Description
Latin name
TORASEMIDE-SZ
Release form
Tablets are white or almost white in color, round, flat-cylindrical, with bevel and notch on one side.
packaging 30 pcs
Pharmacological action of
– edematous syndrome of various origins, including in chronic heart failure, liver, lung and kidney diseases
– arterial hypertension.
Indications
– edematous syndrome of various origins, including in chronic heart failure, liver, lung and kidney diseases
– arterial hypertension.
Contraindications
– renal failure with anuria
– hepatic coma and precoma
– refractory hypokalemia / refractory hyponatremia
– hypovolemia (with or without arterial hypotension, mild or severe disease) )
– glycosidic intoxication
– acute glomerulonephritis
– decompensated aortic and mitral stenosis, hypertrophic obstructive cardiomyopathy
– increased central venous pressure (over 10 mmHg)
– hyperuricemia
– simultaneous use of aminoglycosides and cephalosporins
– pregnancy
– breastfeeding
– under 18 years old
– lactose intolerance, lactase deficiency or glucose-galactose malabsorption
– an allergic reaction to sulfonamides (sulfonamide antimicrobials or sulfonylureas)
– hypersensitivity to torasemide or to any of the components of the drug.
Caution is advised to prescribe the drug for arterial hypotension, stenosing atherosclerosis of cerebral arteries, hypoproteinemia, predisposition to hyperuricemia, impaired urine outflow (benign prostatic hyperplasia, narrowing of the urethra or hydronephrosis), ventricular cardiac arrhythmia, an increase in cardiomyopathy shock), diarrhea, pancreatitis, diabetes mellitus (decreased glucose tolerance), hepatorenal syndrome, gout, anemia alone the use of cardiac glycosides corticosteroids and ACTH.
Composition
1 tab.
torasemide 10 mg
Excipients: lactose monohydrate (lactopress) (milk sugar) – 178.6 mg, pregelatinized starch (starch 1500) – 49 mg, colloidal silicon dioxide (aerosil) – 1.2 mg, magnesium stearate – 1.2 mg.
Dosage and administration of
The drug is taken orally 1 time / day, at any convenient (but at the same time) time, regardless of the meal. The tablets should be swallowed without chewing and drinking plenty of water.
Edema syndrome in chronic heart failure
Recommended starting dose is 10-20 mg 1 time / day. If necessary, the dose can be doubled to obtain the desired effect.
Edema syndrome with kidney disease
Recommended starting dose is 20 mg 1 time / day. If necessary, the dose can be doubled to obtain the desired effect.
Edema syndrome in liver disease
The recommended starting dose is 5-10 mg 1 time / day. If necessary, the dose can be doubled to obtain the desired effect.
It is not recommended to exceed the maximum single dose, which is 40 mg (no experience of use).
The drug is used for a long period or until the edema disappears.
Arterial hypertension
The initial dose is 2.5 mg (1/2 tab. 5 mg) 1 time / day. In the absence of a therapeutic effect within 4 weeks, the dose is increased to 5 mg 1 time / day. In the absence of an adequate decrease in blood pressure when taken at a dose of 5 mg 1 time / day for 4-6 weeks, the dose is increased to 10 mg 1 time / day. If the use of the drug at a dose of 10 mg / day does not give the desired effect, an antihypertensive drug of another group is added to the treatment.
In elderly patients, dose adjustment is not required.
Side effects
The incidence of side effects is classified according to the recommendations of the World Health Organization: very often – 1/10 (> 10%) often – from 1/100 to1% and0.1% and0.01% and
From the nervous systems: often – headache, dizziness, drowsiness infrequently – cramps of the muscles of the lower extremities frequency is unknown – confusion, fainting, paresthesia in the extremities (numbness, crawling and tingling sensations).
On the part of the sensory organs: frequency unknown – visual impairment, hearing impairment, tinnitus and hearing loss (usually reversible) usually in patients with renal failure or hypoproteinemia (nephrotic syndrome).
From the cardiovascular system: infrequently – extrasystole, arrhythmia, tachycardia, frequency is unknown – excessive decrease in blood pressure, orthostatic hypotension, collapse, deep vein thrombosis, thromboembolism, decrease in bcc.
From the respiratory system: infrequently – nosebleeds.
From the digestive system: often – diarrhea infrequently – abdominal pain, flatulence, polydipsia frequency unknown – dry mouth, nausea, vomiting, loss of appetite, pancreatitis, dyspeptic disorders, intrahepatic cholestasis.
From the urinary system: often – an increase in the frequency of urination, polyuria, nocturia infrequently – increased urination frequency is unknown – oliguria, urinary retention (in patients with obstruction of the urinary tract), interstitial nephritis, hematuria.
From the reproductive system: frequency unknown – decreased potency.
From the skin and subcutaneous tissues: frequency unknown – itching, rash, urticaria, polymorphic erythema, exfoliative dermatitis, purpura, vasculitis, photosensitivity.
From the musculoskeletal system: the frequency is unknown – muscle weakness.
From the side of metabolism: the frequency is unknown – hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia, hypochloremia, metabolic alkalosis, hypovolemia, dehydration (more often in elderly patients).
On the part of laboratory indicators: infrequently – hypercholesterolemia, hypertriglyceridemia, frequency is unknown – hyperuricemia, a slight increase in the activity of alkaline phosphatase in the blood plasma, an increase in the concentration of creatinine and urea in the blood plasma, an increase in the activity of some liver enzymes in the blood plasma (for example, GGT), thrombocytopenia, leukopenia, , agranulocytosis, hyperglycemia, decreased glucose tolerance (possible manifestation of latent diabetes mellitus).
Other: frequency unknown – aplastic or hemolytic anemia.
Drug Interaction
Increases concentration and risk of nephro- and ototoxic effects of cephalosporins, aminoglycosides, chloramphenicol, ethacrynic acid, cisplatin, amphotericin B (due to competitive renal excretion).
Increases the efficiency of diazoxide and theophylline, decreases – hypoglycemic agents, allopurinol.
Press amines and torasemide mutually reduce the effectiveness of each other.
Drugs that block canal secretion increase the concentration of torasemide in the serum.
With the use of ACS, amphotericin B increases the risk of hypokalemia, with cardiac glycosides – increases the risk of glycosidic intoxication due to hypokalemia (for high- and low-polar) and lengthening of T1 / 2 (for low-polar).
Reduces the renal clearance of lithium drugs and increases the likelihood of intoxication.
NSAIDs, sucralfate reduces the diuretic effect due to the inhibition of prostaglandin synthesis, impaired plasma renin activity, and elimination of aldosterone.
Enhances the antihypertensive action of antihypertensives, neuromuscular blockade of depolarizing muscle relaxants (suxamethonium) and attenuates the effect of non-depolarizing muscle relaxants (tubocurarin).
Co-administration of high-dose salicylates against torasemide increases the risk of their toxicity (due to competitive renal excretion).
Sequential or co-administration of torasemide with ACE inhibitors or angiotensin II receptor antagonists can lead to a significant decrease in blood pressure. This can be avoided by lowering the dose of torasemide or temporarily discontinuing it.
Concomitant administration of probenecid or methotrexate may impair the effectiveness of torasemide (the same route of secretion). Torasemide, on the other hand, can reduce the renal elimination of these drugs.
The combined use of cyclosporine and torasemide increases the risk of developing gouty arthritis due to the fact that cyclosporine can cause impaired urinary excretion by the kidneys and torasemide causes hyperuricemia.
It has been reported that patients with a high risk of developing nephropathy taking torasemide orally, with the introduction of radiopaque agents, renal dysfunction was observed more frequently than patients with a high risk of developing nephropathy who were treated with / before hypo-contrast.
Bioavailability and, as a consequence, the efficacy of torasemide may be impaired when co-administered with cholestyramine.
overdose
Symptoms: increased diuresis, accompanied by a decrease in BCC and impaired water-electrolyte blood balance, followed by an excessive decrease in blood pressure, drowsiness and confusion, collapse. Gastrointestinal disorders may occur.
Treatment: There is no specific antidote. Vomiting provocation, gastric lavage, activated charcoal. Conducting symptomatic therapy, reducing the dose or discontinuing the drug and simultaneously replenishing BCC and indicators of water-electrolyte balance and acid-base state under the control of serum concentrations of electrolytes, hematocrit. Hemodialysis is ineffective.
Storage conditions
The drug should be stored out of the reach of children, in a dry, dark place at a temperature of no higher than 25 ° C.
The Expiration of
is 3 years.
Active substance
Torasemide
pharmacy terms and conditions for prescription
Northern Star, Russia p1966duct4 Single Star, Russian
