Torsemide

Torsemide

Drug monograph · NCLEX study reference
Trade names	Demadex
Therapeutic class	Diuretic
Pharmacologic class	Loop diuretic
Onset / peak / duration	Onset about 1 hour; duration 6 to 8 hours.
Half-life / level	Half-life 3 to 4 hours; no routine level.
Routes	PO (oral), IV
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	None; supportive.
Pregnancy / lactation	Use only if clearly needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Torsemide (brand name Demadex) — Diuretic; Loop diuretic.

Identification

• Therapeutic class: Diuretic.
• Pharmacologic class: Loop diuretic.

Pharmacology

• Mechanism of action: Same loop mechanism with more predictable oral absorption and longer action.
• Onset / peak / duration: Onset about 1 hour; duration 6 to 8 hours.
• Half-life / therapeutic level: Half-life 3 to 4 hours; no routine level.

Clinical use

• Indications: Edema from heart failure or renal disease, hypertension.
• Usual dose, route, frequency: 10 to 20 mg PO or IV once daily.
• Maximum dose / adjustments: Up to about 200 mg/day in renal failure.

Safety

• Contraindications: Anuria, hypersensitivity.
• Black box warning: Profound diuresis with fluid and electrolyte loss; individualize and monitor.
• Interactions: Same as furosemide.
• Pregnancy / lactation: Use only if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Increased urination, hypokalemia, dizziness.
• Serious effects to report: Dehydration, electrolyte loss, ototoxicity at high IV doses.
• Antidote / reversal: None; supportive.

Nursing process

• Assessment before administration: Weight, electrolytes, renal function.
• Interventions during therapy: Morning dosing; monitor potassium.
• Monitor: Electrolytes, weight, intake and output, renal function.
• Evaluation / expected outcome: Reduced edema.

Patient teaching

• Patient teaching: Reliable oral absorption; take in the morning.
• Notify provider if: Cramps, weakness, severe dizziness.
• Administration tips: Morning dosing.