The arsenal of therapist: torasemide

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Abstract

We performed the comparison of the pharmacological characteristics and clinical efficacy between furosemide and torasemide in patients with arterial hypertension, chronic heart failure (CHF), chronic kidney disease and in patients with ascites and cirrhosis. Antidiuretic mechanism of action of torasemide is similar to that of furosemide, but torasemide has a higher bioavailability (>80%) and a longer half-life (3-4 h). The administration of torasemide once a day at doses of 2.5-5 mg reduces diastolic blood pressure to a target BP of less than 90 mm Hg in 70-80% of patients. Antihypertensive efficacy of torasemide is similar to that of thiazides and thiazide-like diuretics. The administration of torasemide once a day at doses of 5 to 20 mg gives the effective diuretic action in patients with CHF. In CHF patients the bioavailability of torasemide is slightly reduced, diuretic action is smooth. Torasemide causes less potassium loss and rebound effect. Total and cardiovascular mortality in patients receiving torasemide is lower (2.2% vs 4.5% of the comparison group); p<0.05. Torasemide pharmacokinetic parameters are not changed in stages III (glomerular filtration rate - GFR 30 - 59 ml/min) and IV (GFR 15-29 ml/min) chronic kidney disease. Torasemide and furosemide therapy is accompanied by a comparable increase of natriuresis and lowering blood pressure in patients with chronic kidney disease.

About the authors

A. A Kirichenko

Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation

Email: andrey.apollonovich@yandex.ru
д-р мед. наук, проф., зав. каф. терапии ГБОУ ДПО РМАПО 125995, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1

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