Torsemide is a loop diuretic (water pill) that is used to treat fluid retention (edema) in people with heart failure, liver disease, or kidney disease.

Torsemide is also used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Torsemide may also be used for purposes not listed in this medication guide.

You should not use torsemide if you are allergic to sulfa drugs or if you are unable to urinate.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Torsemide oral is taken by mouth.

Torsemide injection is given as an infusion into a vein. A healthcare provider may teach you how to properly use the medication by yourself. Torsemide injection is given either as a slow infusion over 2 minutes, or as a continuous (around the clock) infusion.

If you have cirrhosis or other liver problems, you may receive your first injection in a hospital or clinic setting to quickly treat any serious side effects.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.

Prepare an injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

You may take torsemide with or without food.

Your blood pressure will need to be checked often, and you may need other medical tests. Your blood and urine may both be tested if you have been vomiting or are dehydrated.

Some things can cause your blood pressure to get too low. This includes vomiting, diarrhea, or heavy sweating. Call your doctor if you are sick with vomiting or diarrhea.

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 have high blood pressure, keep taking torsemide oral 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.

Store at room temperature away from moisture and heat.

Usual Adult Dose for Edema:

Edema Associated with Congestive Heart Failure:
IV and oral: 10 to 20 mg once a day; if diuresis remains inadequate, titrate upward by approximately doubling the dose until desired response is achieved; single doses higher than 200 mg have not been adequately studied.

Edema Associated with Renal Disease:
IV and oral: 20 mg once a day; if diuresis remains inadequate, titrate upward by approximately doubling the dose until desired response is achieved; single doses higher than 200 mg have not been adequately studied.

Edema Associated with Hepatic Disease:
IV and oral: 5 to 10 mg once a day together with an aldosterone antagonist or a potassium-sparing diuretic; if diuresis remains inadequate, titrate upward by approximately doubling the dose until desired response is achieved; single doses higher than 40 mg have not been adequately studied.

Comments: Chronic use of any diuretic in hepatic disease has not been studied adequately.

Usual Adult Dose for Hypertension:

5 mg orally once a day; if diuresis remains inadequate after 4 to 6 weeks, titrate up to 10 mg orally once a day; if diuresis remains inadequate with 10 mg, an additional antihypertensive should be added.

You should not use torsemide if you are allergic to it, or if:

• you are unable to urinate; or

• you are allergic to an oral diabetes medicine.

Tell your doctor if you have ever had:

• heart disease;

• kidney problems (unless you are taking torsemide for edema related to kidney disease);

• liver problems such as cirrhosis or hepatitis (unless you are taking torsemide for edema related to liver disease);

• gout;

• an allergy to povidone (sometimes contained in iodine, Betadine); or

• if you are on a low-salt diet.

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, tell your caregivers that you currently take torsemide.

Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether torsemide will harm an unborn baby. However, having high blood pressure during pregnancy may cause complications such as diabetes or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating hypertension may outweigh any risks to the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Torsemide is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Call your doctor for instructions if you miss a dose of torsemide injection.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include dehydration, an electrolyte imbalance (such as low levels of potassium, magnesium, or sodium in your blood), or low blood pressure and fainting.

Keep this medicine in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

If your doctor prescribes a low-salt or low-sodium diet, or to eat or drink increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) in your diet, follow these instructions carefully.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. 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.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

• a light-headed feeling, like you might pass out;

• ringing in your ears, sudden hearing loss;

• kidney problems--little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;

• low magnesium level--dizziness, irregular heartbeats, feeling jittery, muscle cramps, muscle spasms, cough or choking feeling;

• low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or

• low sodium level--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Common side effects of torsemide may include:

• increased urination; or

• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines. Many drugs can affect torsemide, especially:

• any other diuretic medicine;

• cholestyramine, lithium, phenytoin, probenecid, rifampin, warfarin (Coumadin, Jantoven);

• an intravenous (IV) antibiotic medicine;

• antifungal medicine--fluconazole, miconazole;

• heart or blood pressure medicine--amiodarone, dronedarone, enalapril, irbesartan, lisinopril, losartan, olmesartan, valsartan, and others;

• NSAIDs (nonsteroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

• salicylates--aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others or

• steroid medicine--dexamethasone, oxandrolone, prednisone, and others.

This list is not complete and many other drugs may affect torsemide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking torsemide.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.