[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Loop diuretics](https://durgical.com/en/pharmacology/classes/loop-diuretics/) › Torasemide

[Pharmacology](https://durgical.com/en/pharmacology/) · [Loop diuretics](https://durgical.com/en/pharmacology/classes/loop-diuretics/)

# Torasemide

A loop diuretic with reliable oral absorption and longer action than furosemide. Used for oedema and high blood pressure.

Updated 2026-11-01

- Class: [Loop diuretics](https://durgical.com/en/pharmacology/classes/loop-diuretics/)
- Transporter: Na⁺-K⁺-2Cl⁻ cotransporter (NKCC2) of the loop of Henle
- ATC code: C03CA04

Also called: Torsemide

⇄**Na⁺-K⁺-2Cl⁻ cotransporter (NKCC2) of the loop of Henle**Torasemide

ⓘ The figure shows torasemide bound to human NKCC1, the closely related cotransporter found outside the kidney; NKCC2, the renal target, belongs to the same family and binds loop diuretics in the same way.

**Target in 3D:** Na⁺-K⁺-2Cl⁻ cotransporter (NKCC2) of the loop of Henle. PDB structure 9C0G (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/9C0G) · Drag to rotate · pinch to zoom

## Mechanism of action

Torasemide reaches the tubule lumen by secretion in the proximal tubule and blocks the Na⁺-K⁺-2Cl⁻ cotransporter (NKCC2) in the thick ascending limb. Sodium, chloride and water are lost in the urine, with potassium. Its good oral absorption gives a more predictable effect than furosemide.

- Torasemide is secreted into the proximal tubule
- It blocks NKCC2 in the thick ascending limb
- Na⁺, Cl⁻ and water are lost; K⁺ too
- Predictable oral effect: less oedema, lower pressure

## Pharmacokinetics

**Absorption**
About 80% bioavailable by mouth, with little variation between people

**Metabolism**
Mostly by the liver (CYP2C9)

**Elimination**
Liver metabolism and urine

**Half-life**
About 3.5 hours

## Indications

- Oedema from heart failure [Heart failure →](https://durgical.com/en/conditions/heart-failure/)
- Oedema from kidney or liver disease [Chronic kidney disease →](https://durgical.com/en/conditions/chronic-kidney-disease/)
- High blood pressure [Arterial hypertension →](https://durgical.com/en/conditions/arterial-hypertension/)

## Adverse effects

### Common

- Increased urination
- Dizziness and headache
- Hypokalaemia
- Muscle cramps

### Serious (rare, important)

- Dehydration, low blood pressure and worsening kidney function
- Ototoxicity with other ototoxic drugs
- Hepatic encephalopathy in cirrhosis from electrolyte shifts
- Thiamine deficiency

## Contraindications

- Anuria
- Hepatic coma
- Hypersensitivity to torasemide

## Key interactions

**Aminoglycosides or etacrynic acid**
More ototoxicity

**Warfarin, phenytoin or celecoxib (CYP2C9 substrates)**
Torasemide can raise their levels

**Probenecid**
Less torasemide reaches the tubule; weaker diuresis

**Lithium**
Less lithium clearance and risk of toxicity

**Cholestyramine**
Less torasemide absorbed; doses are separated

## What is monitored

- Potassium and other electrolytes
- Kidney function
- Blood pressure
- Weight and fluid balance

## Nursing care

- Before giving: blood pressure, potassium and kidney function.
- Daily weight and signs of dehydration.
- Check INR more closely in patients on warfarin.
- Teach: rise slowly, drink enough fluid in hot weather or with diarrhoea, report dizziness or fainting.

## Pregnancy and breastfeeding

Not a usual treatment in pregnancy; used only if clearly needed.

## Memory aid

Torasemide is the «steady» loop: it is absorbed well and lasts longer, so the diuresis is more predictable.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the advantage of torasemide over oral furosemide?

Its oral absorption is high and consistent between people, so its effect is more predictable.

## Which enzyme metabolises torasemide, and which drugs does that affect?

CYP2C9; torasemide can raise levels of CYP2C9 substrates such as warfarin, phenytoin and celecoxib.

## How does probenecid weaken torasemide?

It competes for secretion into the proximal tubule, so less torasemide reaches its site of action in the lumen.

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## Related drugs

- [Furosemide](https://durgical.com/en/pharmacology/furosemide/)
- [Bumetanide](https://durgical.com/en/pharmacology/bumetanide/)

## Related conditions

- [Heart failure](https://durgical.com/en/conditions/heart-failure/)
- [Chronic kidney disease](https://durgical.com/en/conditions/chronic-kidney-disease/)
- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)

[← Back to the class: Loop diuretics](https://durgical.com/en/pharmacology/classes/loop-diuretics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - TORSEMIDE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=09305350-e317-419c-96f5-aa8fbeb4044d) (DailyMed (U.S. National Library of Medicine), 2026); [Torsemide: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a601212.html) (MedlinePlus (U.S. National Library of Medicine), 2024); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C03CA04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [RCSB PDB - 9C0G: Phosphorylated human NKCC1 in complex with torsemide](https://www.rcsb.org/structure/9C0G) (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/torasemide/