Metaanalysis comparing torsemide versus furosemide in patients. Weight loss was also significantly greater in the 20 mg torsemide. It can be taken by injection into a vein or by mouth. Torsemide demadex is a diuretic water pill used to treat edema due to kidney disease, liver disease, and congestive heart failure. The most commonly used loop diuretic in patients with hf is furosemide. This is a pdf file of an unedited manuscript that has. Compare furosemide vs lasix headtohead with other drugs for uses, ratings, cost, side effects, interactions and more. It is a less preferred treatment for high blood pressure. Torsemide versus furosemide after acute decompensated heart. Torasemide did not differ from furosemide for cumulative 06 h sodium excretion 96 i 17 vs. It is most frequently used in patients who are fluid overloaded such as in congestive heart failure. Comparing furosemide to torsemide pharmacistanswers. Furosemide alleviates clinical signs of congestion and is commonly used in both the acute and chronic treatment phases of disease. Of 4,580 patients, 86% n3,955 received furosemide and 14% n625 received torsemide.
Torsemide 1020 mg is approximately equivalent to 1 mg of bumetanide and 40 mg of furosemide. Loop diuretics are the preferred diuretics in those with heart failure versus the more commonly used thiazide diuretics, that are more often used for hypertension. In this study, the effects of torsemide versus furosemide on renal function in cardiac surgery patients recovering from arf after continuous renal replacement therapy crrt were studied. Torsemide versus furosemide in patients with acute heart. Torsemide is thought to be slightly more potent on a per milligram basis than furosemide, but this isnt thought to be evidence for better outcomes in treating patients. Common side effects include headache, increased urination, diarrhea, cough. Furosemide is the most widely prescribed loop diuretic in the setting of systolic heart failure hf, yet torsemide has been shown to have less inter and intraindividual variation in. A small n234 openlabel, randomized study by murray et al compared chronic hf with reduced ef patients receiving torsemide vs. Torsemide treated patients had lower ejection fraction and blood pressure and higher creatinine and natriuretic peptide level compared with furosemide. Pdf torsemide versus furosemide in heart failure patients. Furosemide is a chlorobenzoic acid that is 4chlorobenzoic acid substituted by a furan2ylmethylamino and a sulfamoyl group at position 2 and 5 respectively.
Capitals indicate lifethreatening, underlines indicate most frequent. This retrospective observational study aimed to assess the impact of switching furosemide to torsemide versus optimizing the furosemide dose after. A number of clinical trials that compared torsemide versus furosemide in hf suggested improved morbidity and mortality with torsemide. These diuretics are sometimes given together, but they are not. But a recent study shows that of the three major types of loop diuretics, the one that may be the most effective is also the least prescribed. Chronic heart failure, edema and high blood pressure. Comparing torsemide to furosemide torsemide and furosemide work the same way and most guidelines do not recommend one drug over the other. Therefore, careful medical supervision is necessary during treatment. Side effects can include headache, diarrhea, runny nose, dizziness, and cough. Torsemide versus furosemide after continuous renal. Drug absorption and bioavailability is better with oral bumetanide or torsemide. Figure 1 presents the percentage of hf patients discharged on furosemide vs. Lasix furosemide will cause the body to excrete potassium while spironolactone will cause the body to retain potassium. Furosemide has an oral bioavailability of around 60%.
It is much stronger than other diuretics used for high blood pressure control. Although torsemides oral bioavailability and halflife theoretically render it a more efficient diuretic than furosemide, the clinical outcomes of. If given the morning of surgery, torsemide may render the patient volume depleted and blood pressure may be labile during general anesthesia. Effectiveness of bumetanide infusion in treatment of. It has a role as a xenobiotic, an environmental contaminant and a loop diuretic. Both are diuretics, but they work in very different ways. Furosemide is a potent diuretic which increases dramatically urine output in most patients. You may not have noticed but the majority of endstage heart failure patients arent generally the ones with good insurance coverage. Torsemide versus furosemide after acute decompensated heart failure.
May 14, 20 loop diuretics are commonly prescribed to heart failure patients because they help reduce fluid buildup in the body, a common problem facing these individuals. Loop diuretics including furosemide and torsemide are prescribed for most of the patients with symptomatic heart failure hf. Use of the loop diuretic torsemide in three dogs with. Torsemide and bumetanide are 10100x more expensive. Torsemide is an anilinopyridine sulfonylurea belonging to the class of loop diuretics. Torsemide versus furosemide after acute decompensated. Patients treated with torsemide had significantly fewer hospital days for heart failure 106 vs.
This is particularly important when converting from iv to oral. Lasix furosemide is a very effective water pill and itll certainly make you go to the bathroom more often. Furosemide, sold under the brand name lasix among others, is a medication used to treat fluid buildup due to heart failure, liver scarring, or kidney disease. Growing evidence demonstrates more favorable pharmacokinetic profiles of torsemide and bumetanide compared with furosemide. Our primary outcome was blood pressure greater than or equal to 150 mm hg systolic or 100 mm hg diastolic or both on two occasions at least 4 hours apart by postpartum day 5 or by the time of hospital. Torsemide versus furosemide in heart failure patients. Should torsemide be loop diuretic of choice in systolic hf.
Sep 28, 2017 transformhf is a largescale, pragmatic, randomized, unblinded clinical effectiveness study comparing torsemide versus furosemide as treatment for heart failure. Patients receiving torsemide were more likely to be female and had more comorbidities compared with furosemide. Demadex torsemide dose, indications, adverse effects. Furosemide versus torsemide is there a difference med. Torsemide has a prolonged duration of action compared to other loop diuretics, is extensively protein bound in plasma and has a relatively long halflife. Torsemide was associated with similar outcomes on unadjusted analysis and nominally lower events on adjusted analysis 30day mortalityhf hospitalization odds ratio 0. Both torsemide and furosemide as classified as loop diuretics and have the same mechanism of action. When taken by mouth, it typically begins working within an hour, while. Leastprescribed loop diuretic may be most helpful for heart.
Torsemide may best furosemide in acute hf patients, but more. The half life of furosemide is 23 hrs while that of torsemide is 46 hrs. Of 4580 patients, 86% n 3955 received furosemide and 14% n 625 received torsemide. Within 24 hours of delivery, women were randomized one to one to oral torsemide, 20 mgd, or placebo, for 5 days. Lasix furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Review drug interactions, dosing, and pregnancy and breastfeeding safety information. Torsemide use began to increase in 2006 and rose to approximately 30% of loop diuretic use in 2010. The 2009 american college of cardiology and american heart association guideline on heart failure recommended for patients with severe chf the same intravenous dose of furosemide but a lower dose of bumetanide 4 to 8 mg and a higher dose of torsemide 100 to 200 mg 3. Openlabel randomized trial of torsemide compared with. Warning lasix furosemide is a potent diuretic which, if.
If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. Compared with furosemidetreated patients, torsemidetreated patients were less likely to need readmission for heart failure 39 32% vs. Prospective trials are needed to investigate the effect of torsemide vs. Potassium, sodium and magnesium can be lost in excess with the use of furosemide and must be closely monitored. The potent diuretic effect of torsemide can cause the loss of large amounts of body water leading to dehydration as well as the loss of electrolytes for example, sodium, potassium, magnesium, and calcium. To compare the efficacy and safety of torsemide versus. Twentynine critically ill patients admitted to an intensive care unit at a university teaching. Improvements in dyspnea and fatigue scores from baseline were greater among patients treated with torsemide, but the differences were statistically significant only for fatigue scores at months 2, 8, and 12. Torsemide furosemide is used to reduce extra fluid in the body edema caused by conditions such as heart failure, liver disease, and kidney disease. Weight loss was also significantly greater in the 20 mg torsemide group vs the 40 mg furosemide group at weeks 4 and 6 2.
Comparing torsemide versus furosemide in patients with heart failure. Another important consideration that can impact dosing is bioavailability. Of these, 4580 patients had an echocardiogram prior to discharge and were discharged on either torsemide or furosemide. In residency i had to keep medicaidself pay patients in the hospital for up to an extra week while we waited for approval for bumex and demadex scripts. It may also be used for the treatment of high blood pressure. Advantages of the new loop diuretic torasemide over. The loop diuretic furosemide is a mainstay of treatment for congestive heart failure chf in dogs. Doctors give trusted answers on uses, effects, sideeffects, and cautions. Bumetanide, furosemide, and torsemide may cause hyperglycemia and glycosuria in patients with diabetes mellitus, probably due to diureticinduced hypokalemia.
Approximately 6,000 patients with heart failure will be enrolled. Torsemide, however, may confer some potential pharmacologic and antifibrotic benefits, and researchers hypothesized that the comparative benefits of postdischarge use of torsemide would be superior to furosemide in a large acute hf trial, the randomized ascendhf trail. Allcause mortality at 12 months was lower with torsemide vs. Therefore, careful medical supervision is required and dose and dose schedule must be adjusted to the individual patients needs. We described baseline characteristics based on discharge diuretic and assessed the relationship with allcause mortality through 5 years. For some patients, despite higher doses of loop diuretic treatment, an adequate diuretic response cannot be attained. Shah et al metaanalysed the mortality of torasemide versus furosemide in hf patients and concluded no difference. Compared with furosemide treated patients, torsemide treated patients were less likely to need readmission for heart failure 39 32% vs. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen. Torasemide, also known as torsemide, is a medication used to treat fluid overload due to heart failure, kidney disease, and liver disease and high blood pressure.
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