Primary hypertension. Swelling of hepatic and renal origin. Edema associated with congestive heart failure, pulmonary edema.
Composition:
1 tabl contains 2.5 mg, 5 mg or 10 mg of torasemide. The preparation contains lactose monohydrate.
Action:
Torasemide is a diuretic loop drug. At low doses, its pharmacodynamic profile resembles thiazide diuretics in terms of intensity and duration of diuresis. At higher doses, it accelerates diuresis in a dose-dependent manner, whereby this effect can be very severe. After oral administration, torasemide is rapidly and almost completely absorbed, and peak plasma concentrations reach after 1-2 h. Over 99% of the drug is bound to plasma proteins. Torasemide is metabolised to three metabolites, M1, M3 and M5, by way of gradual oxidation, hydroxylation and hydroxylation of the aromatic ring. T0,5 is 3-4 hours. About 80% of the administered dose is excreted unchanged and metabolites into the kidney tubule. In the case of renal failure T0,5 it does not change.
Contraindications:
Hypersensitivity to torasemide, sulfonylurea derivatives or other components of the preparation. Renal failure with anuria. Hepatic coma and pre-coma. Low blood pressure. The period of pregnancy and lactation. Heart arythmia. Concomitant use with aminoglycoside antibiotics or cephalosporins or renal failure after using other medicines that cause kidney damage.
Precautions:
Hypokalemia, hyponatremia, hypovolaemia and micturition disorders should be corrected before starting treatment. During long-term treatment, it is recommended to regularly monitor the balance of electrolytes, Glucose, uric acid, creatinine and lipids in the blood. Careful monitoring of patients with a tendency to hyperuricaemia and gout is recommended. In addition, carbohydrate metabolism should be monitored for latent or symptomatic diabetes. Due to the lactose content, the drug should not be used in patients with rare hereditary galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose. There are no adequate data on the use of the preparation in children.
Pregnancy and lactation:
The drug is contraindicated during pregnancy and breastfeeding.
Side effects:
Disorders of water and electrolyte balance, especially when using a low-sodium diet, with intensity depending on the dose and duration of treatment. Hypokalemia may occur, especially with a diet low in potassium, or in case of vomiting, diarrhea, abuse of laxatives, as well as liver failure. In severe diuresis, especially at the beginning of treatment, as well as in elderly patients, symptoms of electrolyte and fluid loss, such as headache and dizziness, low blood pressure, weakness, drowsiness, confusion, loss of appetite, spasms, may occur. Torasemide may cause increased levels of uric acid, Glucose and plasma lipids. Symptoms of metabolic alkalosis may be exacerbated. In addition, there may be: gastrointestinal disturbances, increased urea and creatinine in the plasma, increased activity of some liver enzymes (eg GGT), dry mouth. Patients with narrowing of urinary outflow may retain their retention. Leg paresthesias, thromboembolic complications and circulatory disorders were rarely observed. In individual cases: pancreatitis, reduction in the number of erythrocytes, leukocytes and platelets, allergic reactions (pruritus, rash, hypersensitivity to light), visual and auditory disturbances (tinnitus, hearing loss).
Dosage:
Orally. Adults.Primary hypertension: 2.5 mg once a day; if necessary, the dose can be increased to 5 mg once a day. Studies indicate that doses greater than 5 mg per day do not lead to further lowering of blood pressure. The maximum therapeutic effect is achieved after about 12 weeks of continuous treatment.edema: usually 5 mg once a day. If necessary, the dose can be gradually increased to 20 mg once a day. In individual cases, doses up to 40 mg per day were used.
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