Torsemide | Side Effects, Dosage, Uses & More
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Generic Name:

torsemide, Oral tablet

All Brands

  • Demadex
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Highlights for torsemide

Oral tablet
1

Torsemide is an oral drug used to treat high blood pressure and fluid retention (edema) caused by heart failure or liver or kidney disease.

2

The standard starting dose for fluid retention ranges from 5–20 mg taken once per day. The standard starting dose for high blood pressure is 5 mg taken once per day.

3

Common side effects include frequent urination, headache, cough, ringing in your ears, weakness, and excessive thirst.

4

This drug may cause low blood pressure that makes you feel dizzy or lightheaded when standing up from a sitting or lying position. This is called orthostatic hypotension.

5

You may have to make changes to your diet while you’re taking this drug. Ask your doctor about how much sodium and potassium you should eat.

IMPORTANT INFORMATION

Low blood pressure when standing

Torsemide may cause low blood pressure that makes you feel dizzy or lightheaded when standing up from a sitting or lying position (orthostatic hypotension). This may be more common after just starting this drug. You can avoid this by standing up slowly.

Ear problems

Torsemide may cause ringing in the ears and hearing loss. This is usually reversible once you stop taking the drug.

Dehydration and electrolyte loss

You should watch for symptoms of severe dehydration and electrolyte loss while taking torsemide. These include:

  • dry mouth
  • thirst
  • weakness
  • muscle pain or fatigue
  • nausea
  • vomiting

What is torsemide?

Torsemide is a prescription drug. It is available in these forms: oral and intravenous (IV), which is only given by a healthcare provider.

Torsemide is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

Torsemide may be taken in combination with other drugs.

Why it's used

Torsemide is used to treat high blood pressure. It’s also used to treat fluid retention (edema) due to conditions like heart, liver, or kidney disease.

How it works

Torsemide belongs to a class of drugs known as diuretics or water pills. A class of drugs is a group of medications that work in a similar way.

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How it works

Torsemide belongs to a class of drugs known as diuretics or water pills. A class of drugs is a group of medications that work in a similar way. They are often used to treat similar conditions.

Torsemide works by causing your kidney to excrete more water and electrolytes, including sodium chloride. This helps remove excess fluid (edema) and lowers your blood pressure.

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torsemide Side Effects

Oral tablet

More Common Side Effects

The most common side effects that occur with torsemide include:

  • frequent urination

  • headache

  • cough

  • sore throat

  • hearing loss

  • ringing in your ears

  • upset stomach

  • constipation

  • diarrhea

  • weakness

  • excessive thirst

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have any of these serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

  • dehydration. Symptoms include:

    • drowsiness
    • confusion
    • muscle weakness
    • fast heart rate
  • fast, unexplained weight loss

  • chest pain

  • trouble breathing or swallowing

  • blisters or peeling skin

  • hives, skin rash, or itching

  • vomiting blood

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Torsemide does not cause drowsiness.

It may make you urinate more often.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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torsemide May Interact with Other Medications

Oral tablet

Torsemide can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or cause the drugs that you take to not work as well. To help prevent interactions, your doctor should manage all of your medications carefully. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

The use of drinks that contain alcohol can increase your risk of low blood pressure and dizziness from torsemide. If you drink alcohol, talk to your doctor.

Medications that might interact with this drug

Salicylates

Torsemide can cause the levels of the salicylate in your blood to become dangerously high if you’re taking high doses of a salicylate. Your doctor will let you know if you can take these drugs together.

These drugs include:

  • aspirin

Cholestyramine

Cholestyramine may stop your body from absorbing the right amount of torsemide. If you’re taking cholestyramine, you should take it 4 hours before or 1 hour after torsemide.

Probenecid

Torsemide may not work as well if you’re also taking probenecid.

Lithium

If you’re taking lithium while taking torsemide, you may be at greater risk for lithium toxicity.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Torsemide warnings
liver disease
People with liver disease

Torsemide may cause fluid and electrolyte problems and possibly hepatic coma if you have liver disease. If you have liver problems, talk to your doctor about whether this drug is safe for you.  

gout
People with gout

Torsemide may cause you to have gouty episodes. Let your doctor know if you have gout.

heart disease
People with heart disease

This drug can lower your potassium levels. If this happens, you may have a higher risk for developing an abnormal heart rhythm while you’re taking torsemide. Your risk may be higher if you’re taking digoxin or corticosteroids, or if you have liver cirrhosis. Your doctor should monitor you for this.

diabetes
People with diabetes

Torsemide can increase blood sugar levels. This can worsen your diabetes control.

Pregnant women
Pregnant women

Torsemide is a pregnancy category B drug. That means two things:

  1. Studies of the drug in pregnant animals have not shown risk to the fetus.
  2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or plan to become pregnant. Torsemide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breast-feeding
Women who are breast-feeding

It isn’t known if torsemide passes into breast milk. If it does, it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

seniors
For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

children
For children

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years.

allergies
Allergies

Torsemide can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Don’t take this drug again if you’ve ever had an allergic reaction to it before. Taking it a second time after an allergic reaction could be fatal.

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How to Take torsemide (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Edema (fluid retention)

Brand: Demadex

Form: Oral tablet
Strengths: 5 mg, 10 mg, 20 mg, 100 mg

Generic: torsemide

Form: Oral tablet
Strengths: 5 mg, 10 mg, 20 mg, 100 mg
Adult dosage (ages 18–64 years)

To treat fluid retention due to:

  • congestive heart failure: The standard starting dose is 10 or 20 mg taken by mouth once per day. Your doctor may double your dose until your fluid retention is controlled. The maximum dose is 200 mg per day.
  • kidney failure: The standard starting dose is 20 mg taken by mouth once per day. Your doctor may double your dose until your fluid retention is controlled. The maximum dose is 200 mg per day.
  • liver disease: The standard starting dose is 5 or 10 mg taken by mouth once per day. You’ll take this drug with an aldosterone antagonist or potassium-sparing diuretic. Your doctor may double your dose until your fluid retention is controlled. The maximum dose is 40 mg per day. 
Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

High blood pressure (hypertension)

Brand: Demadex

Form: Oral tablet
Strengths: 5 mg, 10 mg, 20 mg, 100 mg

Generic: torsemide

Form: Oral tablet
Strengths: 5 mg, 10 mg, 20 mg, 100 mg
Adult dosage (ages 18–64 years)

The standard starting dose is 5 mg taken by mouth once per day. Your doctor may increase your dose to 10 mg after 4–6 weeks if needed.

Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Torsemide comes with serious risks if you don't take it as prescribed.

If you don't take it at all

If you don’t take your torsemide as prescribed for edema, your heart will work harder and you may have more trouble breathing due to fluid buildup.

If you’re taking this drug for high blood pressure, your blood pressure will stay high. This will raise your chance of having a stroke or heart attack.

If you stop taking it suddenly

Don’t stop taking torsemide without talking to your doctor. Stopping this drug suddenly can cause your blood pressure to spike. This may increase your chance for a heart attack or stroke. If you have heart failure, liver disease, or kidney disease, you may also have fluid buildup if you stop taking torsemide suddenly.

If you don't take it on schedule

Your blood pressure may not improve or may get worse. You may have a higher chance of a heart attack or stroke. If you have heart failure, liver disease, or kidney disease, you may experience fluid buildup.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours before the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

If you take too much

You may experience dehydration and a change in the amount of electrolytes in your blood. This can be dangerous. You may have the following symptoms:

  • weakness
  • fatigue
  • heart rate or rhythm problems (arrhythmia)

If you think you’ve taken too much of the drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room. 

How to tell this drug is working

If you’re taking this drug for edema, you may have less swelling or fluid retention. You won’t be able to feel torsemide working for high blood pressure, but your blood pressure will be lower.

Torsemide may be a short-term or long-term treatment for fluid retention. Torsemide is a long-term treatment for lowering blood pressure.

Important considerations for taking torsemide
timing
Take torsemide at the same time each day
crush or cut the tablet
You can crush or cut the tablet
storage
Store torsemide carefully
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refillable
Prescription is refillable
Travel
Travel
See Details
Self-management
Self-management
See Details
Clinical monitoring
Clinical monitoring
See Details
diet
Your diet
See Details
not usually stocked
Not every pharmacy stocks this drug. When refilling your prescription, be sure to call ahead
Hidden costs
Hidden costs
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Store torsemide carefully

  • Store torsemide at room temperature between 59°F (15°C) and 86°F (30°C).
  • Don’t freeze torsemide.
  • Keep it away from light.
  • Keep it away from high temperature.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt this medication.
  • You may need to show airport security staff the pharmacy prescription label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medicine in your glove compartment or leave it in the car, especially when the temperature is hot or freezing.

Self-management

You may need to check your blood pressure at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

You’ll need to purchase a home blood pressure monitor to check your blood pressure at home. You can purchase one at the pharmacy.

Clinical monitoring

While being treated with torsemide, your doctor will check your:

  • blood pressure
  • electrolyte levels
  • liver function 

Your diet

Your doctor may have you follow a specific diet, such as a low-salt or a high-potassium diet. Foods high in potassium include prunes, bananas, and orange juice.

Hidden costs

You may need to purchase a blood pressure monitor to check your blood pressure at home. These are available at most pharmacies.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.

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How Much Does torsemide Cost?

Oral tablet

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Lowest price for torsemide

Kroger Pharmacy $9.68
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These prices represent the lowest priced national pharmacies for torsemide on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for torsemide on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 21, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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