Torsid (torasemide) tablets 10 mg. №90

Description

Torsid (torasemide) tablets 10 mg. №90

Composition

active substance: torasemide;

1 tablet contains torasemide anhydrous in terms of 100% substance 5 mg or 10 mg;

Excipients: lactose monohydrate, pregelatinized starch, colloidal anhydrous silica, magnesium stearate.

Dosage form

Tablets.

Main physical and chemical properties: tablets with a flat surface with a dash and bevel, white or almost white.

Pharmacotherapeutic group

Diuretics. Highly active diuretics.
ATX code C0ZS A04.

Pharmacological properties

The main mechanism of diuretic action is due to reverse binding to the Na + / 2Cl- / K + cotransporter in the apical part of Henle’s loop, as a result of which renal reabsorption of sodium and chlorine ions in the ascending part of Henle’s loop is reduced or completely suppressed, and the osmotic pressure of intracellular fluid and water reabsorption decrease. In the dose range of 5–100 mg, the increase in urine output is proportional to the logarithm of the dose. An increase in urine output also occurs when other diuretic drugs (for example, thiazides) no longer show a sufficient effect, for example, with limited renal function.
Eliminates edema, has an antihypertensive effect due to a decrease in peripheral vascular resistance by reducing the content of free calcium in the cells of the muscle layer of arteries and normalizing the disturbed electrolyte balance. As a result, the contractility and reaction of the vessels to the body’s own pressor substances, in particular catecholamines, decrease. Improves the working conditions of the heart by reducing pre- and afterload. After oral administration, the maximum diuretic effect lasts 1–3 hours, and the diuretic effect lasts for almost 12 hours. The hypotensive effect of torasemide develops gradually during the first week and reaches a maximum no later than 12 weeks.

Indications

Essential hypertension. Treatment and prevention of recurrence of edema and / or effusion due to heart failure.

Contraindications

Hypersensitivity to the active substance, to sulfonylurea preparations and to the auxiliary substances of the drug. Renal failure with anuria. Hepatic coma or precoma. Arterial hypotension. Hypovolemia. Hyponatremia. Hypokalemia. Significant violation of urination, for example, due to prostatic hypertrophy. Breastfeeding period.

Method of administration and dosage

Torsid tablets 10 mg take orally 1 time a day in the morning after meals, without chewing, with a small amount of liquid. The dose and duration of the course of treatment should be set individually, taking into account the indications, effectiveness and tolerability of therapy.
With essential hypertension. The usual dose is 2.5 mg of Torsid. If, after 12 weeks of therapy with the drug at a dose of 2.5 mg per day, the normalization of blood pressure is not achieved, the dose can be increased to 5 mg. A further increase in the dose is impractical, since this will not lead to a further decrease in blood pressure.

Children

Torsid tablets 10 mg should not be used in children due to the lack of sufficient clinical experience.

Overdose

The typical symptoms are unknown. Overdose can cause severe diuresis, including the risk of excessive loss of water and electrolytes, drowsiness, amentive syndrome (a form of impaired consciousness), symptomatic hypotension, cardiovascular failure, and disorders of the digestive system.
Overdose treatment. The specific antidote is unknown. Symptoms of intoxication disappear, as a rule, when the dosage is reduced and the drug is discontinued and with appropriate replacement of fluid and electrolytes (it is necessary to monitor the level of electrolytes in the blood). Torasemide is not cleared from the blood by hemodialysis. Treatment for hypovolemia is fluid volume replacement. Treatment in case of hypokalemia: administration of potassium supplements. Treatment of cardiovascular failure: supine position of the patient and, if necessary, prescribe symptomatic therapy.
Anaphylactic shock (emergency measures). At the first appearance of skin reactions (such as, for example, urticaria or redness of the skin), an agitated state of the patient, headache, sweating, nausea, cyanosis, vein catheterization should be performed; give the patient a horizontal position, provide free air flow, prescribe oxygen. If necessary, use the introduction of epinephrine, solutions that replace the volume of fluid, glucocorticoid hormones.

Side effects:

• Metabolism / electrolytes. Often: increased metabolic alkalosis. Muscle spasms (especially at the beginning of treatment), indigestibility of food, flatulence, urge to urinate, skin rashes. An increase in the concentration of uric acid and glucose in the blood, as well as cholesterol and triglycerides. Hypokalemia with concomitant potassium-free diet, vomiting, diarrhea, after excessive use of laxatives, as well as in patients with chronic liver dysfunction. Depending on the dosage and duration of treatment, disturbances in water and electrolyte balance are possible, for example, hypovolemia, hypokalemia and / or hyponatremia. With significant losses of fluid and electrolytes as a result of increased urination, hypotension, headache, fatigue, drowsiness may occur, especially at the beginning of treatment and in elderly patients.
• On the part of the cardiovascular system. Very rare: due to possible blood thickening, thromboembolic complications, confusion, arterial hypotension, as well as circulatory and cardiac disorders, including ischemia of the heart and brain, can occur, which can lead, for example, to arrhythmias, angina pectoris, acute myocardial infarction , syncope.
• From the digestive system. Often: disorders of the digestive system (especially at the beginning of treatment), including lack of appetite, stomach pain, nausea, vomiting, diarrhea, constipation. Very rare: pancreatitis.
• From the kidneys and urinary tract. Sometimes: increased concentration of creatinine and blood urea. In patients with urinary disorders (such as prostatic hypertrophy), increased urine production can lead to urinary retention and excessive distension of the bladder.
• From the liver. Often: an increase in the concentration of certain liver enzymes (gamma-glutamyl transpeptidase) in the blood.
• From the immune system. Very rare: allergic reactions such as pruritus, exanthema, photosensitivity, severe skin reactions.
• On the part of the blood and hematopoietic system. Very rare: a decrease in the number of platelets, erythrocytes and / or leukocytes as a result of hemoconcentration.
• General manifestations and reactions at the injection site. Often: headache, dizziness, increased fatigue, general weakness (especially at the beginning of treatment). Sometimes: dry mouth, discomfort in the limbs (paresthesia). Very rare: visual impairment, tinnitus, hearing loss, hearing loss.