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torasemide (torasemide PR / Britomar / Sutril)

✓ Approved

Takeda · SLC12A1 · Small Molecule

What is torasemide?

torasemide is a small molecule developed by Takeda. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namestorasemide PR, Britomar, Sutril
CompanyTakeda
Drug ClassSmall Molecule
Molecular TargetSLC12A1, SLC12A2
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Takeda

Mechanism of Action

Molecular Targets

torasemide acts on 2 molecular targets:

SLC12A1solute carrier family 12 member 1 (NKCC2, BSC1)
SLC12A2solute carrier family 12 member 2 (PPP1R141, hNKCC1)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

torasemide is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Vascular disordersHypertension✓ Approved

Related Research Articles

PubMedBiomedical engineering letters2026-09-27

Medication-specific risk of atrial fibrillation in patients with coronary artery disease.

Kim Taehyun T, Ryu Gayeon G, Choi Ye Eun YE, Shin Hangsik H

Cardiovascular medications used in coronary artery disease (CAD) can potentially modulate the risk of incident atrial fibrillation (AF). However, comprehensive data regarding medication-specific AF risk in the CAD population remain limited. This study aimed to identify prevalent medications prescribed to patients with CAD and evaluate their independent associations with AF risk. In this retrospective cohort study of 157,750 patients with CAD and related comorbidities, CAD-predominant medications were identified based on a frequency analysis of prescriptions in the overall cohort. Among 99,370 patients who received at least one such medication, associations with incident AF were evaluated using extended Cox proportional hazards models with time-varying covariates. Overall, 30 CAD-predominant medications were identified across nine pharmacological classes. In multivariable Cox proportional hazards models, six medications were significantly associated with AF risk, of which one was associated with a lower risk and five with a higher risk. Ezetimibe/rosuvastatin was associated with reduced AF risk, whereas diltiazem HCl, torasemide, heparin sodium, bisoprolol fumarate, and norepinephrine were associated with increased risk. Torasemide showed the strongest positive association. AF risk demonstrated heterogeneity across different CAD medications. Antilipidemic agents were associated with a lower AF risk, whereas certain diuretics, antianginal agents, antihypertensive, and vasoactive agents were associated with a higher risk. These results may have implications for individualized pharmacotherapy and AF prevention in patients with CAD. The online version contains supplementary material available at https://doi.org/10.1007/s13534-026-00589-6.

PMID 42801026
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PubMedAnimals : an open access journal from MDPI2026-09-15

Long-Term Control of Refractory Cardiogenic Pleural Effusion in a Cat Treated with Sacubitril/Valsartan and Hydrochlorothiazide: A Case Report.

Maftei Mălina-Cristina MC, Scîntei Laura Marina LM, Beschea Chiriac Sorin Ioan SI, Vulpe Vasile V et al.

Sacubitril/valsartan is an angiotensin receptor-neprilysin inhibitor (ARNI) widely used in human heart failure and has demonstrated potential cardiorenal and neurohormonal effects in experimental canine studies. Hydrochlorothiazide is a thiazide diuretic that acts at a more distal segment of the nephron than furosemide. Its addition to loop diuretic therapy may enhance sodium and fluid excretion through sequential nephron blockade and thereby improve the diuretic response in cases of refractory congestion. However, information regarding the combination of these two drugs in cats with congestive heart failure is lacking. This report describes the long-term clinical outcome of a cat with recurrent cardiogenic pleural effusion treated with sacubitril/valsartan and hydrochlorothiazide. A 14-year-old spayed female Persian-cross cat was referred for severe respiratory distress caused by recurrent pleural effusion. Echocardiography identified advanced cardiomyopathy with a nonspecific phenotype and overlapping hypertrophic and restrictive features, including focal basal septal hypertrophy, biatrial enlargement, atrial fibrillation and spontaneous echocardiographic contrast. Despite conventional treatment, which included pimobendan, torasemide, and antithrombotic medications, the cat experienced multiple episodes of pleural effusion over the following months, requiring repeated thoracocentesis. Consequently, the treatment regimen was expanded to include sacubitril/valsartan and hydrochlorothiazide. According to the owner, all other cardiac medications were discontinued approximately one week later without veterinary consultation. At long-term follow-up approximately two years after sacubitril/valsartan and hydrochlorothiazide therapy initiation, the cat remained clinically stable, with no further episodes of respiratory distress. Echocardiography revealed persistent severe structural heart disease, although improved left ventricular systolic indices were observed. This case report describes prolonged clinical stabilization in a cat with advanced cardiomyopathy and recurrent congestive heart failure following the administration of sacubitril/valsartan and hydrochlorothiazide over a two-year period. Whether this outcome reflects a specific effect of sacubitril/valsartan, the addition of hydrochlorothiazide, or a combination of both cannot be determined from a single observation. Nonetheless, the duration and completeness of the response observed here warrant prospective evaluation of combination of ARNI therapy and hydrochlorothiazide in cats with refractory congestive heart failure. Further studies are needed to assess the safety and effectiveness of this approach in feline cardiomyopathy.

PMID 42738489
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PubMedKidney international reports2026-08-28

Comparing Ibuprofen and Loop Diuretics for Protein-Bound Uremic Toxins Clearance During Hemodialysis.

Escudero-Saiz Víctor Joaquín VJ, Cuadrado-Payán Elena E, Rodríguez-García María M, Casals Gregori G et al.

Protein-bound uremic toxins (PBUTs), such as indoxyl sulphate (IS) and p-cresyl sulphate (pCS) are associated with cardiovascular mortality in patients undergoing hemodialysis. Because of their high albumin affinity, conventional dialysis techniques achieve poor clearance. This study aims to evaluate the efficacy of different competitive binding displacement strategies using ibuprofen and loop diuretics during online hemodiafiltration (OL-HDF). A longitudinal, cross-over study in 12 patients undergoing chronic hemodialysis was performed. Each patient underwent 6 different dialysis modalities based on postdilutional HDF. The experimental arms included the following: (i) Standard postdilutional HDF (control), (ii) High-flux hemodialysis (HF-HD) (iii) Oral furosemide 1h predialysis, (iv) Oral torasemide 1h predialysis, (v) 1h arterial infusion of furosemide, and (vi) 1h arterial infusion of ibuprofen. Reduction ratios (RR) for IS and pCS were calculated for each session. Statistical analysis was performed using 1-way repeated measures analysis of variance with Bonferroni post hoc correction. Arterial administration of ibuprofen was the only strategy that significantly enhanced PBUT removal, achieving mean RR of 65% for IS and 60% for pCS (P < 0.05 vs. baseline OL-HDF). In contrast, neither oral nor arterial administration of loop diuretics showed a statistically significant increase in the RR of IS or pCS when compared with OL-HDF. No acute adverse events were reported during the pharmacological interventions. Prefilter arterial infusion of ibuprofen is the most effective strategy for increasing the intradialytic clearance of IS and pCS during OL-HDF. The lack of efficacy observed with furosemide suggests a ceiling effect in high-volume HDF, where only high-affinity competitors can further displace PBUTs from albumin-binding sites. Pharmacological displacement represents a promising adjunct to convective therapies to optimize protein-bound uremic toxin removal.

PMID 42662542
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PubMedJACC. Case reports2026-07-10

Long-Term Hemodynamic Stabilization With TTR-Stabilizing Therapy and Pressure-Guided Management in ATTR Cardiomyopathy.

Sedighi Jamschid J, Unsöld Bernhard B, Boettger Priyanka P, Herrmann Ester J EJ et al.

Transthyretin amyloidosis with cardiomyopathy (ATTR-CM) is underdiagnosed in heart failure with preserved ejection fraction. Although disease-modifying therapies slow the disease progression, their long-term hemodynamic effects remain unclear. An 82-year-old woman with recently confirmed wild-type ATTR-CM and NYHA functional class III heart failure with preserved ejection fraction underwent pulmonary artery pressure (PAP) sensor implantation for recurrent heart failure hospitalizations shortly after the initiation of transthyretin-stabilizing therapy in 2022. During 3.5 years of follow-up, diastolic PAP decreased from 21 to 7 mm Hg, accompanied by torasemide reduction from 60 to 10 mg/day. In this case, the combination of transthyretin-stabilizing therapy and PAP-guided follow-up was associated with sustained hemodynamic improvement and clinical stability. However, the independent contribution of pulmonary artery monitoring cannot be determined from a single uncontrolled observation. Remote PAP-guided management may support disease-modifying treatment in selected patients with ATTR-CM.

PMID 42429736
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PubMedFarmaceuticos comunitarios2026-07-01

Pharmacotherapeutic Optimization in a Polymedicated Patient Through Coordinated Pharmaceutical Intervention: A Community Pharmacy Case Report.

Vera Peña A A, Dévora Gutiérrez S S, Morales Marrero C C, Vitória Figueiredo I I et al.

Case presentation: An 82-year-old woman, polymedicated (receiving chronic treatment with ten active pharmaceutical ingredients) and independent for basic activities of daily living, was evaluated. Following a hospital consultation due to fatigue and electrolyte disturbances, a family member attended the community pharmacy (CP) with the clinical documentation, requesting support to improve adherence and pharmacotherapy follow-up through repackaging using a Multicompartment Compliance Aid (MCA) [1]. Case study and evaluation: During the initial interview, several Drug-Related Problems (DRPs) were identified: inappropriate dosage of olmesartan/hydrochlorothiazide, combination of diuretics with kaliuretic effect (torasemide and hydrochlorothiazide), prolonged use of omeprazole without current indication, lack of recent laboratory monitoring in the management of hypercholesterolemia, untreated cognitive impairment, and unnecessary prescription of paracetamol. These DRPs posed a risk of generating Negative Outcomes associated with Medication (NOMs) within the three categories established by the Community Pharmacy Pharmaceutical Care Forum: necessity, effectiveness, and safety (2). Intervention: From the community pharmacy, and in coordination with the family and the primary care team, the dosage regimen of olmesartan/hydrochlorothiazide was adjusted, torasemide and paracetamol were discontinued, the atorvastatin dose was modified according to recent laboratory results, and, following specialist recommendation, memantine 10 mg/day together with cognitive stimulation measures was initiated. Results: Serum potassium levels normalized, adequate blood pressure control was achieved, the lipid profile was optimized, and therapeutic adherence improved through the use of the MCA. The patient reported better sleep quality, absence of pain, and greater functional autonomy. Conclusions: Coordinated intervention between community pharmacy, family environment, and primary care allowed optimization of pharmacotherapy, reduction of overmedication, and improvement in quality of life. This case illustrates the clinical and social value of Professional Pharmaceutical Care Services when developed within an integrated care framework, reinforcing the strategic role of community pharmacy in the comprehensive care of older polymedicated patients within a person-centered healthcare model.

PMID 42382139
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PubMedJournal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology2026-06-02

Clinical findings and survival time in dogs with myxomatous mitral valve disease at the American College of Veterinary Internal Medicine stage D.

Oricco S S, Crosara S S, Mazzoldi C C, Apolloni I I et al.

Data on dogs with end-stage myxomatous mitral valve disease (MMVD) are sparse. This study aimed to describe the clinical findings and survival time of dogs with MMVD at the American College of Veterinary Internal Medicine (ACVIM) stage D. Dogs with MMVD receiving a total daily dosage of furosemide >8 mg/kg/day, or the equivalent dosage of torasemide, were retrospectively searched. Signalment, clinical, echocardiographic, electrocardiographic, laboratory, therapeutic, and outcome data were retrieved. A statistical analysis was performed to assess the entire population and compare specific subgroups of dogs based on their treatment protocols. Sixty-one dogs were included. At the time of study inclusion, left-sided congestive heart failure, pulmonary hypertension, and arrhythmias were documented in 38 of 49 (77.5%), 23 of 61 (37.7%), and 18 of 61 (29.5%) dogs, respectively. The median time needed to progress from the ACVIM stage C to D was 245 days (144-376 days). After diagnosis of stage D, the median survival time for cardiac-related death was 155 days (103-259 days). When comparing dogs receiving furosemide or torasemide, there were no significant differences in median survival time (P=0.47), serum sodium concentration (P=0.554), or serum chloride concentration (P=0.638). However, dogs receiving torasemide had higher serum creatinine (P=0.025) and lower potassium concentrations (P=0.005). The limitations of this study included the retrospective study design and heterogeneous treatment protocols. This study provides novel data on the clinical characteristics and survival expectations of dogs with MMVD at the ACVIM stage D.

PMID 42225449
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