Torsemide

What is torsemide?

Torsemide, also known as UpCard®CA-1, is a diuretic used to remove excess fluid (water) from the body. It is used in conditions such as heart disease, lung disease, and excessive swelling (edema). It is conditionally approved by the U.S. Food and Drug Administration (FDA) for use in dogs only.

How do I give my pet torsemide?

Torsemide comes in liquid suspension form. 

• Liquids are given orally (by mouth).
• Ensure fresh, clean drinking water is always available.
• This medication may be given with or without food. If your animal vomits or acts sick after receiving the drug on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.  
• Avoid giving the last dose of the day within a few hours of bedtime to reduce the need to get up and take your animal out to urinate.
• Liquid medications must be measured carefully. Contact your veterinarian if you have trouble measuring or giving the medication.
• Give this medication to your pet for the entire time prescribed by your veterinarian, even if it appears that your pet is feeling better.

This medication should take effect within 1 to 2 hours. 

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember and then wait the recommended time as prescribed by your veterinarian for the next dose. Do not give the pet two doses at once.

Are there any potential side effects from torsemide?

Torsemide may cause the following side effects:

• increased urination
• constipation or diarrhea

The following reactions are rare, but if they occur, contact your veterinarian immediately:

• an allergic reaction such as irregular breathing, rash, fever, puffiness and swelling around the face
• weakness
• lethargy
• pale gums
• balance problems
• collapse

Drug sensitivities can develop over time with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This medication is short-acting, meaning that effects will last about 24 hours, though effects may last longer in pets with kidney or liver disease.

Are there any risk factors for this medication?

Torsemide should NOT BE USED in dogs who:

• are allergic to any component of the medication or are allergic to similar medications (e.g., furosemide)
• are dehydrated
• have trouble producing urine
• have low blood pressure (hypotension)

Torsemide should be USED WITH CAUTION in dogs who:

• have kidney or liver disease
• are allergic to sulfa drugs
• are vomiting or having diarrhea
• have diabetes mellitus or other conditions that affect blood sugar, electrolytes, and water balance

Are there any drug interactions I should be aware of?

Certain medications should be USED WITH CAUTION when given with torsemide, including: 

• aminoglycosides (e.g., gentamicin)
• amphotericin B
• angiotensin-converting enzyme (ACE) inhibitors (e.g., benazepril, enalapril)
• cholestyramine
• cisplatin
• corticosteroids (e.g., dexamethasone, prednisone)
• digoxin
• NSAIDs (e.g., carprofen, meloxicam)
• salicylates (e.g., aspirin)

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Your veterinarian will assess blood work, blood pressure, and hydration status before starting this medication. 
• Your veterinarian may schedule follow-up visits for monitoring. In this case, follow your veterinarian’s directions.
• At home, monitor for any abnormal changes, particularly changes in urination and energy level. If these occur, discontinue the medication and contact your veterinarian.

How do I store torsemide?

• Store at or below 40°C (104°F), preferably at room temperature.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

• If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. 
• Adverse effects should be reported to the FDA or Health Canada.