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Torsemide

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

By mouth

Torsemide is used to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney disease. It belongs… Read more

Brand names include: Demadex

By injection

Torsemide belongs to the group of medicines called loop diuretics. Torsemide is given to help reduce the amount of water in the body associated with congestive… Read more

Brand names include: Demadex

Drug classes About this
Cardiovascular Agent

What works? Research summarized

Evidence reviews

Should torsemide be the loop diuretic of choice in systolic heart failure?

Furosemide is the most widely prescribed loop diuretic in the setting of systolic heart failure (HF), yet torsemide has been shown to have less inter- and intra-individual variation in bioavailability and a longer duration of action compared with furosemide. Thus, a systematic review and meta-analysis of randomized controlled trials comparing torsemide versus furosemide in patients with systolic HF using OVID MEDLINE, Excerpta Medica (Embase), Web of Science, PubMed and Google Scholar was performed. Extracted data included study design, sample characteristics, intervention, outcomes and control for potential confounding factors. A DerSimonian and Laird random-effects model was used to compute summary risk ratios for HF and cardiovascular (CV) readmission outcomes. Two randomized trials comparing furosemide with torsemide in 471 patients with systolic HF were identified. Compared to furosemide, torsemide significantly reduced total HF readmissions (relative risk [RR]: 0.41, 95% CI: 0.28-0.61, p < 0.0001) and HF readmissions (RR: 0.53, 95% CI: 0.33-0.84, p = 0.008) as well as CV readmissions (RR: 0.77, 95% CI: 0.60-0.98, p = 0.03) in patients with "at least 1 readmission." Moreover, compared with furosemide, torsemide caused a 14% reduction in all-cause mortality (RR: 0.86 [0.53-1.39], p = 0.54). Compared with furosemide, torsemide significantly reduces HF and CV-related hospital readmissions in systolic HF. Furthermore, torsemide is associated with a trend in reducing all-cause mortality.

Loop diuretics for patients receiving blood transfusions

Blood transfusions are often complicated by water retention, which may worsen lung function, heart function and/or kidney function. Loop diuretics, medications that reduce body water by making the kidneys excrete more urine, are thought to prevent water retention. Accordingly, many doctors pre‐medicate their blood transfusion recipients with loop diuretics.

Acute Heart Failure: Diagnosing and Managing Acute Heart Failure in Adults

The need for this guideline was identified as the NICE guidelines on chronic heart failure were being updated. We recognised at this time that there were important aspects of the diagnosis and management of acute heart failure that were not being addressed by the chronic heart failure guideline, which focussed on long term management rather than the immediate care of someone who is acutely unwell as a result of heart failure. The aim of this guideline is to provide guidance to the NHS on the diagnosis and management of acute heart failure.

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Summaries for consumers

Loop diuretics for patients receiving blood transfusions

Blood transfusions are often complicated by water retention, which may worsen lung function, heart function and/or kidney function. Loop diuretics, medications that reduce body water by making the kidneys excrete more urine, are thought to prevent water retention. Accordingly, many doctors pre‐medicate their blood transfusion recipients with loop diuretics.

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