Torsemide Injection is indicated for the treatment of edema associated with congestive heart failure, renal disease, or hepatic disease. Use of torsemide has been found to be effective for the treatment of edema associated w th chronic renal failure. Chronic use of any diuretic in hepatic disease has not been studied in adequate and well-controlled trials. Torsemide Injection is indicated when a rapid onset of diuresis is desired or when oral administration is impractical. Torsemide Injection is indicated for the treatment of hypertension alone or in combination with other antihypertensive agents.
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DOSAGE AND ADMINISTRATION
General: Special dosage adjustment in the elderly is not necessary. Because of the high bioavailability of torsemide, oral and intravenous doses are therapeutically equivalent, so patients may be switched to and from the intravenous form with no change in dose. Torsemide injection should be administered either slowly as a bolus over a period of 2 minutes or administered as a continuous infusion. If torsemide is administered through an IV line, it is recommended that, as with other IV injections, the IV line be flushed with Normal Saline (Sodium Chloride Injection) before and after administration. Torsemide injection is formulated above pH 8.3. Flushing the line is recommended to avoid the potential for incompatibilities caused by differences in pH which could be indicated by color change, haziness or the formation of a precipitate in the solution. If torsemide injection is administered as a continuous infusion, stability has been demonstrated through 24 hours at room temperature in plastic containers for the following fluids and concentrations: 200 mg torsemide (10 mg/mL) added to: 250 mL Dextrose 5% in water 250 mL 0.9% Sodium Chloride 500 mL 0.45% Sodium Chloride 50 mg torsemide (10 mg/mL) added to: 500 mL Dextrose 5% in water 500 mL 0.9% Sodium Chloride 500 mL 0.45% Sodium Chloride Before administration, the solution of torsemide injection should be visually inspected for discoloration and particulate matter. If either is found, the vial should not be used. Congestive Heart Failure The usual initial dose is 10 mg or 20 mg of intravenous torsemide. II the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied. Chronic Renal Failure The usual initial dose of torsemide is 20 mg of intravenous torsemide. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied. Hepatic Cirrhosis The usual initial dose is 5 mg or 10 mg of intravenous torsemide, administered together with an aldosterone antagonist or a potassium·sparing diuretic. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 40 mg have not been adequately studied. Chronic use of any diuretic in hepatic disease has not been studied in adequate and well-controlled trials. HypertenSion The usual initial dose is 5 mg daily. If the 5 mg dose does not provide adequate reduction in blood pressure within 4 to 6 weeks, the dose may be increased to 10 mg daily. If the response to 10 mg is insufficient, an additional anti-hypertensive agent should be added to the treatment regimen.
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