Drilldown: Medicines
Medicines > classes 
:
[[:Category:Antihypertensives|Antihypertensive]] or
[[:Category:Loop_diuretics|Loop diuretic]]
& routes:
IV
:
[[:Category:Antihypertensives|Antihypertensive]] or
[[:Category:Loop_diuretics|Loop diuretic]]
& routes:
IV Use the filters below to narrow your results.
generic:
brand:
Apresoline (historical); mostly generic; combination with isosorbide dinitrate marketed as BiDil for self-identified Black patients with HFrEF (1) ·
Bumex (1) ·
Calan, Calan SR, Verelan, Verelan PM, Isoptin SR (1) ·
Cardizem, Tiazac, Cartia XT, Dilacor XR, Taztia XT, Matzim LA (1) ·
Demadex, Soaanz (1) ·
Lasix (1) ·
Vasotec, Vasotec IV, Epaned (1)
classes: (Click arrow to add another value)
mechanism:
None (5) ·
'"`UNIQ--vote-0000063C-QINU`"' Avoid in HFrEF (negative inotropy). CYP3A4 substrate AND moderate inhibitor — interacts substantially with statins (especially simvastatin), tacrolimus, cyclosporine, and many other CYP3A4 substrates'"`UNIQ--ref-0000063D-QINU`"'. (1) ·
'"`UNIQ--vote-00000B40-QINU`"' The TRANSFORM-HF trial (2023) found no all-cause mortality difference between torsemide and furosemide in heart failure, although torsemide remains pharmacologically preferred where furosemide oral absorption is unreliable'"`UNIQ--ref-00000B41-QINU`"'. (1)
uses:
'"`UNIQ--vote-0000021C-QINU`"', '"`UNIQ--vote-0000021D-QINU`"', '"`UNIQ--vote-0000021E-QINU`"', '"`UNIQ--vote-0000021F-QINU`"', '"`UNIQ--vote-00000220-QINU`"', '"`UNIQ--vote-00000221-QINU`"' (1) ·
'"`UNIQ--vote-0000063E-QINU`"', '"`UNIQ--vote-0000063F-QINU`"', '"`UNIQ--vote-00000640-QINU`"', '"`UNIQ--vote-00000641-QINU`"' (1) ·
'"`UNIQ--vote-00000683-QINU`"', '"`UNIQ--vote-00000684-QINU`"', '"`UNIQ--vote-00000685-QINU`"', '"`UNIQ--vote-00000686-QINU`"' (1) ·
'"`UNIQ--vote-00000A66-QINU`"', '"`UNIQ--vote-00000A67-QINU`"', '"`UNIQ--vote-00000A68-QINU`"', '"`UNIQ--vote-00000A69-QINU`"', '"`UNIQ--vote-00000A6A-QINU`"' (1) ·
'"`UNIQ--vote-00000B42-QINU`"', '"`UNIQ--vote-00000B43-QINU`"', '"`UNIQ--vote-00000B44-QINU`"', '"`UNIQ--vote-00000B45-QINU`"' (1) ·
'"`UNIQ--vote-00000B81-QINU`"', '"`UNIQ--vote-00000B82-QINU`"', '"`UNIQ--vote-00000B83-QINU`"' (1) ·
'"`UNIQ--vote-00000DDF-QINU`"', '"`UNIQ--vote-00000DE0-QINU`"', '"`UNIQ--vote-00000DE1-QINU`"', '"`UNIQ--vote-00000DE2-QINU`"' (1)
starting dose:
0.5-1 mg PO/IV once or twice daily; titrate to clinical response. Approximate equipotency: bumetanide 1 mg ≈ furosemide 40 mg ≈ torsemide 20 mg (1) ·
10-20 mg PO/IV once daily; titrate by clinical response. 1:1 IV to PO conversion (unlike furosemide's 1:2) (1) ·
20-40 mg PO/IV; titrate by clinical response. In diuretic-resistant heart failure or CKD, doses to 200 mg or higher may be needed (1) ·
5-10 mg PO once daily (2.5 mg if on diuretic or in heart failure); titrate to 10-20 mg BID for HFrEF (1) ·
ER 180-240 mg PO once daily; IR 30 mg PO QID; IV 0.25 mg/kg over 2 min for acute rate control, then 5-15 mg/h infusion (1) ·
IR 80-120 mg PO TID; ER 180-240 mg PO daily; IV 2.5-5 mg over 2 min for SVT termination (under monitoring); cluster prophylaxis up to 480-960 mg/d in divided doses (1) ·
PO 10 mg QID; IV 5-10 mg every 20-30 minutes for hypertensive emergency (1)
preparations:
0.5, 1, 2 mg tablets; 0.25 mg/mL IV (1) ·
10, 25, 50, 100 mg tablets; 20 mg/mL IV (1) ·
2.5, 5, 10, 20 mg tablets; 1 mg/mL oral solution (Epaned); 1.25 mg/mL IV (enalaprilat) (1) ·
20, 40, 80 mg tablets; 10 mg/mL oral solution; 10 mg/mL IV (1) ·
5, 10, 20, 100 mg tablets; 10 mg/mL IV (1) ·
IR 30, 60, 90, 120 mg tablets; multiple ER capsules and tablets 60-420 mg; IV 5 mg/mL (1) ·
IR 40, 80, 120 mg tablets; SR/ER 100-360 mg; IV 2.5 mg/mL (1)
fda max:
200 mg/d typical practical ceiling (1) ·
300 mg/d typical practical limit (toxicity rises sharply above) (1) ·
40 mg/d (1) ·
600 mg/d typical practical ceiling in heart failure (1) ·
~10 mg/d typical (1) ·
~480 mg/d (oral) for cardiovascular indications; higher off-label for cluster (1) ·
~480 mg/d (oral); IV per protocol (1)
routes: (Click arrow to add another value)
onset:
BP effect 1 hour; max at 4-6 hours (1) ·
IV: 1-3 minutes (SVT termination); PO IR: 30-60 minutes; ER: hours (1) ·
IV: 3-7 minutes (rate control); PO IR: 30-60 minutes; ER: hours (1) ·
IV: 5 minutes; PO: 30-60 minutes (1) ·
IV: 5-20 minutes; PO: 30-60 minutes (1) ·
PO 1 hour; IV 10 minutes (1) ·
PO 30-60 minutes; IV minutes (1)
duration:
halflife:
1-1.5 hours'"`UNIQ--ref-00000DE3-QINU`"' (1) ·
1.5-2 hours (longer in renal failure)'"`UNIQ--ref-00000222-QINU`"' (1) ·
3-4 hours (similar between PO and IV due to high oral bioavailability)'"`UNIQ--ref-00000B46-QINU`"' (1) ·
3-4.5 hours (IR); 5-7 hours (ER; effective duration 24 hours via formulation)'"`UNIQ--ref-00000642-QINU`"' (1) ·
3-7 hours (IR); functional 24 hours (ER)'"`UNIQ--ref-00000A6B-QINU`"' (1) ·
3-7 hours (slow acetylators) vs 1-3 hours (rapid acetylators) via NAT2 polymorphism'"`UNIQ--ref-00000687-QINU`"' (1) ·
~11 hours (enalaprilat, the active metabolite)'"`UNIQ--ref-00000B84-QINU`"' (1)
bioavailability:
~20-35% (oral; extensive first-pass via CYP3A4 with R/S enantiomer differences)'"`UNIQ--ref-00000A6C-QINU`"' (1) ·
~25-50% (oral; substantial first-pass via NAT2 acetylation, phenotype-dependent)'"`UNIQ--ref-00000688-QINU`"' (1) ·
~40% (oral; extensive first-pass via CYP3A4)'"`UNIQ--ref-00000643-QINU`"' (1) ·
~50% (oral; highly variable, 10-100%, hence the standard 1:2 IV-to-PO conversion)'"`UNIQ--ref-00000223-QINU`"' (1) ·
~60% (oral; food does not affect absorption)'"`UNIQ--ref-00000B85-QINU`"' (1) ·
~80% (oral; predictable absorption — a substantive practical advantage over furosemide whose oral absorption is 10-100% variable)'"`UNIQ--ref-00000B47-QINU`"' (1) ·
~80-95% (oral; more reliable than furosemide, comparable to torsemide)'"`UNIQ--ref-00000DE4-QINU`"' (1)
pregnancy:
'''Contraindicated in pregnancy''' (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection'"`UNIQ--ref-00000B86-QINU`"' (1) ·
Avoid where possible; can reduce uteroplacental perfusion and produce neonatal electrolyte disturbance. Reserved for compelling indications.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Avoid where possible; class concerns as for other loop diuretics.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (2) ·
Limited data; alternative antihypertensives generally preferred. Crosses placenta.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; labetalol/nifedipine generally preferred. Crosses placenta.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
One of the historically preferred IV agents for severe hypertension in pregnancy alongside labetalol and nifedipine.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
Showing below up to 7 results in range #1 to #7.