Torsemide belongs to a group of medications known as the loop diuretics. Loop diuretics act in the kidney to remove excess water from the blood, by causing an increase in the removal of salts such as potassium and sodium. This removal of salts causes water to be drawn out of the blood and into the kidneys, where it is then excreted in the urine. Removing water from the blood causes a decrease in the volume of fluid circulating through the blood vessels. This drop in fluid volume decreases the effort required by the heart to pump blood around the body. There are many conditions which may lead to an accumulation of fluid in the body (oedema). Torsemide is commonly used in conditions such as heart failure, where the pumping mechanism of the heart is less effective. It is used to relieve the symptoms of heart failure, such as the shortness of breath seen with fluid on the lungs. At higher doses the amount of water drawn from the blood into the urine is much greater, therefore torsemide is also used when there is reduced production of urine in patients with kidney failure, and liver failure. Torsemide is also used at lower doses in the management of hypertension. What is it used for? • Excess fluid retention causing swelling (oedema) due to any cause • High blood pressure (hypertension)

Demadex Side Effects:

Warning! • It is recommended that individuals taking this medicine have their fluid and salt (electrolyte) balance monitored regularly. • If you experience any of the following symptoms while taking this medicine you should inform your doctor promptly, so that the amount of fluids and salts in your body can be checked: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting. • As diuretics cause your kidneys to produce more urine, you may prefer to take this medicine in the morning rather than before going to bed, as this will reduce the likelihood of you needing to get up in the night to visit the toilet. Seek further advice from your doctor or pharmacist. • The levels of uric acid, glucose, creatine and lipids in the blood should be monitored with long term use of this medicine. Use with caution in • Diabetes • Gout • Low blood potassium levels (hypokalaemia) • Low blood sodium levels (hyponatraemia) • Low volume of circulating blood (hypovolaemia) • Obstruction of the urinary tract (urethra) Not to be used in • Allergy to medicines from the sulphonamide group, eg the antibiotic sulphamethoxazole • Breastfeeding • Kidney failure, preventing production of urine (anuria) • Liver disease that is causing the patient to become unconscious (precomatose state) • Low blood pressure (hypotension) • Pregnancy This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately. Pregnancy and Breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine. • This medicine should not be used in pregnancy. Seek medical advice from your doctor. • There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor. Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect. • Dry mouth • Low blood potassium level (hypokalaemia) • Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain • High blood glucose level (hyperglycaemia) • High blood uric acid level (hyperuricaemia) which can cause kidney problems and gout • Pins and needles (paraesthesia) • Change in the amount of fats in the blood • Disturbances in the levels of chemical components (electrolytes) in the blood The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist. How can this medicine affect other medicines? Torsemide causes a loss of potassium (hypokalaemia) from the blood, which may increase the risk of adverse effects when taken with cardiac glycosides such as digoxin. Corticosteroids such as hydrocortisone may also cause potassium loss, therefore severe depletion may occur if they are used with torsemide. When torsemide is taken together with medicines that decrease blood pressure there is an increased risk of a large drop in blood pressure and fainting, especially when given with the first dose of ACE inhibitors (eg. captopril). The blood pressure lowering and diuretic effects of torsemide may be reduced or abolished when used together with indomethacin and possibly other non-steroidal anti-inflammatory medications (NSAID's).