General information

High blood pressure is a serious health condition. According to statistics this condition usually results in the majority of severe health disorders leading to such fatal outcomes as: stroke, hypertensive crisis, acute cardiac insufficiency, heart attack, acute renal insufficiency.

High blood pressure is traditionally treated by using specific medications. However, despite the huge range of modern medicine, the number of victims of hypertension syndrome is constantly growing. In ought to be said that the administration of those medications is often accompanied by the following undesired reactions: dizziness, palpitations, fatigue, indigestion, legs swelling and even sexual disorders. It should be said that the drugs action is mostly aimed at eliminating the symptoms of the disease, and not at the mechanisms underlying the development of this insidious disease.

There are a number of preventive measures aimed at preventing the development of this disease. These include:

• reduce salt intake;
• balanced nutrition;
• avoiding the harmful use of alcohol;
• regular physical activity;
• maintaining a healthy body weight;
• quitting tobacco use.

The main pathogenetic mechanism and the main clinical symptom of congestive cardiac failure is sodium and fluid retention, which leads to so called edematous syndrome development.

It is evidenced that the kidney function also affects the vascular tone, and in the case of the pathology or disorder of this internal organ, the pressure may increase. Renin – it is a biologically active substance which is generated by the disordered nephros resulting in the artery wall muscles overdrive and, as consequence, leading to hypertension development.

That is why it is very important to keep healthy life style and regularly check blood pressure at the age of over 40. In case if the problem is already diagnosed it is vitally important to follow all recommendations given by attending physicians and take prescribed medications aimed at pressure stabilization.

There are a lot of antihypertensive medications of new class appearing in the market. They are mainly aimed at the source of high pressure.
One of those agents is Demadex (active ingredient – Torsemide), which is one of the most effective medication among modern diuretics. Demadex belongs to the group of loop diuretics. The bioavailability of the discussed substance is several times higher than that of Furosemide. This mendication is 80% metabolized in hepatocytes, so that renal insufficiency has almost no impact on the pharmacodynamic properties of this agent.

The greatest therapeutic effect is observed in two-three hours and can last around 18 hours. It starts acting immediately; the patient does not feel frequent urination. This is a positive thing, because everyday life of the individual is not limited. The substance is almost completely absorbed by the gastrointestinal tract. Its maximum level in blood serum is reached in two-three hours. The bioavailability is very high, which usually amounts to 80-90%. It ought to be noticed that there can be minor deviations based on the individual characteristics of the person.

Precautions

This medication should never be given in case if the patient has any of the following disorders:

• anuria (no urine);
• liver coma or pre-coma;
• resistant hypokalemia;
• a disorder of the urine passage of any reason;
• resistant hyponatremia;
• severe dehydration;
• glycosidic intoxication;
• acute poststreptococcal glomerulonephritis;
• sensitivity to Torsemide, sulfanilamide or intolerance to auxiliary ingredients.
• Also it has to be said that this drug should never be used by children / teenagers;
• Pregnancy is also a contraindication for this medicine use.

All above mentioned precautions and contraindications should be strictly observed before start using this medication.

Torsemide Dosage

• The amount of this drug depends on the disorder severity and ranged between 5 – 20 mg a day.
• It should be said that a single amount of the agent should not exceed 40mg.

How to take Torsemide?

The pill is administered orally once a day, washing down with plenty of fluid. A pill is taken without chewing, at any time, regardless of the meal.

Torsemide Side-effects

As practically all medications this one also has recorded side effects, which include the following:

• Metabolic disorders: Hyper-triglyceridemia, hypercholesterolemia, polydipsia.
• Nervous disorders: drowsiness, dizziness, fainting, leg muscular cramps, cephalgia, stupefaction, limbs paresthesias.
• Cardiovascular disorders: excessive heart rate, extrasystole, rapid heartbeat, facial flushing, thrombembolia, deep venous thrombosis, hypovolemia disorder, hypotension.
• Respiratory disorders: nosebleeds.

Overdose

Overdose is possible in case of uncontrolled administration and unauthorized dose increase. Overdose symptoms are manifested by indigestion, too much urination, a decrease in circulating blood volume. Also registered overdose symptoms are: frequent urination, dehydration, hypotension, drowsiness, confusion, cardiovascular insufficiency, digestive disorders.

In case of overdose it is recommended to wash the stomach and stimulate vomiting. In severe cases, it is important to lay down the patient horizontally, provide the sufficient inflow of air, and ensure the recovery of the lost fluid by introducing special solutions. Sometimes it may require the introduction of hormonal drugs. There is no definite antidote, nor is there any indication for hemodialysis. Be sure to reduce the dose or cancellation of the medication – depending on the severity of symptoms.

Interactions

Simultaneous intake of Torsemide and other medicines may affect its effectiveness or enhance the risk of unexpected reactions development. It is advisable to make a list of constantly taken drugs (this also includes dietary supplements, herbs as well as vitamins) and show it to the doctor before prescription of a new medicine. Perhaps the doctor will recommend the individual to change the medication amount or to closely check the possible adverse reactions when they are taken. During use of the substance, it is undesirable to start taking a new substance or change the amount or stop taking the old one without first consulting a doctor.

• It is evidenced that in case of potassium or magnesium deficiency Torsemide enhances the reaction of the cardiac muscle to cardiac glycosides.
• The potassium excretion increase is possible if it is taken together with minerals and glucocorticoids, purgatives.
• This agent enhances the impact of antihypertensive medications.
• If taken in excessive amounts, it is able to enhance the harmful effect of such substances as antibacterial agents, aminoglycosides, cisplatin; it also may enhance nephrotoxic impact of cephalosporins.

Long-term or simultaneous intake of Demadex together with angiotensin-converting-enzyme (ACE) inhibitors can result in a temporary blood pressure decrease. In order to avoid such effect it is recommended to reduce the initial amount of ACE, or reduce the Torsemide amount (or even terminate its intake for a while).

The discussed agent reduces the vasoconstrictor agents effect (epinephrine and norepinephrine).

Torsemide and Alcohol interaction

Any doctor will tell you: if you take pills, it is better not to drink alcohol at all. In the information leaflet attached to many drugs it is usually indicated in such frightening formulations “enhances the impact of ethanol,” “increases the stomach bleeding risk”, and so on. These are not just words. All those warnings are factually based.

Moreover, alcohol in combination with pharmaceutical products can both slow down the effectiveness of drugs, and increase many times over. Furthermore it can even generally result in unexpected consequences.

The most dangerous combinations when pressure pills, sleeping pills, anti-depressants, as well as muscle relaxants and painkillers are taken with alcohol. Consequences of such combinations can be not just unpredicted and unexpected but even fatal.

Diuretics and Torsemide in particular, are incompatible with alcohol. Such a combination can cause side reactions, manifested in the most severe form.

Torsemide Reviews

Below there are some comments and feedback related to use of the discussed medicine provided by both physicians and medication users.

Cardiologist: I always say to my patient that self-prescribing drugs can result in the undesirable side effects, complications development, leading to fatal result!

Furthermore I always recommend while taking this drug follow a diet rich in magnesium and potassium: regularly use sunflower seeds, dried apricots, potatoes, bananas. It is possible to use potassium and magnesium preparations, which should be prescribed only by the attending physician.

If there are manifestations of dryness in the mouth, severe thirst, weakness, drowsiness, cramps, you need to see a doctor as soon as possible.

Victor: I am a doctor. I myself take Torsemide and recommend it to my patients as a diuretic. These days there are a lot of hypertension sufferers, so using this drug gives a double benefit: it is a diuretic and hypertensive substance. In addition, the mild effect of the drug does not cause discomfort.

Viola: I am very pleased with the mild effect of the drug. I was prescribed a dose of 10 mg for treating edema resulted from high pressure. It is very convenient that it is used in a single dose – I took it during meal in the morning and there was no need to keep in mind another dose. Also I appreciated that there was no constant running around in the toilet, and the result is noticeable. Swelling is decreasing. It can also be used for a long time.

Vera: Despite the fact that Demadex is difficult to call a cheap medicine, I was satisfied with its action – the pressure returned to normal, I stopped feeling my heart, in general, my condition improved.

Oliver: This diuretic was taken by my mom when she had kidney problems. Due to this disorder the fluid accumulated in her body, resulting in edema. Doctors have advised these pills. At first we used natural home remedies, but then we switched to pills, since natural home remedies did not help. The drug really helps, mum has taken it for two weeks, and stopped taking when the situation was adjusted.