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Jan 10, 2023

Blood Pressure


The Ultimate Guide to Diuretics: Exploring the Benefits and Differences of Furosemide and Torsemide

Furosemide (brand name: Lasix) and torsemide (brand name: Demadex) are both loop diuretics or "water pills".

Both work by blocking sodium and chloride reabsorption in the ascending loop of Henle in your kidneys. They increase the excretion of sodium, potassium, chloride, magnesium, calcium, and water. As a result diuretics cause excessive urination .

Furosemide and Torsemide are FDA approved to treat the following conditions:

  • Edema—(fluid retention or swelling that may occur in your lower limbs and/or stomach) that’s caused by congestive heart failure, liver disease, or kidney disease.
  • High blood pressure (hypertension)—Controlling your weight and being careful about what foods you consume, particularly those heavy in salt, may be used as an additional treatment for high blood pressure.

Furosemide vs Torsemide

Although Furosemide and Torsemide share the same drug class and work in similar ways, they still have distinct characteristics and adverse effects.

Torsemide is more bioavailable, which means a large portion of the drug gets absorbed and used in your body. This medication also has a longer half-life when compared to furosemide, which means Torsemide takes longer to work.

On the other hand, in the event of a hypertensive emergency, Furosemide may occasionally be taken as an off-label medication. Due to the FDA's lack of approval for this use, the use of Furosemide in this way is regarded as “off-label.”

During a hypertensive emergency, blood pressure can damage your organs since it's so high. A systolic or diastolic blood pressure of more than 180 or 110 mmHg is considered a hypertensive emergency.

Side effects

Because Furosemide and Torsemide are both loop diuretics, they share very similar side effects:

  • Increased urination (Furosemide > Torsemide)
  • Headache
  • Decreased blood volume
  • Low levels of potassium and sodium
    —Torsemide causes less excretion of potassium compared to Furosemide
  • Urinary loss of calcium
  • Dizziness and/or lightheadedness
    —When getting up from a sitting or laying posture, take your time to stand up so you don't feel lightheaded or dizzy.
  • Your blood sugar levels may rise as a result of this medication.
    —Talk to your physician if you have diabetes and observe a change in the results of your blood or urine sugar testing.
  • Dehydration
    —Dehydration can be increased by excessive perspiration, diarrhea, or vomiting.

Serious side effects

  • Muscle cramps and/or weakness
  • Extreme fatigue and/or dizziness
  • Dry mouth
  • Nausea
  • Vomiting
  • Increased heartbeat
  • Numbness
  • Tingling
  • Pain, redness, and/or swelling
  • Ototoxicity or hearing problems, including ringing that occurs in your ear(s) or hearing loss

If you’re experiencing any of the serious side effects listed above, immediately call your doctor and stop taking this medication.

Warning: If you are unable to urinate, it’s not recommended for you to take either medication.

What happens if I miss a dose?

Although both medications can be taken at any time of the day, they should be taken at roughly the same time every day so you don’t forget to take them.

However, if you do forget to take a dose, take it as soon as you remember unless it's almost time for your next dose. In this case, skip the forgotten dose and take the next one at the usual time. Do not take 2 doses together to make up for a missed dose.


It's crucial that your physician be aware of any additional medications you are taking because some of them might significantly raise your chance of developing serious issues.

Both medications may interact with the following drugs:

  • Aminoglycoside antibiotics due to the increased risk of causing severe ear problems, including ototoxicity.
  • Lithium, which may increase your risk of developing lithium toxicity
  • ACE (angiotensin-converting enzyme) inhibitors which may increase your risk of low blood pressure and renal damage.

Torsemide is a CYP P450 2C9 (cytochrome P450, which is an important enzyme in your body that’s responsible for the metabolism of numerous drugs) inhibitor and inducer.

Therefore, medications that are CYP 2C9 inducers and/or inhibitors can affect Torsemide and may need a dose adjustment, including the following medications:

  • Amiodarone
  • Fluconazole
  • Miconazole
  • Rifampin

In addition, Furosemide has been shown to interact with drugs that include the following:

What if I’m pregnant or breastfeeding?

Data regarding the usage of these medications during pregnancy and the risk of severe birth abnormalities or miscarriages are not yet known, however, they’re not recommended.

If taking a loop diuretic, you should inform your doctor if you get pregnant or think you could be pregnant.

Your doctor will advise you on whether you should discontinue this medication during pregnancy and if you should temporarily stop using rosuvastatin while nursing or breastfeeding.

It is unclear whether torsemide enters breast milk, however, Furosemide has been shown to appear in breast milk. Therefore, prior to breastfeeding, speak with your doctor.

Furosemide vs Torsemide: Which is better?

Torsemide and Lasix were evaluated in a recent meta-analysis for congestive heart failure patients (CHF).

According to the findings, Torsemide usage was linked to a decreased risk of congestive heart failure hospitalization. When compared to Furosemide, Torsemide was also linked to a considerably larger number of individuals seeing improvement in status, as well as a reduced risk of cardiac death.

In another study conducted by the American College of Cardiology, individuals with heart failure who were admitted to the hospital without first using a diuretic saw decreased mortality (death) and readmission rates after being released while on a loop diuretic.

Based on these results, your doctor may decide to start treating your congestive heart failure with Torsemide, while Furosemide would also be a suitable option.

Torsemide and Furosemide are both approved treatments for chronic heart failure by the American Heart Association (AHA).

SOAANZ - New Formulation of Torsemide Available

SOAANZ may help patients experiencing worsening problems while taking a loop diuretic like torsemide and furosemide

SOAANZ (torsemide) is a novel formulation of torsemide (generic Demadex) available in 20mg, 40mg and 60mg tablets. SOAANZ was designed to release drug more slowly than generic version of torsemide allowing the medications to have prolonged action.

Benefits of SOAANZ include:

  • Releases drug slowly
  • Causes no excessive urination
  • Maintains natriuresis for up to 8 hours
  • May help patients with worsening bladder problems on loop diuretics

Learn more about SOAANZ (torsemide) and how to access it through Marley Drug.

Speak With Your Doctor

Both medications are considered safe and effective medications when taken appropriately (as prescribed by your doctor). Talk to your doctor today about using Furosemide and Torsemide and send your prescription to Marley Drug. Save up to 95% compared to your local pharmacy by using Marley Drug.

Marley Drug provides free nationwide shipping, allowing you to receive your medication at no additional cost straight to your door.

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