torsemide

 Q: What advantage torsemide has over furosemide? 

Answer: Predictable bioavailability

Oral torsemide has high and reliable bioavailability. This can be of advantage in ICU while converting intravenous meds to the oral route. Bumetanide has the same advantage. 

In contrast, the bioavailability of oral furosemide is almost half. Also, the response of oral furosemide can't be predicted. Interestingly, response varies in the same patient from dose to dose.

#phamacology

#nephrology

#cardiology

References:

1. Abraham B, Megaly M, Sous M, Fransawyalkomos M, Saad M, Fraser R, Topf J, Goldsmith S, Simegn M, Bart B, Azzo Z, Mesiha N, Sharma R. Meta-Analysis Comparing Torsemide Versus Furosemide in Patients With Heart Failure. Am J Cardiol. 2020 Jan 1;125(1):92-99. doi: 10.1016/j.amjcard.2019.09.039. Epub 2019 Oct 10. PMID: 31699358.

2. Kaojarern S, Day B, Brater DC. The time course of delivery of furosemide into urine: an independent determinant of overall response. Kidney Int 1982; 22:69. 

3. Cohen N, Dishi V V, Zaidenstein R, Soback S, Weissgarten J, Averbukh Z, Gips M, Blatt A, Berman S, Modai D, Golik A. Effects of Various Modalities of Oral Furosemide Administration in Mild or Severe Congestive Heart Failure. J Cardiovasc Pharmacol Ther. 1996 Oct;1(4):271-278. doi: 10.1177/107424849600100402. PMID: 10684427.