Torsemide

Torsemide is used alone or in combination with other medications to treat high blood pressure. Torsemide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, kidney, or liver disease. Torsemide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

High blood pressure is a common condition, and when not treated it can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Torsemide comes as a tablet to take by mouth. It usually is taken once a day. To help you remember to take torsemide, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take torsemide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Torsemide controls high blood pressure and edema but does not cure these conditions. Continue to take torsemide even if you feel well. Do not stop taking torsemide without talking to your doctor.

This medicine is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking torsemide,

• tell your doctor and pharmacist if you are allergic to torsemide, sulfonamide medications, any other medications, or any of the ingredients in torsemide tablets. Ask your pharmacist or check the patient information for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking torsemide. Your doctor may need to change the doses of your medications or monitor you carefully for side effects
• the following nonprescription products may interact with torsemide: aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking torsemide. Do not start any of these medications while taking torsemide without discussing with your healthcare provider.
• if you are taking cholestyramine (Questran), take it 4 hours before or 1 hour after toresemide.
• tell your doctor if you have or have ever had kidney disease. Your doctor may tell you not to take toresemide.
• tell your doctor if you have or have ever had diabetes, gout, heart, or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Do not breastfeed while taking this medicine. If you become pregnant while taking torsemide, call your doctor.
• you should know that torsemide may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking torsemide. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Alcohol can add to these side effects.

If your doctor prescribes a low-salt or low-sodium diet, or to eat or drink increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) in your diet, follow these instructions carefully.

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Tell your doctor if any of these symptoms are severe or do not go away:

• frequent urination
• cough
• constipation
• diarrhea
• hearing loss
• ringing in ears
• sore throat
• headache
• upset stomach

Some side effects can be serious. If you have any of these symptoms, call your doctor immediately or get emergency medical treatment:

• dry mouth; thirst; nausea; vomiting; weakness, tiredness; drowsiness; restlessness; confusion; muscle weakness, pain, or cramps; fast heartbeat and other signs of dehydration and electrolyte imbalance
• rapid, excessive weight loss
• vomiting blood
• chest pain
• difficulty breathing or swallowing
• blisters or peeling skin
• hives
• rash
• itching
• ongoing pain that begins in the stomach area, but may spread to the back

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medicine in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking torsemide.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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