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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Dosage Of Torsemide For CHF

Patient with CHF currently on Lasix 40mg BID - has been on this dose for awhile (except when has experienced CHF episodes with difficulty breathing and fluid buildup and placed in hospital. I have read positive information regarding the use of torsemide over lasix in this patient. If this patient were to switch to Torsemide what should the dose be?
Wed, 5 Nov 2014
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Cardiologist, Interventional 's  Response
Very true that Torsemide has an edge over Lasix in the treatment of heart failure. Patients on long term treatment with lasix can develop tolerance to this medication. In this situation, switching over to Torsemide will invariably help to improve urine output. Moreover the chances of developing low sodium in the body with heart failure therapy is less with torsemide.
The ideal dosage would be 20 mg twice a day, preferably the second dose at 4 pm. Depending on the urine output, improvement in symptoms, good looking feet(lack of swelling) the dosage could be reduced. Ofcourse one should reduce the total fluid intake also. Do not forget to monitor sodium, potassium and creatinine levels frequently.
Wishing good health,
Regards,
Deepak
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General & Family Physician Dr. Bihle Nestor Mbinkar's  Response
Hi, thank you for asking Healthcare Magic.
I am sorry to hear about this. The dosage of Torsemide in adult with CHF is 10 to 20 mg orally or IV once a day. Effective control of CHF often needs an association of at least two drugs. If I were your treating doctor, I would first associate an ACE inhibitor drug like Captopril to the Lasix that you are taking before thinking of another option.


I hope that answers your query. If you have more questions or any follow up query do not hesitate to write to us. Wish you well
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Suggest Dosage Of Torsemide For CHF

Very true that Torsemide has an edge over Lasix in the treatment of heart failure. Patients on long term treatment with lasix can develop tolerance to this medication. In this situation, switching over to Torsemide will invariably help to improve urine output. Moreover the chances of developing low sodium in the body with heart failure therapy is less with torsemide. The ideal dosage would be 20 mg twice a day, preferably the second dose at 4 pm. Depending on the urine output, improvement in symptoms, good looking feet(lack of swelling) the dosage could be reduced. Ofcourse one should reduce the total fluid intake also. Do not forget to monitor sodium, potassium and creatinine levels frequently. Wishing good health, Regards, Deepak