1 tabl contains 5 mg, 10 mg or 20 mg of torasemide. The preparation contains lactose.
Action:
A drug from the group of loop diuretics. At low doses, the pharmacodynamic profile of the drug is similar to thiazide diuretics, taking into account the severity and duration of diuresis. At higher doses, torasemide causes rapid diuresis depending on the dose used. After oral administration, the torasemide is absorbed quickly and almost completely, reaching a maximum blood concentration after 1-2 hours. Over 99% of the drug is bound to plasma proteins. Torasemide is metabolised to three metabolites by oxidation and hydroxylation of the aromatic ring. About 80% of the administered dose is excreted unchanged and as metabolites as a result of tubular secretion. T0,5 is 3-4 hours.
Contraindications:
Hypersensitivity to torasemide, sulfonylurea derivatives or other components of the preparation. Renal failure with anuria. Hepatic coma and pre-coma. Hypotension. Hypovolemia. Breastfeeding period.
Precautions:
Hypokalemia, hyponatraemia and hypovolaemia should be leveled before treatment. In patients with impaired urination (eg due to prostate hyperplasia) increased urine production may lead to urinary retention and excessive bladder stretching. Careful observation of the health of patients with a tendency to hyperuricaemia and gout is recommended. Due to the possible increase in blood Glucose levels, careful monitoring of carbohydrate management is recommended in patients with latent or overt diabetes. In use, there is a risk of cardiac arrhythmias (eg sinoatrial block, atrio-ventricular block of the second or third century). Due to insufficient experience in the use of torasemide, caution should be exercised in disturbing the acid-base balance, in renal failure induced by neurotoxic drugs and in patients with impaired blood picture (eg thrombocytopenia or anemia in patients without renal failure). Attention should be paid to the symptoms of loss of electrolytes and blood thickening, especially at the beginning of treatment and in elderly patients. There is no clinical experience with the use of the preparation in children under 12 years. Due to the lactose content, the preparation should not be used in patients with galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose.
Pregnancy and lactation:
There are no data on the effects of torasemide on the development of the embryo and fetus in humans. Torasemide passes into the fetus and causes electrolyte disturbances. There is also a risk of thrombocytopenia in newborns. It can only be used during pregnancy if the benefits clearly outweigh the risks. The lowest possible dose should be used. The drug is contraindicated during breastfeeding.
Side effects:
Common: decreased appetite, worsening of metabolic alkalosis, disorders of water and electrolyte metabolism depending on the dose and duration of treatment, especially eg hypovolemia, hypokalaemia (in the case of simultaneous use of low-pot diet, vomiting, diarrhea, abuse of laxatives and in patients with chronic liver dysfunction ) and / or hyponatremia; pain and dizziness of labyrinthine origin (especially at the beginning of treatment), stomach pain, nausea, vomiting, diarrhea, constipation (especially at the beginning of treatment), muscle cramps (especially at the beginning of treatment), fatigue, weakness, increased uric acid and glucose in the blood, increase the concentration of fats (triglycerides, cholesterol) in the blood, increase the activity of some of the liver enzymes (gamma-GT) in the blood. Uncommon: paresthesia, dry mouth, urinary retention and excessive bladder stretching as a result of increased urine production in patients with impaired urination (eg due to prostate hyperplasia), increased creatinine and urea in the blood.Very rare: thrombocytopenia, erythropenia, leukopenia, visual disturbances, tinnitus, deafness, thromboembolic complications, confusion, hypotension, circulatory disorders (including cardiac and cerebral ischemia) that may lead to arrhythmia, angina pectoris, acute myocardial infarction or syncope; pancreatitis, hypersensitivity reactions (eg pruritus, rash, hypersensitivity to light), severe skin reactions.
Dosage:
Orally. Adults: 5 mg once a day, usually also a maintenance dose. If necessary, the dose can be increased gradually to 20 mg once a day. The tablets should be taken in the morning without chewing, with a small amount of liquid. The 5 mg and 10 mg tablets can be divided into halves, 20 mg into four parts.
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