Torasemide

What it is

Torasemide is a loop diuretic. It blocks sodium, potassium and chloride reabsorption in the ascending limb of the loop of Henle, producing a stronger and more predictable fluid loss than thiazides. It is used for oedema, for congestion in heart failure, and for high blood pressure where the national label licenses that use, as the UK MHRA licence for Torem does and Japan's MHLW label, limited to oedema, does not.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Oedema
• Heart failure
• Hypertension

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It can be taken with or without food and is normally a morning medicine, since the urge to pass urine follows within hours. Potassium and magnesium go out with the water, so potassium and sodium are monitored, along with creatinine, which reflects how the kidneys are coping with the reduced fluid volume, and uric acid, which tends to rise on diuretics. Drinking enough matters even though the drug removes fluid, and daily weight is a practical measure of how much has actually been lost.

When to see a doctor

Cramps, pronounced weakness, palpitations, dizziness on standing or confusion can mean potassium or sodium has fallen too far and are reasons to see a doctor. Rapid weight loss or gain, much reduced urine output, or hearing changes such as ringing in the ears also warrant medical review.

Worth knowing

• Can lower potassium
• Drink enough water

Markers to watch

• Potassium
• Sodium
• Creatinine
• Uric acid

Nutrients affected

• potassium — depleted by (Potassium)
• magnesium — depleted by (Glucose, HOMA-IR, Magnesium)