torasemide: clinical use

Prescribing considerations

• Assess and correct electrolyte or volume depletion before treatment.
• Correct urinary retention and closely monitor partial urinary-tract obstruction.
• Use particular caution with cirrhosis and ascites, previous hepatic encephalopathy, gout or diabetes.
• There is no clinical experience described for children in the selected SmPC.
• The tablets contain lactose.

Contraindications and cautions

• Hypersensitivity to torasemide, sulphonamides or product excipients
• Anuria with renal failure
• Hepatic coma until corrected
• Hypotension
• Pre-existing hypovolaemia
• Cardiac arrhythmias
• Simultaneous aminoglycoside or cephalosporin treatment
• Renal dysfunction caused by nephrotoxic medicines

Monitoring

• Volume status, blood pressure and signs of haemoconcentration
• Sodium, potassium and broader electrolyte balance
• Creatinine and renal function
• Glucose, particularly with diabetes
• Uric acid and gout symptoms

Clinical pharmacology

Torasemide is a high-ceiling loop diuretic that inhibits renal sodium and chloride reabsorption in the ascending loop of Henle. It is rapidly and almost completely absorbed, highly protein bound, metabolised to active and inactive metabolites, and eliminated through hepatic metabolism and renal excretion. It is not removed by haemodialysis.

Formulation and product differences

• The selected product is an oral, white to off-white round tablet with a break mark.
• It contains lactose, maize starch, colloidal silicon dioxide and magnesium stearate.
• No special storage precautions are specified.

Tablet

Route: Oral

Strengths: 10 mg