Torosic
Generic Name
Torsemide 60 mg Injection
Manufacturer
Acme Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| torosic 60 mg injection | ৳ 100.00 | N/A |
Description
Overview of the medicine
Torosic 60 mg Injection contains Torsemide, a loop diuretic used to treat edema associated with congestive heart failure, renal disease, or hepatic disease. It is also used to treat hypertension.
Uses & Indications
Dosage
Adults
For severe edema: Initial dose typically 20-40 mg IV once daily. Dose may be titrated up to 60 mg, 100 mg, or even 200 mg daily based on patient response. 60 mg is a common higher dose for inadequate response to lower doses.
Elderly
Lower initial doses may be considered. Monitor renal function and electrolyte balance carefully due to increased susceptibility to side effects.
Renal_impairment
No dose adjustment usually needed for mild to moderate impairment. For severe renal failure, higher doses might be needed but careful monitoring is essential. Avoid in anuria.
How to Take
Torosic 60 mg Injection is administered intravenously (IV). It should be given slowly over 2-3 minutes or as an intravenous infusion. Do not administer intramuscularly. May be diluted with 0.9% sodium chloride injection or D5W.
Mechanism of Action
Torsemide acts on the thick ascending limb of the loop of Henle, where it inhibits the Na+-K+-2Cl- cotransport system. This reduces the reabsorption of sodium, potassium, and chloride, leading to increased excretion of water, sodium, and chloride.
Pharmacokinetics
Onset
Within 10 minutes (IV)
Excretion
Primarily renal (approximately 80% as metabolites, 20% as unchanged drug)
Half life
Approximately 3.5 hours (range 2.1-5.7 hours)
Absorption
Rapid and complete bioavailability (100%) after intravenous administration.
Metabolism
Primarily hepatic via cytochrome P450 system, mainly CYP2C9.
Side Effects
Contraindications
- Anuria (absence of urine production)
- Known hypersensitivity to torsemide or sulfonylureas
- Severe electrolyte depletion (e.g., hyponatremia, hypokalemia)
- Hepatic coma or pre-coma
Drug Interactions
NSAIDs
May reduce the diuretic and antihypertensive effects of torsemide.
Lithium
Reduced renal clearance of lithium, leading to increased lithium levels and toxicity.
Aminoglycosides
Increased risk of ototoxicity and nephrotoxicity.
Digitalis glycosides
Increased risk of digitalis toxicity due to hypokalemia.
Antihypertensive agents
Potentiated hypotensive effects.
Storage
Store at controlled room temperature (20-25°C), away from light and moisture. Do not freeze. Keep out of reach of children. Do not use if the solution is discolored or contains particulate matter.
Overdose
Symptoms of overdose include dehydration, electrolyte depletion (hypokalemia, hyponatremia, hypochloremia), hypotension, and gastrointestinal disturbances. Treatment is supportive, involving fluid and electrolyte replacement and monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category B. Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is not known whether torsemide is excreted in human milk, so caution is advised during breastfeeding.
Side Effects
Contraindications
- Anuria (absence of urine production)
- Known hypersensitivity to torsemide or sulfonylureas
- Severe electrolyte depletion (e.g., hyponatremia, hypokalemia)
- Hepatic coma or pre-coma
Drug Interactions
NSAIDs
May reduce the diuretic and antihypertensive effects of torsemide.
Lithium
Reduced renal clearance of lithium, leading to increased lithium levels and toxicity.
Aminoglycosides
Increased risk of ototoxicity and nephrotoxicity.
Digitalis glycosides
Increased risk of digitalis toxicity due to hypokalemia.
Antihypertensive agents
Potentiated hypotensive effects.
Storage
Store at controlled room temperature (20-25°C), away from light and moisture. Do not freeze. Keep out of reach of children. Do not use if the solution is discolored or contains particulate matter.
Overdose
Symptoms of overdose include dehydration, electrolyte depletion (hypokalemia, hyponatremia, hypochloremia), hypotension, and gastrointestinal disturbances. Treatment is supportive, involving fluid and electrolyte replacement and monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category B. Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is not known whether torsemide is excreted in human milk, so caution is advised during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months when stored under recommended conditions. Refer to packaging for exact expiry date.
Availability
Hospitals, Clinics, Retail pharmacies
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available (Off-patent for active ingredient)
WHO Essential Medicine
YesClinical Trials
Torsemide has been extensively studied in numerous clinical trials demonstrating its efficacy and safety for treating edema and hypertension. Ongoing post-market surveillance and research continue to refine its therapeutic profile.
Lab Monitoring
- Serum electrolytes (potassium, sodium, chloride, magnesium, calcium)
- Renal function tests (BUN, creatinine)
- Blood glucose levels (especially in diabetic patients)
- Liver function tests (in patients with hepatic impairment)
- Uric acid levels
Doctor Notes
- Monitor fluid and electrolyte status closely, especially serum potassium, sodium, and magnesium, in all patients, particularly those receiving high doses or concomitant medications.
- Adjust dose based on diuretic response and tolerability, aiming for the lowest effective dose.
- Be aware of potential drug interactions, especially with NSAIDs, aminoglycosides, digitalis, and lithium.
- Caution in patients with hepatic impairment due to risk of hepatic encephalopathy or coma; use should be carefully titrated.
- Educate patients on symptoms of electrolyte imbalance and the importance of adhering to dietary recommendations.
Patient Guidelines
- Report any unusual side effects, especially dizziness, muscle weakness, or irregular heartbeats, to your doctor immediately.
- Ensure adequate fluid intake unless advised otherwise by your doctor.
- Do not stop the medication without consulting your doctor, even if you feel better.
- Understand the signs and symptoms of electrolyte imbalance.
- Follow a low-sodium diet as advised by your healthcare provider.
Missed Dose Advice
As this is an injection typically administered by a healthcare professional, contact your doctor or nurse if you believe a dose has been missed. Do not attempt to self-administer or take a double dose.
Driving Precautions
This medicine may cause dizziness, lightheadedness, or blurred vision, especially at the start of treatment or when changing dose. Exercise caution when driving or operating machinery until you know how Torosic affects you.
Lifestyle Advice
- Follow a low-sodium diet to maximize the diuretic effect and manage fluid retention.
- Limit alcohol intake as it can worsen dehydration and low blood pressure.
- Regular physical activity, as appropriate for your condition, can improve overall cardiovascular health.
- Monitor your weight daily and report significant changes to your doctor.
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