Torsemide
DEMADEX
Pronunciation: TOR-se-mide
“Demanding Torso”
Bananas dispersing → ↓ serum potassium
What it isNKCC2-inhibiting loop diuretic; edema and hypertension, especially with heart failure or kidney disease.
Why this oneOral absorption is more reliable and its action longer than furosemide, making outpatient response more predictable.
What limits itVolume depletion, hypokalemia, and hyponatremia require monitoring; excessive diuresis can worsen kidney function.
Torsemide prescription history
Animated chart of estimated U.S. prescriptions per year, Diuretics (1953–2026). Torsemide enters in 1993 (estimated).
FDA-approved for
- edema/hypertension (1993)
Principal riskVolume depletion with hypokalemia
Sulfonamide
Sulfonamide-derived drug — label silent
A sulfonylurea-type loop diuretic with no N4 aromatic amine and no N1 heterocycle; unlike furosemide and bumetanide, its label carries no sulfonamide warning. Not named by Khan; the evidence for the non-antimicrobials as a group says cross-reactivity is unlikely.
Open the sulfonamide hypersensitivity presentation → · sources [n] are on its References slide.
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityVolume depletion and electrolyte disturbances; kidney function and interacting medications modify risk.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Edema - heart failure | Adult | 10-20 mg QD | 200 mg/day (higher not studied) | |
| Edema - chronic renal failure | Adult | 20 mg QD | 200 mg/day (higher not studied) | |
| Edema - hepatic cirrhosis | Adult (with aldosterone antagonist or K-sparing diuretic) | 5-10 mg QD | 40 mg/day (higher not studied) | |
| Hypertension | Adult | 5 mg QD | 10 mg QD |
Titration Hypertension: increase after 4-6 weeks if needed; edema: titrate by doubling per diuretic response
Renal Undefined (contraindicated in anuria)
Hepatic Contraindicated in hepatic coma
Available strengths
- tab 5, 10, 20, 40, 100 mg
Contraindications
- Anuria
- Hepatic coma
Cautions
- Hypotension and worsening renal function
- Electrolyte/metabolic abnormalities (hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia, alkalosis); hyperglycemia; hyperuricemia/gout
- Ototoxicity
Adverse reactions
- Excessive urination
Pregnancy No human data; animal fetal/maternal toxicity at high doses
Lactation No data; diuretics can suppress lactation
Cost
Generic entry2002
Open Torsemide in the interactive console ↗
Memory aids: interaction avatars
Open Torsemide in the interactive console ↗
Self-check
- How does torsemide oral absorption compare with furosemide?
More reliable. - What can excessive torsemide diuresis worsen?
Kidney function.