Loop diuretic – sulfonamide derivative
ATC code: C03CA04 (Torasemide)
Brand names
Demadex, Sutril, Dilutol, Isodiur
Inhibits the Na-K-2Cl cotransporter in the ascending loop of Henle. Reduces sodium, potassium, and chloride reabsorption – potent diuresis. Compared with furosemide, more predictable bioavailability (80–90% vs furosemide's 10–80%), longer half-life (3.5 hours vs 1.5), and additional antialdosterone effect. The TORIC trial in HF patients showed 49% mortality reduction versus furosemide.
First line
First-line for symptomatic congestion in chronic heart failure per 2023 alongside furosemide. Dose 5–20 mg once daily. TORIC and DiNicolantonio 2012 meta-analysis showed 13% mortality reduction and 20% fewer hospitalizations in HF versus furosemide – likely due to additional antialdosterone effect.
Second line
Second-line for hypertension in patients with concomitant HF or CKD per 2024, when thiazides are ineffective. Dose 2.5–5 mg once daily.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Torasemide is a loop diuretic. It is prescribed for edema in heart failure, cirrhosis, nephrotic syndrome, and for hypertension ( 2024, AEMPS Ficha Técnica). In alt circles, torasemide is occasionally promoted for detox and removal of excess fluid in healthy adults. In people without edema, no clinical studies of such use exist; diuretics in healthy people cause volume imbalance. The drug has serious risks: hypokalemia (dangerous for cardiac rhythm), hyponatremia, dehydration, orthostatic hypotension, prerenal azotemia, hyperuricemia with gout flare risk, and elevated glucose and lipids. If torasemide was prescribed for detox in a healthy person, consider seeking a second opinion.
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Limited data. In pregnant HF patients, decisions are made with the cardiologist. Loop diuretics are not routine therapy in pre-eclampsia.
Suppresses lactation. Not used during lactation.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Torasemide is evaluated for the following indications with varying evidence strength: Heart failure (evidence tier A), Hypertension (evidence tier B), Body detoxification and cleansing (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Torasemide (≥ 1 in 100): Polyuria, Thirst, Hypokalemia, Hyponatremia, Hypomagnesemia, Hyperuricemia. See the Safety section for uncommon and serious reactions.
FDA category B. Limited data. In pregnant HF patients, decisions are made with the cardiologist. Loop diuretics are not routine therapy in pre-eclampsia.
Suppresses lactation. Not used during lactation.
Torasemide is contraindicated in: Hypersensitivity to torasemide or sulfonamides; Anuria; Hepatic coma; Severe hypotension; Severe hypokalemia or hyponatremia. Full list in the Safety section.