsemide has a longer half-life, longer duration of action, and a higher and less variable bioavailability. Compared to furosemide, torsemide significantly reduced total heart failure readmissions , I 2 = 0%.

    Also Know, is Lasix and torsemide the same? Torsemide and Lasix are effective loop diuretics used for symptomatic treatment of heart failure. They both increase urine output to decrease fluid accumulation in the body. Torsemide is considered to have a longer duration of action compared to Lasix. It is eliminated from the body at a slower rate of 3.5 hours.

    what diuretic is stronger than Lasix?

    Although Bumex and Lasix are similar medications, Bumex has a shorter duration of action and is considered to be more potent than Lasix. Diuretic effects from Bumex last 4 to 6 hours while diuretic effects last 6 to 8 hours with Lasix.

    Is torsemide hard on the kidneys?

    Torsemide is used to help treat fluid retention and swelling that is caused by congestive heart failure, liver disease, kidney disease. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure.

    Can I Use Torsemide Or Lasix While Pregnant

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    Torsemide is pregnancy category B, meaning no animal studies have shown fetal harm and there have been no studies in pregnant women. It should not be used unless absolutely necessary. Lasix is pregnancy category C, meaning there have been no well-controlled clinical trials to establish safety. Lasix should only be used when the benefits clearly outweigh the risks.

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    Drug Interactions Of Torsemide Vs Lasix

    Torsemide, when administered with opiates such as codeine or fentanyl, may have a decreased diuretic effect. Torsemide and Lasix may also be much more likely to cause orthostatic hypotension in patients taking either drug with codeine. Orthostatic hypotension describes a condition of a sudden shift in blood pressure that occurs when you rise suddenly from sitting or lying down. It may leave you feeling dizzy, lightheaded, faint, nauseous, or confused. It may only last for a very short period of time. If it lasts for a prolonged period of time , you should discuss this with your doctor.

    When taken with torsemide or Lasix, non-steroidal anti-inflammatory drugs may result in decreased kidney function and decreased diuretic effects. Celecoxib, a COX-2 NSAID, is metabolized by an enzyme that is inhibited by torsemide. This results in a potential for significantly higher plasma concentrations of celecoxib in the body. These higher plasma concentrations over time carry an increased risk of stroke and other serious cardiovascular events.

    The following table is not meant to include all potential drug interactions. Please consult your physician or pharmacist for a complete list. Before you are given torsemide or Lasix, make sure your healthcare provider is aware of all medications you are taking.

    Drug
    Yes

    What Is Nephrogenic Systemic Fibrosis

    NSF is a rare but serious disease affecting skin and other organs that has been found in some patients with advanced CKD after exposure to gadolinium-containing contrast dyes that are used in magnetic resonance imaging . NSF appears to affect about 4 percent of patients with advanced CKD. People with acute kidney injury are also at higher risk. NSF has not been reported in people with mild kidney damage or normal kidney function.

    NSF can be painful, debilitating, or even fatal. Symptoms and signs of NSF can include burning and itching of the skin, red or dark patches on the skin, joint stiffness, or muscle weakness. The disease can develop within 24 hours up to around 3 months.

    MRIs are routinely used in patients to visualize internal organs and limbs to help detect and monitor many different diseases or injuries. Contrast dyes are often used during MRI to enhance the images obtained, and these dyes contain an element called gadolinium. In people with CKD, the kidneys are not able to filter out wastes, drugs and toxins the way they normally should. In advanced CKD, the excretion of gadolinium-containing contrast dyes used in MRIs is slower than in people with normal kidney function. This delay in excretion is thought to be one the main reasons why NSF may happen.

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    What Kind Of Diuretic Is Torsemide

    Torsemide is a part of the pyridine-sulfonylurea class of loop diuretics. It primarily carries out its function on the thick ascending limb of the loop of Henle in the kidney. It promotes urination and stops the reabsorption of sodium and chloride. Consult our experts to know more about how loop diuretics work.

    Is Torsemide Bad For Kidneys

    Diuretics

    Torsemide is considerably safe to use but could be hard on the kidneys for people who suffer from pre-existing kidney diseases. A condition called hypovolemia which is less fluid volume in the body, can be caused by a diuretic like Torsemide and be extremely dangerous for a person and precautions are advisable.

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    Should You Drink A Lot Of Water When Taking Torsemide

    Taking Torsemide can sometimes lead to dehydration because of sweating and diarrhea. The average daily fluid intake should be 2-3 liters for a person. It is advisable to at least consume the minimum daily intake of fluids to avoid getting dangerously dehydrated. Contact our medical experts for proper recommendations for fluid intake.

    Torsemide Vs Furosemide In Heart Failure Patients

    Background: Treatment goals of heart failure include improvement in quality of life, prevention of hospitalization, and decreases in mortality. Loop diuretics can improve these goals. Furosemide is the most widely used diuretic in heart failure patients. Torsemide has a better pharmacokinetic and pharmacodynamic profile than does furosemide, with greater bioavailability, a longer half-life, and higher potency. In addition, there is a suggestion that torsemide has a vasodilatory effect and a possible antialdosterone effect that may contribute to its efficacy. However, it is not known if that better profile leads to differences or improvements in primary treatment goals.

    Dr. Margaret Tsien

    Study design: Systematic review and meta-analysis.

    Setting: 19 published randomized, controlled trials or observational studies in the English language.

    Bottom line: The use of torsemide is associated with significant improvement in functional status. It is also though less significantly associated with lower hospitalization rates for heart failure and lower cardiac mortality.

    Citation: Abraham B et al. Meta-analysis comparing torsemide versus furosemide in patients with heart failure. Am J Cardiol. 2020 Jan 1 125: 92-9.

    Dr. Tsien is assistant professor in the division of hospital medicine, Loyola University Medical Center, Maywood, Ill.

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