This medicine may cause you to have an unusual feeling of tiredness when you begin to take it. You may also notice an increase in the amount of urine or in your frequency of urination. After you have taken the medicine for a while, these effects should lessen.

It is best to plan your dose or doses according to a schedule that will least affect your personal activities and sleep. Ask your health care professional to help you plan the best time to take this medicine.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

For patients taking this medicine for high blood pressure :

• In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.
• Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
• Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems, such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing

The dose of torsemide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of torsemide. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the length of time you take the medicine depends on the medical problem for which you are taking torsemide.

• For oral dosage form (tablets):
  • For lowering the amount of water in the body:
    • Adults Dose is usually 5 to 20 milligrams (mg) once a day. However, your doctor may increase your dose as needed.
    • Children Use and dose must be determined by your doctor.
  • For high blood pressure:
    • Adults 5 to 10 mg once a day.
    • Children Use and dose must be determined by your doctor.
• For injection dosage form:
  • For lowering the amount of water in the body:
    • Adults Dose is usually 5 to 20 mg injected into a vein once a day. However, your doctor may increase your dose as needed.
    • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For torsemide, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to bumetanide, ethacrynic acid, furosemide, sulfonamides (sulfa drugs), or thiazide diuretics (water pills). Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Studies have not been done in pregnant women. In general, diuretics are not useful for normal swelling of feet and hands that occurs during pregnancy. Diuretics should not be taken during pregnancy unless recommended by your doctor.

Breast-feeding It is not known whether torsemide passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of torsemide in children with use in other age groups.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of torsemide in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking torsemide, it is especially important that your health care professional know if you are taking any of the following:

• Acetazolamide (e.g., Diamox) or
• Alcohol or
• Amphotericin B by injection (e.g., Fungizone) or
• Azlocillin (e.g., Azlin) or
• Capreomycin (e.g., Capastat) or
• Carbenicillin by injection (e.g., Geopen) or
• Corticosteroids (cortisone-like medicine) or
• Corticotropin (ACTH) or
• Dichlorphenamide (e.g., Daranide) or
• Diuretics (water pills) or
• Insulin or
• Laxatives (with overdose or chronic misuse) or
• Methazolamide (e.g., Neptazane) or
• Mezlocillin (e.g., Mezlin) or
• Piperacillin (e.g., Pipracil) or
• Salicylates or
• Sodium bicarbonate (e.g., baking soda) or
• Ticarcillin (e.g., Ticar) or
• Ticarcillin and clavulanate (e.g., Timentin) or
• Vitamin B ₁₂ (e.g., AlphaRedisol, Rubramin-PC) (when used in megaloblastic anemia) or
• Vitamin D Use of these medicines with torsemide may increase the chance of potassium loss

• Aldesleukin (e.g., Proleukin) or
• Anti-infectives by mouth or by injection (medicine for infection) or
• Carmustine (e.g., BiCNU) or
• Cisplatin (e.g., Platinol) or
• Combination pain medicine containing acetaminophen and aspirin (e.g., Excedrin) or other salicylates (with large amounts taken regularly) or
• Cyclosporine (e.g., Sandimmune) or
• Deferoxamine (e.g., Desferal) (with long-term use) or
• Gold salts (medicine for arthritis) or
• Inflammation or pain medicine, except narcotics, or
• Methotrexate (e.g., Mexate) or
• Penicillamine (e.g., Cuprimine) or
• Pentamidine (e.g., Pentam 300) or
• Plicamycin (e.g., Mithracin) or
• Streptozocin (e.g., Zanosar) or
• Tiopronin (e.g., Thiola) Use of these medicines with torsemide may increase the chance of kidney damage

• Anticoagulants (blood thinners) Torsemide may decrease the effects of these medicines

• Lithium (e.g., Lithane) Use of lithium with torsemide may increase the chance of kidney damage; also, the chance of side effects of lithium may be increased

• Diabetes mellitus (sugar diabetes) Torsemide may increase the amount of sugar in the blood

• Gout or
• Hearing problems Torsemide may make these conditions worse

• Heart attack (recent) Use of torsemide after a recent heart attack may make this condition worse

• Kidney disease (severe) or
• Liver disease Higher blood levels of torsemide may occur, which may increase the chance of side effects