Toramax
Generic Name
Torasemide
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| toramax 30 mg injection | ৳ 110.00 | N/A |
Description
Overview of the medicine
Toramax 30 mg Injection contains Torasemide, a loop diuretic used to treat edema associated with congestive heart failure, renal disease, or hepatic cirrhosis, and also for the management of hypertension.
Uses & Indications
Dosage
Adults
Initial dose for edema: 10-20 mg IV once daily, titrate up to 200 mg daily if needed. For acute pulmonary edema, 10-20 mg IV as a single dose.
Elderly
No specific dose adjustment generally required, but close monitoring is advised due to potential age-related renal impairment.
Renal_impairment
Dosage adjustment may be necessary in severe renal impairment. Max dose up to 200 mg/day (IV).
How to Take
For intravenous (IV) administration. Administer slowly over 2-3 minutes or as an infusion. Do not administer intramuscularly.
Mechanism of Action
Torasemide is a loop diuretic that acts on the thick ascending limb of the loop of Henle in the kidney. It inhibits the Na+/K+/2Cl- cotransport system, leading to increased excretion of sodium, potassium, chloride, and water, thereby reducing fluid retention and blood pressure.
Pharmacokinetics
Onset
Within 10 minutes of IV administration.
Excretion
Mainly renal excretion (approximately 80% as metabolites, 20% unchanged drug).
Half life
Approximately 3.5 hours.
Absorption
Immediate and complete bioavailability after intravenous administration.
Metabolism
Primarily hepatic metabolism via cytochrome P450 enzymes (CYP2C9, CYP2C8, CYP2C18).
Side Effects
Contraindications
- Anuria (absence of urine production)
- Hepatic coma and pre-coma
- Severe hypokalemia or hyponatremia
- Hypotension
- Hypersensitivity to torasemide or sulfonylureas
Drug Interactions
NSAIDs
May reduce diuretic effect and increase risk of renal toxicity.
Digoxin
Increased risk of digoxin toxicity due to hypokalemia.
Lithium
Reduced renal clearance of lithium, leading to increased lithium levels.
Antihypertensives
Potentiated hypotensive effect.
Aminoglycoside antibiotics
Increased risk of ototoxicity.
Storage
Store below 30°C. Protect from light. Do not freeze.
Overdose
Symptoms include dehydration, electrolyte depletion (hypokalemia, hyponatremia, metabolic alkalosis), and hypotension. Management involves fluid and electrolyte replacement, and symptomatic supportive care.
Pregnancy & Lactation
Use in pregnancy only if clearly needed and potential benefits outweigh risks. Caution advised during lactation; it is unknown if torasemide is excreted in human milk.
Side Effects
Contraindications
- Anuria (absence of urine production)
- Hepatic coma and pre-coma
- Severe hypokalemia or hyponatremia
- Hypotension
- Hypersensitivity to torasemide or sulfonylureas
Drug Interactions
NSAIDs
May reduce diuretic effect and increase risk of renal toxicity.
Digoxin
Increased risk of digoxin toxicity due to hypokalemia.
Lithium
Reduced renal clearance of lithium, leading to increased lithium levels.
Antihypertensives
Potentiated hypotensive effect.
Aminoglycoside antibiotics
Increased risk of ototoxicity.
Storage
Store below 30°C. Protect from light. Do not freeze.
Overdose
Symptoms include dehydration, electrolyte depletion (hypokalemia, hyponatremia, metabolic alkalosis), and hypotension. Management involves fluid and electrolyte replacement, and symptomatic supportive care.
Pregnancy & Lactation
Use in pregnancy only if clearly needed and potential benefits outweigh risks. Caution advised during lactation; it is unknown if torasemide is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture when stored correctly.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Generic available
Clinical Trials
Extensive clinical trials have demonstrated torasemide's efficacy and safety in reducing edema and controlling hypertension, particularly in patients with heart failure and renal impairment, with some trials showing advantages over other loop diuretics in specific patient populations.
Lab Monitoring
- Serum electrolytes (especially potassium, sodium, magnesium)
- Renal function (BUN, creatinine)
- Blood pressure
- Fluid balance
- Uric acid levels
Doctor Notes
- Carefully monitor fluid and electrolyte status, especially in patients receiving high doses, those with pre-existing electrolyte imbalances, or elderly patients.
- Adjust dose based on patient response, urine output, and renal function.
- Educate patients and caregivers on symptoms of dehydration and electrolyte disturbances and when to seek medical attention.
- Administer slowly intravenously to avoid adverse effects.
Patient Guidelines
- Report any symptoms of dehydration or electrolyte imbalance (e.g., excessive thirst, muscle weakness, severe dizziness).
- Do not stop the medication without consulting your doctor.
- Maintain regular follow-up appointments for monitoring of fluid and electrolyte status.
Missed Dose Advice
Since it is an injection administered by a healthcare professional, a missed dose is unlikely. If a scheduled dose is missed in an outpatient setting, contact your doctor for advice.
Driving Precautions
May cause dizziness or lightheadedness, especially at the start of treatment or after dose changes. Patients should be cautious when driving or operating machinery until they know how the drug affects them.
Lifestyle Advice
- Maintain a balanced diet as advised by your doctor, which may include specific dietary restrictions.
- Limit sodium intake to manage fluid retention and blood pressure.
- Stay hydrated as advised by your healthcare provider, avoiding both excessive and insufficient fluid intake.
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