Torasemid

Торасемид Drug photo

The description is actual on 13.01.2015

  • Latin name: Torasemide
  • ATH code: C03CA04
  • Active ingredient: Torasemid (Torasemide)
  • Producer: Sandoz Gmbh, Austria

Structure

One tablet of drug can include 2,5/5/10/20/50/100 or 200 mg of a torasemid as active ingredient.

Additional ingredients of tablets on 2,5/5/10 and 20 mg: corn starch, lactose, silicon dioxide colloid, magnesium stearate, cellulose microcrystallic.

Additional ingredients of tablets on 50; 100 and 200 mg: silicon dioxide colloid, magnesium stearate, cellulose microcrystallic, attracts (E 421), krospovidon, kopolividon, the hydrogenated castor oil.

Release form

Torasemid Sandoz is issued in the form of tablets on 20 or 100 pieces in one packaging.

Pharmacological action

Diuretic (diuretic).

Pharmacodynamics and pharmacokinetics

Torasemid Sandoz treats group of the diuretics called by loopback diuretics. Small doses of a torasemid apply to treatment of arterial hypertension, both in monotherapy and in a complex with other anti-hypertensive drugs where torasemid shows slight saluretichesky and diuretic action. Higher doses of drug render the strengthened diuretic effects depending on the applied dose. The maximum diuretic activity Torasemida Sandoz is observed after 2-3 hours after oral (internal) administration.

Internal reception of a torasemid leads to fast absorption and almost full absorption. Plasma Cmax is observed in 60-120 minutes, system bioavailability at the level of 80–90%. Communication with plasma proteins more than for 99%, at the distribution volume equaling to 16 liters.

The metabolism passes by a hydroxylation and oxidation with allocation of 3 metabolites: M1, M3 and M5 where active are M1 and M3 (about 10% of pharmacological effects of drug).

Healthy people have final T½ of a torasemid, as well as its metabolites equals to the 3-4th hours. The renal clearance makes close to 10 ml/min. at the general clearance in 40 ml/min.

About 80% of a dose, the most not changed torasemid (24%) and products of his metabolism of M1 (12%), M3 (3%) and M5 (41%) are allocated.

At insufficiency of kidneys of T½ of metabolites of drug (M3 and M5) increases though T½ of a torasemid remains invariable. Haemo filtering and a hemodialysis are almost not effective.

At heart failure and pathologies of a liver of T½ of a metabolite of M5 and active ingredient it is a little extended, but without the proved drug cumulation.

Indications to use

  • For tablets with the mass content of torasemid of 2,5 and 5 mg: – therapy of essential hypertensia.
  • For tablets with the mass content of torasemid of 5; 10 and 20 mg: – prevention or decrease in hypostases at the patients having heart failure.
  • For tablets with the mass content of torasemid of 50; 100 and 200 mg: – prevention or decrease in hypostases, and also raised by the ABP at a renal failure (HPN) of difficult character with KK is less than 20 ml/min., on condition of existence of residual diuresis it is more than 200 ml in days, including to patients on a hemodialysis.

Contraindications

Side effects

Gepatobiliarny system:

  • increase in a blood plasma of content of separate liver enzymes, in particular γ-glutamil-transpeptidaza.

Cardiovascular system:

System of blood and lymphatic system:

Bodies of a gastrointestinal tract:

Integuments:

Urinary system:

  • increase in a blood plasma of level of urea and creatinine;
  • desires to an urination;
  • at the patients suffering from disorders of process of an urination, for example at prostate adenoma observed expansion of a bladder and an ischuria.

Metabolism:

  • metabolic alkalosis;
  • spasms of muscular tissue (especially at the beginning of therapy);
  • hypopotassemia at patients with dysfunction of a liver of chronic character, at diarrhea or vomiting, the accompanying low-potassium diet, excessive reception of purgatives;
  • increase in a blood plasma of content of glucose, uric acid and lipids (XC, TG);
  • disturbances of an electrolytic and water balance of various weight, depending on duration of therapy and a dosage of drug;
  • arterial hypotension, adynamy, headaches, drowsiness because of the strengthened urination that leads to significant loss of liquid, in particular at the beginning of therapy and at elderly patients.

The general:

  • the general weakness (in particular at the beginning of therapy);
  • headaches;
  • dryness in a mouth;
  • confusion of consciousness;
  • visual disturbances;
  • dizziness;
  • sonitus;
  • increased fatigue;
  • hearing loss;
  • paresthesias of extremities.

Application instruction of Torasemid

The application instruction Torasemida Sandoz recommends oral (internal) administration of the whole tablets in the morning, washing down with water.

Duration of reception depends on character of a disease state (at heart failure therapy is continued before disappearance of hypostases).

At arterial hypertension, the initial dose of a torasemid for adults equals 2,5 mg in 24 hours. In case of insufficient lowering of the ABP after carrying out 2-month treatment, increase of a daily dose to 5 mg is possible. Maximum efficiency is, as a rule, noted after 3 months of therapy. Drug doses higher than 5 mg do not give additional anti-hypertensive effect.

For prevention or decrease in hypostases recommend to begin treatment torasemidy with a daily dose of 5 mg which is doubled in case of need (10 mg). At heavy hypostases perhaps gradual increase in a daily dose up to 20 mg.

Cirrhosis demands use of the general initial daily dose from 5 to 10 mg, with parallel reception of drugs antagonists of Aldosteronum or the diuretics promoting a delay in a potassium organism. In the absence of sufficient diuretic effect the dose is doubled (from 10 to 20 mg).

At HPN a dosage Torasemida Sandoz is defined individually depending on degree of a disease state. Usually initial daily dose of drug makes 20 mg and if necessary gradually increases up to a dose of 200 mg at 24 o'clock which is maximum. This dose appoint only in cases of a heavy renal failure at KK less than 20 ml/min., and also during passing of a hemodialysis, in case of existence of the diuresis making not less than 200 ml a day.

Overdose

The typical symptomatology of overdose torasemidy is unknown. The artificial diuresis with excessive loss of electrolytes and liquids, drowsiness, arterial hypotension, confusion of consciousness, disorder of a digestive tract, cardiovascular insufficiency is possible.

The specific antidote does not exist. Depending on manifestations of overdose lowering of the accepted dose or full drug withdrawal is shown. Recommend carrying out actions for compensation of losses in water and electrolytic balance. The hemodialysis is inefficient.

At a hypovolemia carry out substitution of volume of the lost liquid. At a hypopotassemia appoint potassium drugs. At manifestation of cardiovascular insufficiency the patient is given a sitting position and carry out a symptomatic treatment.

At the first emergence of skin reactions (for example, erubescence or the small tortoiseshell), a headache, excitement, the increased sweating, cyanosis, nausea, recommends carrying out catheterization of a vein. The patient is given horizontal position, provide a free air flow, appoint oxygen. In case of need enter Epinephrinum, glucocorticoids and solutions compensating liquid loss.

Interaction

Parallel reception of a torasemid and cardiac glycosides can increase sensitivity of a myocardium to these drugs, because of observed deficit of magnesium or potassium.

Torasemid strengthens effects of other anti-hypertensive means including APF inhibitors that can become the reason of heavy hypotension. For the prevention of development of hypotension it is necessary to correct a dose of one or other medicine.

At the combined use with laxative drugs, glucocorticoids and mineralokortikoida the risk of development of deficit of potassium increases.

Torasemid lowers efficiency of antidiabetic drugs and weakens vasoconstrictive action of Norepinephrinum and Epinephrinum.

High doses of a torasemid, can exponentiate ototoksichesky and nephrotoxic effects of antibiotics of an aminoglikozidny row (Kanamycinum, Tobramycinum, Gentamycin), nephrotoxic effect of cephalosporins and toxic effect of drugs of platinum.

Torasemid increases efficiency of kurarepodobny muscle relaxants and Theophylline.

NPVP and Probenetsid weaken hypotensive and diuretic action of a torasemid.

The combined administration of drugs of lithium and torasemid can lead to increase of content of lithium in blood that will strengthen its neurotoxicity and cardiotoxicity.

Torasemid strengthens toxic effects of salicylates (in high doses) on TsNS.

The concomitant use of Colestyraminum can lower absorption of a torasemid that leads to weakening of its action.

Terms of sale

Torasemid Sandoz it is possible to get according to the recipe of the doctor.

Storage conditions

Torasemid Sandoz, in original packaging, it is necessary to keep at a temperature up to 25 °C.

Period of validity

36 months.

Special instructions

Before purpose of therapy using Torasemida Sandoz it is necessary to normalize concentration of sodium and potassium, and also the volume of the circulating blood.

When carrying out prolonged treatment recommend to conduct regular researches of electrolytic balance (in particular at the patients who are at the same time applying glucocorticoids, foxglove glycosides, laxative drugs, mineralokortikosteroida), contents of glucose, creatinine, uric acid and lipids of blood.

Sick diabetes mellitus it is necessary to watch a metabolism of carbohydrates.

Patients with tendency of development of gout and a hyperuricemia require special attention from the doctor.

Do not recommend reception of a torasemid to patients with pathological changes of acid-base balance; the changed blood picture (anemia, thrombocytopenia, etc.) at patients without insufficiency of kidneys; in a combination with lithium, cephalosporins and aminoglycosides; to children; at pathologies of kidneys because of reception of nephrotoxic substances; at advanced age.

Torasemid Sandoz demands extra care of appointment to patients with liver pathologies which are followed by ascites and cirrhosis as sharp fluctuations of water and electrolytic balance can become the reason of a hepatic coma. In this regard treatment by diuretics of patients of this group should be carried out in a hospital. Prevention of manifestations of a metabolic acidosis and a hypopotassemia requires parallel appointment of antagonists of Aldosteronum or kaliysberegayushchy drugs.

Sometimes after reception of a torasemid observed the ototoxicity phenomena (a hearing loss, a sonitus) having reversible character and without the proved relationship of cause and effect.

Therapy by diuretics demands a constant control of electrolytic balance, an extrarenal azotemia, a hypovolemia and other disturbances by symptoms of which can be: dryness in an oral cavity, thirst, slackness, weakness, drowsiness, tachycardia, muscular spasms or pains, excitement, a myasthenia, an oliguria, hypotonia, the nausea passing into vomiting. High diuresis can lead to dehydration of an organism and reduction in the amount of the circulating blood, an embolism and a thrombogenesis in vessels, in particular at elderly patients.

At water and electrolytic disturbances it is necessary to interrupt therapy, with a possibility of its continuation in lower doses after elimination of negative symptoms.

It is regularly necessary to carry out laboratory control of levels in a blood plasma of potassium and other electrolytes.

Drug tablets from 2,5 mg to 20 mg include lactose that should be considered at purpose of drug to patients with intolerance of sugars.

Tablets from 50 mg to 200 mg contain the hydrogenated castor oil which can lead to disorders of a gastrointestinal tract and diarrhea.

Torasemid's analogs

Coincidence on the ATH code of the 4th level:

Analogs Torasemida Sandoz are provided by drugs: Furosemide, Lasixum and Bufenoks.

Zdravzona

  • Torasemid Kanon of 10 mg No. 60 of a tabletkikanonfarm production closed joint stock company
  • Torasemid Kanon of 5 mg No. 60 of a tabletkikanonfarm production closed joint stock company
  • Torasemid Kanon of 5 mg No. 20 of a tabletkikanonfarm production closed joint stock company
  • Torasemid Kanon of 10 mg No. 20 of a tabletkikanonfarm production closed joint stock company
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Apteka24

  • Torasemid20
  • Torasemid30
  • Torasemid20
  • Torasemid20
  • Torasemid20

Paniapteka

  • Torasemid of the tab. of 100 mg No. 20sandoz
  • Torasemid of the tab. of 100 mg No. 20sandoz
  • Torasemid of the tab. of 100 mg No. 20sandoz
Section: Diuretic
in more detail

Education: Graduated from the Vinnytsia national medical university of N. I. Pirogov, pharmaceutical faculty, the higher pharmaceutical education – the specialty "Pharmacist".

Experience: Work in Koneks and Bios-Media pharmacy chains as "Druggist". Work as "Pharmacist" in Avicenna pharmacy chain of the city of Vinnytsia.

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use Torasemid surely consult with the attending physician.