Torasemide compared to other diuretics Review article
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Abstract
Loop diuretics remains a cornerstone of therapy for symptomatic patients with chronic kidney disease and chronic heart failure. The apparent mortality and cardiac benefits seen in studies comparing torasemide with furosemide in CHF suggest that torasemide may have beneficial effects beyond diuresis. It has been reported that torasemide but not furosemide, may block the renin-angiotensin-aldosterone system by inhibiting the binding of aldosterone to its receptor and therefore it might attenuate myocardial remodeling accompanied by left ventricular dysfunction. Furthermore, torasemide is associated with a trend in reducing all-cause mortality. Torasemide is also frequently used for the treatment of hypertension. It has been shown to have less inter- and intra-individual variation in bioavailability and a longer duration of action compared with furosemide. Thus combines the effectiveness of loop diuretics with the convenient diuretic profile of thiazides. A broad dose range have been implemented for different indication starting with 2,5–5 mg for hypertension, 5–10 mg for chronic heart failure up to 200 mg for the treatment in overhydrated patients with chronic kidney failure or on dialysis. These low but effective doses are responsible for the safety profile of torasemide with only small and transient changes in serum electrolytes.
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