Recently, modern doctors have increasingly begun to prescribe a drug such as Torsid to their patients. Instructions for use include only the basic data that a person needs for the normal use of the drug, but many try to find out more information about this product before buying or after acquiring it.
Pharmacodynamics
This drug is a saluretic. He is responsible for inhibiting the reverse renal reabsorption of sodium and chlorine ions located in the ascending part of the Henle loop, as indicated by the instructions for use for the Torsid preparation.
Pharmacokinetics
In a person after the introduction of this drug intravenously, a diuretic effect begins to appear quite quickly. In this case, the maximum effect of the drug develops during the first 3 hours and subsequently persists until 12 hours. Against the background of the use of this agent, diuresis is directly dependent on the dose, which is also indicated by the instructions for use for the Torsid preparation.
The degree of binding of torasemide with plasma proteins reaches 99%, which is a very good result, while the metabolites M1, M3 and M5 bind to 86.95 and 97%, respectively. The maximum possible half-life of torasemide, as well as its various metabolites in healthy subjects, is from three to four hours, which was determined during the clinical trials.
The total clearance of this substance is approximately 40 ml / min., While the renal clearance has an indicator of about 10 ml / min. The metabolite M5 does not produce any diuretic effect, while the combination of metabolites M3 and M1 accounts for approximately 10% of the total pharmacodynamic effect exerted on the human body.
Features of the drug in people with various diseases
If the patient has kidney failure, this in no way affects the overall clearance and half-life of torasemide, while this period increases for the metabolites M5 and M3. At the same time, the initial pharmacodynamic characteristics are fully preserved, but renal failure also has no effect on the duration of the drug, regardless of the severity of the disease.
In those patients who experience impaired liver function or have heart failure, the periods of excretion of the M5 metabolite and torasemide are slightly increased, as indicated by the instructions for use for the Torsid preparation.
The amount of substance excreted with urine almost completely corresponds to the amount observed in healthy volunteers, in connection with which both torasemide and its metabolites do not cumulate in any way.
Indications
In the overwhelming majority of cases, this drug is prescribed by doctors in the process of treating various effusions or edema that has arisen in connection with heart failure. It is worth noting that the instructions for use (tablets) for the Torsid preparation indicate that it is prescribed if standard therapy is necessary.
Contraindications
There are several cases in which the use of this drug is not recommended or even completely prohibited. They are described by the instructions for use attached to the Torsid preparation (tablets - the form under consideration), it is worth highlighting several main ones:
- the presence of arterial hypotension in the patient;
- excessive sensitivity to various auxiliary or active substances, as well as other sulfonylurea preparations;
- not recommended for use by patients suffering from renal failure with anuria;
- with severe violations of the liver;
- all kinds of violations in the water-electrolyte balance system;
- gout;
- if the patient suffers from severe disorders in the urinary system;
- all kinds of violations of the conduction system of the heart of a high degree;
- with pathological changes in the general picture of the blood and the acid-base state of a person;
- disorders in the functioning of the kidneys caused by damage to various nephrotoxic substances.
Among other things, it is not recommended to use this tool for women staying during pregnancy or breastfeeding.
How is it used?
If a liquid form is used, then the product should be administered exclusively intravenously and slowly, as indicated by the instructions for use for the Torsid preparation. The price of this remedy (from five hundred rubles) is quite affordable, in connection with which most people should not have any problems in order to correctly observe the indicated indications for its use.
The initial single dose is about 10 mg per day, that is, 2 ml of this drug. If there is an insignificant clinical effect, then in this case the dose can be doubled. If this does not allow achieving the proper effectiveness, then in this case it is possible to increase the dose two more times, but the therapy should last a maximum of three days.
Acute pulmonary edema
If acute pulmonary edema is treated with this agent, the starting dose is 20 mg, and depending on the general clinical picture, this dose can be administered every half hour. It is worth noting that with this treatment, the total dose should be no more than 100 milligrams of torsemide per day.
For subsequent treatment, it is recommended to switch to oral administration as soon as possible, since it is not necessary to use the drug intravenously for more than a week, which is also noted by the instructions for use for the Torsid drug. The price (reviews confirm this) of both tablets and a liquid substance is affordable for many, so a full course of treatment rarely causes any difficulties. In any case, the maximum possible daily dose should be no more than 100 mg.
Liver failure
In the case of using the drug in patients with liver failure, it is necessary to use it as carefully as possible, since in this case there is a risk of an increased concentration of torasemide in the blood plasma. This separately notes to the preparation “Torsid” (10 mg) instructions for use (tablets or liquid form of the drug - it does not matter).
Elderly people
An individual approach to the dose selection process is not provided for the treatment of this category of patients. It is worth noting the fact that there have been no serious clinical studies regarding the comparison of the treatment procedure in young and old people, and therefore it is always better to consult with a qualified doctor in advance.
The solution for injection should be administered slowly intravenously, and at the same time it is by no means intra-arterial, which is specifically emphasized by the application instruction (ampoules) for the Torsid preparation.
Side effects
It is worth noting the fact that adverse reactions can affect the process of various organs, so each case will be considered separately:
- The cardiovascular system. In this case, when taking the drug, various disturbances in the water-electrolyte balance may be present, and in some isolated cases, metabolic alkalosis also increases. In addition, confusion of consciousness, thrombosis, arterial hypotension, cerebral and cardiac ischemia, acute myocardial infarction, angina pectoris and syncope appear in a certain category of patients.
- Nervous system. In rare cases, and especially at an early stage of treatment, headache, excessive fatigue, dizziness, and muscle cramps can occur.
- Digestive system. In rare cases, there may be disruption of the digestive system in the process of how the medicine “Torsid” is used. Instructions for use note the following side effects: nausea, lack of appetite, vomiting, diarrhea, stomach pain. An excessively high level of liver enzymes may also be present.
- Urinary system. In patients experiencing various disorders in the urination system, a sufficiently intense urination is observed, which ultimately can lead to its delay, as well as too much distention of the bladder. In rare cases, there may be an overestimated norm of creatinine and urea in the blood.
- Metabolism. In rare cases, patients have an increase in the total level of uric acid, lipids and glucose in the blood.
- Blood system. In extremely rare cases, the total number of red blood cells, white blood cells and platelets decreases.
- The immune system. In rare cases, exanthema, photosensitivity, itching occurs. For the preparation “Torsid” (injections), the instructions for use indicate that in some cases, acute reactions of increased sensitivity may begin to develop after intravenous administration, as a result of which the patient should be given the fastest possible help. In certain cases, severe skin reactions may occur.
If we talk about less significant effects, then paresthesia and dry mouth are rare. Among other things, special attention should be paid to the fact that in extremely rare situations, people have a certain visual impairment, as well as the appearance of tinnitus or complete hearing loss.
Overdose
Typical symptoms in case of drug overdose are currently unknown. The instruction indicates that in case of an overdose, there may be a sufficiently strong diuresis, as well as the risk of severe loss of electrolytes and water, drowsiness and amenity syndrome. Among other things, with an overdose , cardiovascular failure, arterial hypotension, and all kinds of disorders in the digestive tract occur.
How to be treated?
No specific antidote has been discovered at the moment. In most cases, the symptoms resulting from intoxication completely disappear after a dosage reduction or a complete cessation of the use of this drug, as well as if adequate replenishment of electrolytes and fluids is ensured, which should be carried out under conditions of maximum control. Torasemide is in no way eliminated from the blood via hemodialysis.
This is the basic information regarding the Torsid preparation (instructions for use, price, reviews). Analogues of this drug (Britomal, Sutrilneo) in most cases differ in similar action and side effects, but at the same time, this medicine is most often prescribed by doctors as one of the most effective in its group.