Hirshom WI, Taylor RG, Sheehan JC. Arrhythmias produced by combinations of halothane and small amounts of vasopressor. Your doctor may need to adjust your medication or diet. Impaired effectiveness and possible delayed excretion of loop diuretics may occur in patients with severe renal dysfunction. These individuals may require high dosages that are associated with an increased risk of electrolyte abnormalities hyponatremia, hypochloremic alkalosis, hypokalemia, hypomagnesemia, hypocalcemia and ototoxicity tinnitus, hearing loss. Therapy with loop diuretics should be administered cautiously in patients with significantly impaired renal function. Prolongation of the dosing intervals may be appropriate to prevent drug accumulation. The patient should be monitored closely for the signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Excessive diuresis should be avoided as it may induce dehydration and hypovolemia, which can result in an abrupt reduction in glomerular filtration and renal blood flow. If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, or if renal function becomes progressively worse as indicated by rising BUN or serum creatinine levels, an interruption or discontinuation of therapy should be considered. buy metronidazole us
Tinnitus and hearing loss usually reversible have been observed with loop diuretics, including Demadex. Higher than recommended doses, severe renal impairment, and hypoproteinemia, appear to increase the risk of ototoxicity. Initially, 5 mg once daily. Hospitalization of the patient during initiation of therapy is advisable for patients with hepatic cirrhosis and ascites or chronic renal failure. Most renal clearance of torsemide occurs via active secretion of the drug by the proximal tubules into tubular urine.
The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. What are the side effects of bumetanide? Your condition may be treated with a combination of drugs. Use all medications as directed by your doctor. Do not change your doses or medication schedule without your doctor's advice.
If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up carefully. These considerations may guide selection of therapy. Demadex can cause sudden alterations of fluid and electrolyte balance which may precipitate hepatic coma in patients with hepatic disease with cirrhosis and ascites. In these patients, diuresis with Demadex is best initiated in the hospital.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. Roche Pharmaceuticals. Demadex torsemide tablets and injection prescribing information. Nutley, NJ: 2003 Apr. Safety and effectiveness in pediatric patients have not been established. Concomitant use of torsemide and cholestyramine has not been studied in humans but, in a study in animals, coadministration of cholestyramine decreased the absorption of orally administered torsemide. If Demadex and cholestyramine should be coadministered, administer Demadex at least one hour before or 4 to 6 h after cholestyramine administration. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Therapy in such patients is best initiated in the hospital. 1 14 Use an aldosterone antagonist or potassium-sparing agent concomitantly with torsemide to prevent hypokalemia and metabolic alkalosis in such patients. American Regent announces increased production and availability of torsemide injection. If adequate response not observed with 10 mg once daily, an additional antihypertensive agent should be added to antihypertensive therapy. Constipation; dizziness or lightheadedness when sitting up or standing; excessive urination; headache; increased cough; nasal inflammation; nausea. Therapeutic Equivalence-Related Terms, Pharmaceutical Equivalents generally will be coded AB if a study is submitted demonstrating bioequivalence.
In patients with decompensated heart failure, hepatic and renal clearance are reduced, resulting in delivery of less drug to the intraluminal site of action and decreased natriuretic effect. 1 12 13 14 Total clearance is about half of that of healthy individuals; half-life and AUC increased. There are no available data on use of Demadex in pregnant women and the risk of major birth defects or miscarriage. Demadex is indicated for the treatment of edema associated with heart failure, renal disease or hepatic disease. Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension for example, patients with diabetes or hyperlipidemia and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs. The pharmacokinetic profile and diuretic activity of torsemide are not altered by cimetidine. Safety and efficacy not established. Do not take other medicines unless they have been discussed with your doctor. This especially includes prescription or nonprescription over-the-counter medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems. lotrisone
Some of the side effects that can occur with torsemide may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Check with your pharmacist about how to dispose of unused medicine. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Not known whether torsemide is distributed into milk. 1 12 13 14 Caution if used in nursing women. Gupta D, Georgiopoulou VV, Kalogeropoulos AP et al. Dietary sodium intake in heart failure. Circulation. The recommended initial dose is 5 mg or 10 mg oral Demadex once daily, administered together with an aldosterone antagonist or a potassium-sparing diuretic. If the diuretic response is inadequate, titrate upward by approximately doubling until the desired diuretic response is obtained. Doses higher than 40 mg have not been adequately studied in this population. It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood or urine tests may be needed to check for unwanted effects. May cause side effects to become worse. Do not stop taking any medications without consulting your healthcare provider. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider. Torsemide is a "water pill" that causes you to make more urine. This helps your body get rid of extra water and salt. Risk of hypokalemia, especially with brisk diuresis, with inadequate oral electrolyte intake, in those with cirrhosis, or during concomitant use of corticosteroids or ACTH. 1 12 Risk of arrhythmias secondary to hypokalemia in patients with cardiovascular disease, especially those receiving concomitant therapy with a cardiac glycoside. To help you remember to take your medicine, try to get into the habit of taking it at the same time each day. online cetirizine information cetirizine
Maximum of 200 mg as a single dose daily. US Food and Drug Administration FDA. Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Fetal and maternal toxicity decrease in average body weight, increase in fetal resorption and delayed fetal ossification occurred in rabbits and rats given doses 4 rabbits and 5 rats times larger. Increase as necessary by approximately doubling daily dosage until desired diuresis is attained. 1 12 Single doses exceeding 200 mg not adequately studied. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; chest pain; dizziness; irregular heartbeat; pain, redness, or swelling at the injection site; severe headache. It is unknown if this drug passes into milk. Consult your doctor before -feeding. Another problem is the severe leg cramps. They strike without warning and are bad enough to take my breath away. After several months of being on Demadex, my lags and ankles are swollen twice their normal size. Known hypersensitivity to torsemide or to sulfonylureas. No mutagenic activity was detected in any of a variety of in vivo and in vitro tests of torsemide and its major human metabolite. The tests included the Ames test in bacteria with and without metabolic activation tests for chromosome aberrations and sister-chromatid exchanges in human lymphocytes, tests for various nuclear anomalies in cells found in hamster and murine bone marrow, tests for unscheduled DNA synthesis in mice and rats, and others. Torsemide does not affect the protein binding of glyburide or warfarin. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Disclaimer: Every effort has been made to ensure that the information provided by Multum, Truven Health Analytics, Inc. generic glucotrol with prescription
Demadex is a strong "water pill" diuretic. Using too much of this drug can lead to serious water and mineral loss. Therefore, it is important that you be monitored by your doctor. Should not be used in patients with these conditions. In healthy subjects, coadministration of torsemide was associated with significant reduction in the renal clearance of spironolactone, with corresponding increases in the AUC. However, the pharmacokinetic profile and diuretic activity of torsemide are not altered by spironolactone. Possible increased blood glucose concentrations; hyperglycemia occurred rarely. Administer orally without regard to meals. Ask your health care provider any questions you may have about how to use Demadex. Symptoms may include confusion; dizziness; dizziness or lightheadedness when sitting up or standing; dry mouth; excessive urination followed by a decrease in the amount of urine; muscle cramps or weakness; rapid or irregular heartbeat.
Demadex may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Demadex with caution. Excessive diuresis may cause potentially symptomatic dehydration, blood volume reduction and hypotension and worsening renal function, including acute renal failure particularly in salt-depleted patients or those taking renin-angiotensin aldosterone inhibitors. No clinically important effects on hemoglobin; hematocrit; WBC, erythrocyte, or platelet counts; or serum alkaline phosphatase concentrations. Demadex into the proximal tubule and thereby decreases the diuretic activity of Demadex. Monitor diuretic effect and blood pressure during coadministration. The other loop diuretic, when administered during the first weeks of life, has also been reported to increase the risk of persistent patent ductus arteriosus. The use of Demadex in such patients has not been studied. American Regent. Torsemide injection prescribing information. Shirley, NY: 2009 Dec. Keep out of the reach of children. Management of hypertension alone or in combination with other classes of antihypertensive agents. Torsemide is metabolized by the hepatic cytochrome CYP2C9 and, to a minor extent, CYP2C8 and CYP2C18. Three main metabolites have been identified in humans. Metabolite M1 is formed by methyl-hydroxylation of torsemide, metabolite M3 is formed by ring hydroxylation of torsemide, and metabolite M5 is formed by oxidation of M1. The major metabolite in humans is the carboxylic acid derivative M5, which is biologically inactive. Metabolites M1 and M3 possess some pharmacological activity; however, their systemic exposures are much lower when compared to torsemide. In long-term studies, no clinically important differences in lipid profiles compared to baseline. In patients with hepatic cirrhosis, the volume of distribution, plasma half-life, and renal clearance are all increased, but total clearance is unchanged. Importance of informing patients with diabetes mellitus that blood glucose concentrations may increase. For these reasons, FAERS case reports cannot be used to calculate incidence or estimates of risk for a particular product or compare risks between products. Not considered a preferred agent for initial management of hypertension; 501 502 503 504 however, may be useful in selected patients with renal impairment 500 502 504 or heart failure. dramamine brand reviews
Risks associated with excessive fluid loss or electrolyte imbalance. In the placebo-controlled hypertension studies excessive urination was dose related; 1% of patients receiving placebo, 4% of those treated with 5 mg of daily Demadex, and 15% of those treated with 10 mg. Excessive urination was generally not reported as an adverse event among patients who received Demadex for cardiac, renal, or hepatic failure. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. In controlled studies in the United States, Demadex was administered to hypertensive patients at doses of 5 mg or 10 mg daily. Kaufman L. Unforeseen complications encountered during dental anaesthesia. Cardiac arrhythmias during dental anaesthesia. cpol.info epogen
For direct IV injection, administer slowly over a period of 2 minutes. Additional monitoring of your dose or condition may be necessary if you are presently taking ketanserin. Some MEDICINES MAY INTERACT with Demadex. Seizures reported in patients with acute renal failure receiving higher than recommended dosages of torsemide. Demadex can be used alone or in combination with other antihypertensive agents. In patients with renal failure, renal clearance of torsemide is markedly decreased but total plasma clearance is not significantly altered. A smaller fraction of the administered dose is delivered to the intraluminal site of action, and the natriuretic action of any given dose of diuretic is reduced. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs. Meda Demadex torsemide tablets prescribing information. Somerset, NJ: 2010 Feb. Increase as necessary by approximately doubling dosage until desired diuresis is attained. 1 12 14 Single doses exceeding 200 mg not adequately studied. alavert
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The recommended initial dose is 20 mg oral Demadex once daily. If the diuretic response is inadequate, titrate upward by approximately doubling until the desired diuretic response is obtained. Doses higher than 200 mg have not been adequately studied. At first, 10 or 20 milligrams mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 200 mg per day. Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough. toprol
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. Increase as necessary by approximately doubling dosage until desired diuresis is attained. 12 13 14 Single doses exceeding 40 mg not adequately studied. Wallbank WA. Cardiac effects of halothane and adrenaline in hare-lip and cleft- palate surgery. Alexander JP, Bekheit S, Fletcher E. Dysrhythmia and oral surgery. II. Junctional rhythms. shoppers drug mart avelox price
Not known whether torsemide is distributed into milk. In geriatric patients, decreased renal clearance. Olesen OV, Jensen ON. The influence of folic acid on phenytoin DPH metabolism and the 24- hours fluctuation in urinary output of 5-p-hydroxyphenyl-5 phenyl- hydantoin HPPH.
Our Demadex Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. May use IV administration when a rapid onset of diuresis is desired or when oral therapy is not practical. Demadex is to be used only by the patient for whom it is prescribed. Do not share it with other people. Torsemide increases the urinary excretion of sodium, chloride, and water, but it does not significantly alter glomerular filtration rate, renal plasma flow, or acid-base balance.