Dopamine is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using dopamine at home, carefully follow the injection procedures taught to you by your health care provider. Store Demadex at room temperature, between 59 and 86 degrees F 15 and 30 degrees C. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Demadex out of the reach of children and away from pets. Torsemide is metabolized by the hepatic cytochrome CYP2C9 and, to a minor extent, CYP2C8 and CYP2C18. Three main metabolites have been identified in humans. Metabolite M1 is formed by methyl-hydroxylation of torsemide, metabolite M3 is formed by ring hydroxylation of torsemide, and metabolite M5 is formed by oxidation of M1. The major metabolite in humans is the carboxylic acid derivative M5, which is biologically inactive. Metabolites M1 and M3 possess some pharmacological activity; however, their systemic exposures are much lower when compared to torsemide. albuterol
Alexander JP. Dysrhythmia and oral surgery. Your doctor may need to adjust your medication or diet. American Regent announces increased production and availability of torsemide injection. Boehringer Mannheim. Demadex torsemide tablets and injection prescribing information. Rockville, MD: 1993 Oct.
Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC. Of the total number of patients who received Demadex in United States clinical studies, 24% were 65 or older while about 4% were 75 or older. No specific age-related differences in effectiveness or safety were observed between younger patients and elderly patients. Use with caution. May make these conditions worse.
There was no effect of age or sex on the incidence of adverse reactions. May cause side effects to become worse. Demadex is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including the class to which this drug principally belongs. There are no controlled trials demonstrating risk reduction with Demadex. Report prolonged or to your doctor. Follow your doctor's instructions about the amount of fluids you can drink.
You may develop an irregular heartbeat. L. Little further change occurred with long-term treatment, and all changes reversed when treatment was discontinued. In patients with hepatic cirrhosis, the volume of distribution, plasma half-life, and renal clearance are all increased, but total clearance is unchanged. American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. Torsemide is a white to off-white crystalline powder. After a single oral dose, the amounts recovered in urine were: torsemide 21%, metabolite M1 12%, metabolite M3 2%, and metabolite M5 34%. Exclusivity is the sole marketing rights granted by the FDA to a manufacturer upon the approval of a drug and may run simultaneously with a patent. Exclusivity periods can run from 180 days to seven years depending upon the circumstance of the exclusivity grant. To help you remember to take your medicine, try to get into the habit of taking it at the same time each day. Demadex has been administered together with β-adrenergic blocking agents, ACE inhibitors, and calcium-channel blockers. Adverse drug interactions have not been observed, and special dosage adjustment has not been necessary. Torsemide is a substrate of CYP2C9. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use. What happens if I miss a dose? Risk of hypokalemia, especially with brisk diuresis, with inadequate oral electrolyte intake, in those with cirrhosis, or during concomitant use of corticosteroids or ACTH. 1 12 Risk of arrhythmias secondary to hypokalemia in patients with cardiovascular disease, especially those receiving concomitant therapy with a cardiac glycoside.
American Society of Health-System Pharmacists: Shortage and resumed manufacturing of torsemide Injection. The dose of this medicine 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 this medicine. Coadministration of digoxin is reported to increase the AUC for torsemide by 50%, but dose adjustment of Demadex is not necessary. Torsemide does not affect the pharmacokinetics of digoxin. What is bumetanide, and how does it work mechanism of action? Reynolds EH. Effects of folic acid on the mental state and fit-frequency of drug- treated epileptic patients. Ask your healthcare professional how you should dispose of any medicine you do not use. For information on systemic interactions resulting from concomitant use, see Interactions. This may not be a complete list of all interactions that may occur. Ask your health care provider if dopamine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. In single-dose studies in patients with non-anuric renal failure, high doses of Demadex 20 mg to 200 mg caused marked increases in water and sodium excretion. In patients with non-anuric renal failure, severe enough to require hemodialysis, chronic treatment with up to 200 mg of daily Demadex has not been shown to change steady-state fluid retention. When patients in a study of acute renal failure received total daily doses of 520 mg to 1200 mg of Demadex, 19% experienced seizures. Symptoms may include fast or irregular heartbeat; inability to urinate; nausea; severe headache; vomiting. Food delays the time to peak plasma concentration following oral dosing but does not affect extent of absorption or diuretic activity. You may take torsemide with or without food. Laboratory determinations of serum levels of torsemide and its metabolites are not widely available. lamivudine
Is bumetanide available as a generic drug? Fast heartbeat; headache; nausea; vomiting. Diabetic patients - Demadex may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. National Library of Medicine and Drugs. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. atica.info dapoxetine
May use IV administration when a rapid onset of diuresis is desired or when oral therapy is not practical. All medicines may cause side effects, but many people have no, or minor, side effects. Demadex torsemide is a used to reduce edema swelling from multiple causes and also used to treat . Demadex is available as a generic. Following IV administration, onset of diuresis occurs within 10 minutes; maximal effect within 1 hour. The recommended initial dose is 20 mg oral Demadex once daily. If the diuretic response is inadequate, titrate upward by approximately doubling until the desired diuretic response is obtained. Doses higher than 200 mg have not been adequately studied. Excessive diuresis may cause potentially symptomatic dehydration, blood volume reduction and hypotension and worsening renal function, including acute renal failure particularly in salt-depleted patients or those taking renin-angiotensin aldosterone inhibitors. Torsemide increases the urinary excretion of sodium, chloride, and water, but it does not significantly alter glomerular filtration rate, renal plasma flow, or acid-base balance. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables. Vargo DL, Kramer WG, Black PK et al. Bioavailability, pharmacokinetics, and pharmacodynamics of torsemide and furosemide in patients with congestive heart failure. Clin Pharmacol Ther. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Initially, 5 mg once daily. L during the subsequent year. In long-term studies in diabetics, mean fasting glucose values were not significantly changed from baseline. Great for killing ticks on dogs. Just put the pure oil on the tick and they just about dissolve into jelly and are easily pulled off. Administer orally without regard to meals. Great for Tooth Aches Caused by infection. I applied to infected Gum - Tooth. Within an hour all pain gone. Next morning infection gone and no pain. fast tabs combivent
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. For direct IV injection, administer slowly over a period of 2 minutes. Excessive diuresis may cause dehydration and blood volume reduction with circulatory collapse and possibly vascular thrombosis and embolism, particularly in geriatric patients. Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plan to become pregnant during treatment with Demadex; it is not expected to harm a fetus. It is unknown if Demadex passes into breast milk or if it could harm a nursing baby. Consult your doctor before breastfeeding. Adequate studies of Demadex have not been done in pregnant or breast-feeding women. Safety and effectiveness in pediatric patients has not been established for Demadex. Our Demadex Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Serious. These medicines may interact and cause very harmful effects. Demadex may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. HID. Trissel LA. Handbook on injectable drugs. Demadex is a strong "water pill" diuretic. Using too much of this drug can lead to serious water and mineral loss. Therefore, it is important that you be monitored by your doctor. Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medicine, which can lead to severely low blood pressure or a serious electrolyte imbalance. Demadex produces small dose-related increases in each of these laboratory values. The pharmacokinetic profile and diuretic activity of torsemide are not altered by cimetidine. To prevent hypokalemia and metabolic alkalosis, use an aldosterone antagonist or potassium-sparing drug with Demadex in patients with hepatic disease. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; chest pain; dizziness; irregular heartbeat; pain, redness, or swelling at the injection site; severe headache. keflex
Increases in total plasma cholesterol concentrations may occur; usually subside during chronic therapy. Furlanut M, Benetello P, Avogaro A, Dainese R. Effects of folic acid on phenytoin kinetics in healthy subjects. Headache, excessive urination, dizziness, rhinitis, asthenia, diarrhea, ECG abnormality, increased cough. Increases urinary excretion of sodium, chloride, and water without having an important effect on glomerular filtration rate, renal plasma flow, or acid-base balance. If you have any questions about Demadex, please talk with your doctor, pharmacist, or other health care provider. The blood level of your hydantoin may need to be monitored more often. The dose of your hydantoin may need to be adjusted. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. If you have any signs of side effects from your medicine, contact your doctor. Tinnitus and hearing loss, usually reversible, have been observed following rapid IV injection of other loop diuretics and following oral torsemide administration. 1 12 13 14 Administer IV slowly over 2 minutes; do not exceed 200 mg as a single dose. DEMEDEX can increase the risk of renal toxicity related to administration of radiocontrast agents. Dopamine is usually handled and stored by a health care provider. If you are using dopamine at home, store dopamine as directed by your pharmacist or health care provider. Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough. PREGNANCY and BREAST-FEEDING: If you become pregnant while taking dopamine, discuss with your doctor the benefits and risks of using dopamine during pregnancy. It is unknown if dopamine is excreted in breast milk. If you are or will be breast-feeding while you are using dopamine, check with your doctor or pharmacist to discuss the risks to your baby. 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 receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Maximum of 200 mg as a single dose daily. Kutt H, Winters W, McDowell FH. Depression of prahydroxylation of diphenylhydantoin by antituberculosis chemotherapy. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Drugs. American Regent. Torsemide injection prescribing information. Shirley, NY: 2009 Dec. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. These medicines are used during surgical procedures or in a hospital. If you are to have either inpatient or outpatient surgery, or are to be admitted to the hospital, make sure that all the healthcare professionals are aware of all the different medicines that you are taking. This includes prescription medicines, herbal drugs, and nutraceuticals. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. dipyridamole buy online shopping canada
Most renal clearance of torsemide occurs via active secretion of the drug by the proximal tubules into tubular urine. Increase as necessary by approximately doubling daily dosage until desired diuresis is attained. 1 12 Single doses exceeding 200 mg not adequately studied. At first, 20 milligrams mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 200 mg per day. Your condition may be treated with a combination of drugs. Use all medications as directed by your doctor. Do not change your doses or medication schedule without your doctor's advice. This information should not be used to decide whether or not to take Demadex or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Demadex. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Demadex. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Demadex. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. MEDA PHARMACEUTICALS and Demadex are registered trademarks of Meda AB. Any other trademarks are the property of their respective owners. Three-character codes are assigned only in situations when more than one reference listed drug of the same strength has been designated under the same heading. Two or more reference listed drugs are generally selected only when there are at least two potential reference drug products which are not bioequivalent to each other. If a study is submitted that demonstrates bioequivalence to a specific listed drug product, the generic product will be given the same three-character code as the reference listed drug it was compared against. Reisner LS, Lippmann M. Ventricular arrhythmias after epinephrine injection in enflurane and in halothane anesthesia. Known hypersensitivity to torsemide or to sulfonylureas. reload ipratropium pills
Disclaimer: The indications, uses and warnings for individual medications outside the USA are determined by local regulatory bodies in each country or region. The Drugs. Check with your pharmacist about how to dispose of unused medicine. It is not known whether torsemide passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby. Following oral administration, peak plasma concentrations achieved within 1 hour. Matteo RS, Katz RL, Papper EM. The injection of epinephrine during general anesthesia. Concomitant use with DEMEDEX may increase risk of hypokalemia. AHFS Drug Information 2017. McEvoy GK, ed. Furosemide. Yuen GJ. Interaction of phenytoin and folic acid: an alternative explanation. Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Demadex. These medications may be counterfeit and potentially unsafe. If you purchase medications online, be sure you are buying from a reputable and valid online pharmacy. Ask your health care provider for advice if you are unsure about the online purchase of any medication. Overdose symptoms may include severe forms of some of the side effects listed in this medication guide. What should I avoid while taking Demadex torsemide? Dosage is based on your medical condition and response to treatment. not increase your dose or take it more often than directed. order generic remeron from india
Inoue F. Clinical implications of anticonvulsant-induced folate deficiency. Ikezono E, Yasuda K, Hattori Y. Effects of propranolol on epinephrine-induced arrhythmias during halothane anesthesia in man and cats. Feb 8. Press Release. Therapy in such patients is best initiated in the hospital. 1 14 Use an aldosterone antagonist or potassium-sparing agent concomitantly with torsemide to prevent hypokalemia and metabolic alkalosis in such patients. Avoid eating licorice or Korean ginseng while taking Demadex. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Katz RL, Katz GJ. Surgical infiltration of pressor drugs and their interaction with volatile anaesthetics. MacCosbe PE, Toomey K. Interaction of phenytoin and folic acid. Jensen ON, Olesen OV. Subnormal serum folate due to anticonvulsive therapy. A double-blind study of the effect of folic acid treatment in patients with drug- induced subnormal serum folates. The manufacturers state that since oral and IV doses of torsemide are therapeutically equivalent, torsemide dosage is identical for oral or IV administration. 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 this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. The information contained in the Truven Health Micromedex products as delivered by Drugs. Weiner N. Norepinephrine, epinephrine, and the sympathomimetic amines. In Gilman AG, Goodman LS, Rall TW, Murad F, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 7th ed. New York: MacMillan Publishing Company. 1985. Potential for postural hypotension; importance of rising slowly from a seated position. Demadex is to be used only by the patient for whom it is prescribed. Do not share it with other people. anafranil
Demadex has been studied in controlled trials in patients with New York Heart Association Class II to Class IV heart failure. Patients who received 10 mg to 20 mg of daily Demadex in these studies achieved significantly greater reductions in weight and edema than did patients who received placebo. This medicine will not cure your high blood pressure but it does help control it. 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. Ueda W, Hirakawa M, Mae O. Appraisal of epinephrine administration to patients under halothane anesthesia for closure of cleft palate. Patent and Trademark Office and assigns exclusive legal right to the patent holder to protect the proprietary chemical formulation. The patent assigns exclusive legal right to the inventor or patent holder, and may include entities such as the drug brand name, trademark, product dosage form, ingredient formulation, or manufacturing process A patent usually expires 20 years from the date of filing, but can be variable based on many factors, including development of new formulations of the original chemical, and patent infringement litigation. With oral dosing, the onset of diuresis occurs within 1 hour and the peak effect occurs during the first or second hour and diuresis lasts about 6 to 8 hours. Coadministration of Demadex with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. Associated Press American Diabetes Association. Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site. If your symptoms do not improve or if they become worse, check with your doctor. In patients with decompensated congestive heart failure, hepatic and renal clearance are both reduced, probably because of hepatic congestion and decreased renal plasma flow, respectively. The total clearance of torsemide is approximately 50% of that seen in healthy volunteers, and the plasma half-life and AUC are correspondingly increased. Because of reduced renal clearance, a smaller fraction of any given dose is delivered to the intraluminal site of action, so at any given dose there is less natriuresis in patients with heart failure than in normal subjects. On a body-weight basis, these doses are 27 to 96 times a human dose of 20 mg; on a body-surface-area basis, they are 5 to 8 times this dose. In the rat study, the high-dose female group demonstrated renal tubular injury, interstitial inflammation, and a statistically significant increase in renal adenomas and carcinomas. The tumor incidence in this group was, however, not much higher than the incidence sometimes seen in historical controls. Similar signs of chronic non-neoplastic renal injury have been reported in high-dose animal studies of other diuretics such as furosemide and hydrochlorothiazide. Chronic use of any diuretic in hepatic disease has not been adequately studied. No mutagenic activity was detected in any of a variety of in vivo and in vitro tests of torsemide and its major human metabolite. The tests included the Ames test in bacteria with and without metabolic activation tests for chromosome aberrations and sister-chromatid exchanges in human lymphocytes, tests for various nuclear anomalies in cells found in hamster and murine bone marrow, tests for unscheduled DNA synthesis in mice and rats, and others. Many drugs can interact with torsemide. Not all possible interactions are listed here.
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Andersen N, Johansen SH. Incidence of catechol-amine-induced arrhythmias during halothane anesthesia. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. Please refer to the for information on shortages of one or more of these preparations. Demadex 20 mg caused small increases in total cholesterol and triglycerides in short term hypertension studies. The changes subsided with chronic therapy. Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests. online combigan indication
Advise patients receiving Demadex that lightheadedness can occur, especially during the first days of therapy, and that it should be reported to the prescribing physician. The patients should be told that if syncope occurs, Demadex should be discontinued until the physician has been consulted. Concomitant use of torsemide and cholestyramine has not been studied in humans but, in a study in animals, coadministration of cholestyramine decreased the absorption of orally administered torsemide. If Demadex and cholestyramine should be coadministered, administer Demadex at least one hour before or 4 to 6 h after cholestyramine administration.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. If you have cirrhosis or other liver problems, your doctor may want to give your first dose of this medicine in a hospital or clinic setting to quickly treat any serious side effects that occur. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of torsemide in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for elderly patients receiving torsemide.
Hirshom WI, Taylor RG, Sheehan JC. Arrhythmias produced by combinations of halothane and small amounts of vasopressor. Use dopamine as directed by your doctor. Check the label on the medicine for exact dosing instructions. Concomitant use of nonsteroidal anti-inflammatory drugs NSAIDs and torsemide has been associated with the development of acute renal failure. The antihypertensive and diuretic effects of Demadex can be reduced by NSAIDs.