toralin
Generic Name
torsemide 10 mg tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| toralin 10 mg tablet | ৳ 10.07 | ৳ 100.70 |
Description
Overview of the medicine
Toralin 10 mg Tablet contains Torsemide, a loop diuretic used to treat edema (fluid retention) associated with conditions like heart failure, kidney disease, and liver cirrhosis. It is also used to treat high blood pressure.
Uses & Indications
Dosage
Adults
For edema: Initially 10-20 mg once daily, adjusted based on response. Max 200 mg/day. For hypertension: Initially 5 mg once daily, may be increased to 10 mg after 4-6 weeks if needed.
Elderly
No specific dosage adjustment is generally required, but monitor renal function carefully.
Renal_impairment
Dosage adjustment may be necessary in severe renal impairment; close monitoring of fluid and electrolyte balance is essential.
How to Take
Toralin tablets should be taken orally, once daily. It can be taken with or without food. It is recommended to take it at the same time each day, preferably in the morning.
Mechanism of Action
Torsemide acts on the thick ascending limb of the loop of Henle in the kidneys, inhibiting the Na+/K+/2Cl- cotransporter. This action increases the excretion of water, sodium, chloride, and potassium, leading to diuresis and reduction of edema and blood pressure.
Pharmacokinetics
Onset
Diuresis typically begins within 1 hour after oral administration.
Excretion
Approximately 20-30% of the unchanged drug is excreted renally. Metabolites are also excreted via the kidneys.
Half life
The elimination half-life is approximately 3.5 hours in healthy individuals, but may be prolonged in patients with renal or hepatic impairment.
Absorption
Rapidly and almost completely absorbed from the gastrointestinal tract. Bioavailability is approximately 80-90%. Peak plasma concentrations are reached within 1 hour.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 system (primarily CYP2C9) to inactive metabolites.
Side Effects
Contraindications
- Anuria (absence of urine production)
- Hypersensitivity to torsemide or sulfonylureas
- Hepatic coma and pre-coma states
Drug Interactions
Digoxin
Increased risk of digitalis toxicity due to hypokalemia caused by torsemide.
Lithium
Torsemide can decrease lithium excretion, leading to increased lithium levels and toxicity.
Antihypertensives
Additive hypotensive effects when co-administered with other blood pressure lowering agents.
Aminoglycoside antibiotics
Increased risk of ototoxicity (hearing damage).
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the diuretic and antihypertensive effects of torsemide.
Storage
Store below 30°C in a cool, dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dehydration, electrolyte depletion (hypokalemia, hyponatremia), hypotension, and gastrointestinal disturbances. Management involves supportive care, fluid and electrolyte replacement, and monitoring vital signs.
Pregnancy & Lactation
Pregnancy Category C. Torsemide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Anuria (absence of urine production)
- Hypersensitivity to torsemide or sulfonylureas
- Hepatic coma and pre-coma states
Drug Interactions
Digoxin
Increased risk of digitalis toxicity due to hypokalemia caused by torsemide.
Lithium
Torsemide can decrease lithium excretion, leading to increased lithium levels and toxicity.
Antihypertensives
Additive hypotensive effects when co-administered with other blood pressure lowering agents.
Aminoglycoside antibiotics
Increased risk of ototoxicity (hearing damage).
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the diuretic and antihypertensive effects of torsemide.
Storage
Store below 30°C in a cool, dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dehydration, electrolyte depletion (hypokalemia, hyponatremia), hypotension, and gastrointestinal disturbances. Management involves supportive care, fluid and electrolyte replacement, and monitoring vital signs.
Pregnancy & Lactation
Pregnancy Category C. Torsemide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 years from the date of manufacture.
Availability
Available in pharmacies
Approval Status
Approved
Patent Status
Generic available
Clinical Trials
Torsemide has been extensively studied in clinical trials demonstrating its efficacy and safety for the treatment of edema and hypertension. Ongoing research may explore new applications or refine existing treatment protocols.
Lab Monitoring
- Serum electrolytes (sodium, potassium, magnesium, calcium)
- Renal function tests (creatinine, BUN)
- Blood pressure monitoring
- Fluid status and weight
Doctor Notes
- Counsel patients on symptoms of fluid and electrolyte imbalance.
- Regularly monitor serum electrolytes, renal function, and blood pressure.
- Adjust dose carefully in patients with severe hepatic impairment due to increased risk of hepatic encephalopathy.
Patient Guidelines
- Take Toralin exactly as prescribed by your doctor.
- Monitor your weight daily and report any sudden changes.
- Avoid dehydration; drink adequate fluids unless advised otherwise by your doctor.
- Report any symptoms of dizziness, muscle weakness, or irregular heartbeats to your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Toralin may cause dizziness, especially when initiating therapy or increasing the dose. Patients should be cautioned against driving or operating hazardous machinery until they know how the drug affects them.
Lifestyle Advice
- Follow a low-sodium diet as recommended by your healthcare provider.
- Engage in regular physical activity as appropriate for your condition.
- Avoid excessive alcohol consumption.
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