INTRODUCTION

TORZEST 20MG TABLET contains Torsemide which belongs to the group of medicines called Diuretics. It is indicated for the treatment of oedema associated with congestive heart failure, renal or hepatic disease and essential hypertension.

Oedema is a build-up of fluid in the body which causes the affected tissue to become swollen. The swelling can occur in one particular part of the body or may be more general, depending on the cause.

Prior to the treatment, your doctor may want you to take several blood tests to understand your existing condition.

TORZEST 20MG TABLET is not recommended for use if you have anuria (failure of kidney to produce urine), hepatic coma (loss of brain function due to liver damage).

Before taking TORZEST 20MG TABLET, inform your doctor if you have any liver, kidney, or heart failure. Avoid consumption of alcohol while taking this medicine.

Safety and effectiveness of TORZEST 20MG TABLET in pregnant or breastfeeding women has not been established yet, therefore consult your doctor before taking it.

It is not recommended for use in children and adolescents below 18 years of age. TORZEST 20MG TABLET should be used with caution in elderly patients above 65 years of age.

The most common side effects of taking TORZEST 20MG TABLET are muscle cramps, loss of appetite, stomach pain, nausea, vomiting, diarrhea, constipation. Consult your doctor if any of the side effects worsen.

USES OF TORZEST 20MG TABLET

It is used to treat:

• oedema associated with congestive heart failure, kidney, or liver disease
• essential hypertension (high blood pressure)

HOW TORZEST 20MG TABLET WORKS

TORZEST 20MG TABLET inhibits reabsorption of sodium and chloride in kidney by increasing urinary excretion of sodium, chloride, and water.  Thus, removing excessive fluid from the body.

DIRECTIONS FOR USE

Take TORZEST 20MG TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. Do not stop taking TORZEST 20MG TABLET unless your doctor advises you to stop.

SIDE EFFECTS OF TORZEST 20MG TABLET

HOW TO MANAGE SIDE EFFECTS

Nausea or Vomiting:

Take TORZEST 20MG TABLET with, or just after meals. Stick to simple meals. Avoid eating oily or spicy foods. Inform your doctor if symptoms do not improve. Get adequate rest. Drink lots of fluids, especially water.

Headache:

Avoid bright lights, take rest and drink enough water. Inform your doctor if symptoms do not improve. Apply pain relieving balm if needed.

Dizziness:

Lie down until dizziness is gone, then get up slowly. Move slowly and carefully, do not hurry. Get adequate rest. Drink plenty of water and other fluids. Avoid coffee, cigarettes, alcohol, and drugs. Inform your doctor if symptoms do not improve.

Constipation:

Eat plenty of fiber rich foods such as fresh fruits, vegetables, and cereals and drink plenty of water. Exercise more regularly. Inform your doctor if symptoms do not improve.

Diarrhea:

Drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor. Inform your doctor if symptoms do not improve.

Stomach pain:

Try to rest and relax. Eat and drink slowly or try to have smaller meals more frequently. Keep a heat pad on your stomach. If the symptom does not improve, contact your doctor.

Loss of appetite:

Eat when you are hungry. Eat smaller meals more often than usual. Snack only when you're hungry. Eat a nutritious snack which is rich in calories and protein, such as dried fruit and nuts. Inform your doctor if symptoms do not improve.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before taking TORZEST 20MG TABLET, inform your doctor if you are taking any of the following medicine:

• medicines used to treat heart conditions like increased blood pressure and heart insufficiency (Ex. captopril, enalapril, digoxin, digitoxin, methyldigoxin)
• probenecid (used to treat gout)
• medicines used to treat high blood sugar (Ex. chlorpropamide, glibenclamide, glipizide, tolbutamide)
• medicines used to relieve pain, stiffness, and inflammation (Ex. aspirin, ibuprofen, indomethacin, celecoxin)
• medicines used to treat chronic inflammatory bowel diseases (Ex. sulfasalazine, mesalazine, olsalazine)
• medicines used to treat infections (Ex. cefixime, cefuroxime, cefaclor, cefalexin, cefadroxil, cefpodoxime, kanamycin, neomycin, gentamycin, amikacin, tobramycin, rifampin)
• lithium (used to treat mood disorders)
• medicines used during cancer chemotherapy (Ex. amifostine, cisplatin)
• theophylline (used to treat asthma)
• medicines used to relax muscles (Ex. atracurium, doxacurium)
• medicines used to treat constipation (Ex. methylcellulose, psyllium)
• cholestyramine (used to treat high amount of cholesterol)
• medicines used to treat inflammation and certain skin conditions (Ex. hydrocortisone, prednisone, dexamethasone)
• medicines used to treat low blood pressure (Ex. adrenaline, noradrenaline)
• medicines which help you to excrete excess body fluid (Ex. spironolactone, furosemide)

Overdosage:

If you or anyone else accidentally took too much of TORZEST 20MG TABLET, contact your doctor immediately. Symptoms of TORZEST 20MG TABLET overdose include excessive urine, sleepiness, confusion, weakness, dizziness, low blood pressure, circulatory collapse or upset stomach.

SYNOPSIS

MORE INFORMATION

• Keep TORZEST 20MG TABLET out of reach of children
• Store at room temperature

FAQs ABOUT TORZEST 20MG TABLET

What is TORZEST 20MG TABLET used for?

It is used to treat oedema (excessive fluid trapped in your body's tissues lead to swelling or puffiness) related to congestive heart failure, kidney, or liver disease. It is also used to treat essential hypertension.

Can TORZEST 20MG TABLET be used on infants?

No. TORZEST 20MG TABLET is used for adults and not recommended for children and adolescents under 18 years of age as safety data has not been established yet. Consult your doctor before taking the medicine.

What if I forget to take a dose of TORZEST 20MG TABLET?

If you forget to take a dose of TORZEST 20MG TABLET, take it as soon as you remember. However, omit the missed dose if it is almost time for the next dose. Do not take the medicine twice to make up for a forgotten dose.

Can I stop taking TORZEST 20MG TABLET?

Do not stop taking TORZEST 20MG TABLET without consulting your doctor as it can seriously harm you and reduce the therapy effect. If you have any more doubts regarding the use of TORZEST 20MG TABLET, ask your doctor.

Can TORZEST 20MG TABLET cause diarrhea?

Diarrhea is a side effect of TORZEST 20MG TABLET. If you experience it, drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor. Consult your physician if you have continuous diarrhea.

REFERENCES

1. Barbara G. Wells, Joseph T. DiPiro, Terry L. Shwinghammer, Cecily V. DiPiro. Hypertension. Pharmacotherapy Handbook. Ninth edition. Page-87.

2. Tejaswi Kanderi; Pradeep Vaitla. Torsemide. National library of Medicine. National center for Biotechnology information. StatPearls Publishing. [Revised on July 2021] [Accessed on 4th June 2022] https://www.ncbi.nlm.nih.gov/books/NBK559175/#:~:text=Go%20to%3A-,Mechanism%20of%20Action,K%2B%2F2Cl%2D%20cotransport%20mechanism.

3. H A Friedel, M. M Buckley. Torasemide. A review of its pharmacological properties and therapeutic potential. National library of Medicine. National center for Biotechnology information. Pubmed.gov. 1991[Accessed on 4th June 2022] https://pubmed.ncbi.nlm.nih.gov/1706990/#:~:text=Torasemide%20%28torsemide%29%20is%20a%20high-ceiling%20loop%20diuretic%20which,is%20from%20the%20luminal%20side%20of%20the%20cell.

4. Cipla House. Dytor tablet (Torsemide). [Revised in January 2021] [Accessed on 4th June 2022] https://www.ciplamed.com/content/dytor-tablets-injection

5. M/s Swiss Garnier Genexiaa Sciences Pvt. Ltd. Torsemide. [Revised in April 2021] [Accessed on 4th June 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/3043.pdf

6. Torsemide. [Revised in June 2017] [Accessed on 4th June 2022] https://docetp.mpa.se/LMF/Torasemid%20Sandoz%20tablet%20ENG%20PL_09001be6801d86a1.pdf

USEFUL DIAGNOSTIC TESTS

• Complete Blood Count (CBC)
• ECG
• Serum electrolyte test