Torasemide

Torasemide
Clinical data


AHFS/Drugs.com	International Drug Names
MedlinePlus	a601212
Pregnancy category	US: C (Risk not ruled out)
Routes of administration	Oral, IV
ATC code	C03CA04 (WHO)
Legal status
Legal status	US: ℞-only
Pharmacokinetic data
Bioavailability	80-90%
Protein binding	Highly bound (>99%).
Metabolism	Hepatic (80%)
Biological half-life	3.5 hours; Cirrhosis: 7-8 hours
Identifiers
IUPAC name N-[(isopropylamino)carbonyl]-4-[(3-methylphenyl)amino]pyridine-3-sulfonamide
CAS Number	56211-40-6^Y
PubChem (CID)	41781
IUPHAR/BPS	7312
DrugBank	DB00214^Y
ChemSpider	38123^Y
UNII	W31X2H97FB^Y
KEGG	D00382^Y
ChEBI	CHEBI:9637^N
ChEMBL	CHEMBL1148^Y
ECHA InfoCard	100.164.924
Chemical and physical data
Formula	C₁₆H₂₀N₄O₃S
Molar mass	348.421 g/mol
3D model (Jmol)	Interactive image
SMILES O=S(=O)(c2c(Nc1cc(ccc1)C)ccnc2)NC(=O)NC(C)C
InChI InChI=1S/C16H20N4O3S/c1-11(2)18-16(21)20-24(22,23)15-10-17-8-7-14(15)19-13-6-4-5-12(3)9-13/h4-11H,1-3H3,(H,17,19)(H2,18,20,21)^Y Key:NGBFQHCMQULJNZ-UHFFFAOYSA-N^Y
^NY (what is this?) (verify)

Torasemide (rINN) or torsemide (USAN) is a pyridine-sulfonyl urea type loop diuretic mainly used in the management of edema associated with congestive heart failure. It is also used at low doses for the management of hypertension. It is marketed under the brand names Demadex, Diuver, and Examide.

Compared with other loop diuretics, torasemide has a more prolonged diuretic effect than equipotent doses of furosemide and relatively decreased potassium loss. No evidence of torasemide-induced ototoxicity has been demonstrated in humans.^[1]

Recent publications suggest improved outcomes when used for heart failure compared with furosemide.^[2]^[3]^[4]

References

↑ Dunn CJ, Fitton A, Brogden RN (January 1995). "Torasemide. An update of its pharmacological properties and therapeutic efficacy". Drugs. 49 (1): 121–42. doi:10.2165/00003495-199549010-00009. PMID 7705212.
↑ Roush GC, Kaur R, Ernst ME (2014). "Diuretics: a review and update". J. Cardiovasc. Pharmacol. Ther. 19: 5–13. doi:10.1177/1074248413497257. PMID 24243991.
↑ Buggey J, Mentz RJ, Pitt B, Eisenstein EL, Anstrom KJ, Velazquez EJ, O'Connor CM (2015). "A reappraisal of loop diuretic choice in heart failure patients". Am. Heart J. 169: 323–33. doi:10.1016/j.ahj.2014.12.009. PMC 4346710. PMID 25728721.
↑ Mentz RJ, Hasselblad V, DeVore AD, Metra M, Voors AA, Armstrong PW, Ezekowitz JA, Tang WH, Schulte PJ, Anstrom KJ, Hernandez AF, Velazquez EJ, O'Connor CM (2016). "Torsemide Versus Furosemide in Patients With Acute Heart Failure (from the ASCEND-HF Trial)". Am. J. Cardiol. 117: 404–11. doi:10.1016/j.amjcard.2015.10.059. PMID 26704029.

External links

Medlineplus drug information: Torsemide (Systemic) – information from USP DI Advice for the Patient

Antihypertensives: diuretics (C03)

Sulfonamides
(and etacrynic acid)

CA inhibitors (at PT)	Acetazolamide

Loop (Na-K-Cl at AL)	Furosemide^# Bumetanide Etacrynic acid Etozolin Muzolimine Ozolinone Piretanide Tienilic acid Torasemide

Thiazides (Na-Cl at DCT, Calcium-sparing)	Altizide Bendroflumethiazide Chlorothiazide Cyclopenthiazide Cyclothiazide Epitizide Hydrochlorothiazide^# Hydroflumethiazide Mebutizide Methyclothiazide Polythiazide Trichlormethiazide

Thiazide-likes (primarily DCT)	Quinethazone Clopamide Chlortalidone Mefruside Clofenamide Metolazone Meticrane Xipamide Indapamide Clorexolone Fenquizone

Potassium-sparing (at CD)

ESC blockers	Amiloride^# Triamterene Benzamil

Aldosterone antagonists	Spirolactones: Spironolactone^# Eplerenone Potassium canrenoate Canrenone Non-steroidal: Finerenone

Osmotic diuretics (PT, DL)

Vasopressin receptor inhibitors
(DCT and CD)

Other

Ethanol, Isopropanol, 2M2B
mercurial diuretics (Chlormerodrin, Mersalyl, Meralluride)
Theobromine
Cicletanine

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

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