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Suggest Alternate Over The Counter Medication For Torsemide
Question: I am diabetic.
For controlling Blood Pressure I am taking:
1) Losartan Potassium 50 mg 1-0-1
2) Amlodipine 5 mg 0-0-1
3) Hydrochlorothiazide 12.5 mg 1-0-0
4) Torsemide 5 mg 1-0-1
Also taking:
a) Atorvastatin 10 mg 0-0-1
b) Ecosprin75 0-1-0
My BP is under control.
Can I do away with one chemical in Torsemide by taking following combination? (Yes/No):
(Doubling the dose of Amlodipine and Hydrochlorothiazide as follows:)
1) Losartan Potassium 50 mg 1-0-1
2) Amlodipine 5 mg 0-0-2
3) Hydrochlorothiazide 12.5 2-0-0
Please advice. Thanks.
For controlling Blood Pressure I am taking:
1) Losartan Potassium 50 mg 1-0-1
2) Amlodipine 5 mg 0-0-1
3) Hydrochlorothiazide 12.5 mg 1-0-0
4) Torsemide 5 mg 1-0-1
Also taking:
a) Atorvastatin 10 mg 0-0-1
b) Ecosprin75 0-1-0
My BP is under control.
Can I do away with one chemical in Torsemide by taking following combination? (Yes/No):
(Doubling the dose of Amlodipine and Hydrochlorothiazide as follows:)
1) Losartan Potassium 50 mg 1-0-1
2) Amlodipine 5 mg 0-0-2
3) Hydrochlorothiazide 12.5 2-0-0
Please advice. Thanks.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I could say that you can make these changes in your therapy, if you don't tolerate torasemide.
But, first it is important to determine the reason you were prescribed torasemide.
Do you suffer from cardiac failure? What about your renal function?
Could you please upload the reports of your latest cardiac ultrasound and your blood lab tests (renal function tests) for me to review?
If you don't suffer from any of the above disorders, there is not problem in making these changes to your therapy (stop torasemide and double the dose of hydrochlorthiazide and amlodipine).
Nevertheless, I recommend you to closely monitor your blood pressure during the first 2 weeks after changing the therapy and refer those values to your attending physician. If your blood pressure will not be under control after making some changes, you should discuss with your doctor the possibility of further changes to your therapy.
Hope you will find this answer helpful!
If you have any other questions, don't hesitate to ask me!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I could say that you can make these changes in your therapy, if you don't tolerate torasemide.
But, first it is important to determine the reason you were prescribed torasemide.
Do you suffer from cardiac failure? What about your renal function?
Could you please upload the reports of your latest cardiac ultrasound and your blood lab tests (renal function tests) for me to review?
If you don't suffer from any of the above disorders, there is not problem in making these changes to your therapy (stop torasemide and double the dose of hydrochlorthiazide and amlodipine).
Nevertheless, I recommend you to closely monitor your blood pressure during the first 2 weeks after changing the therapy and refer those values to your attending physician. If your blood pressure will not be under control after making some changes, you should discuss with your doctor the possibility of further changes to your therapy.
Hope you will find this answer helpful!
If you have any other questions, don't hesitate to ask me!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir,
Main reason to reduce amlodipine by 5 mg and to add torasemide was edema on foot. But, createnine was within limit and edema was due to Pioglitazone.
So, if the change what i am suggesting can keep my BP in control i am OK. if there is little swelling on foot i don't mind as far as i know that it is not because of my kidney... Also, reducing one chemical can also reduce drug interactions and undue side-effects.
What is your opinion Sir?
Main reason to reduce amlodipine by 5 mg and to add torasemide was edema on foot. But, createnine was within limit and edema was due to Pioglitazone.
So, if the change what i am suggesting can keep my BP in control i am OK. if there is little swelling on foot i don't mind as far as i know that it is not because of my kidney... Also, reducing one chemical can also reduce drug interactions and undue side-effects.
What is your opinion Sir?
Brief Answer:
My opinion:
Detailed Answer:
Hi again,
You are right about Pioglitazone; it may be the cause of edema and heart failure exacerbation in up to around 30% of patients especially when used concomitantly with insulin or sulfonylurea derivates.
I think that stopping Torasemide and increasing Amlodipine and Hydrochlorothiazide would be an acceptable option for controlling your high blood pressure.
But, first we need to be sure of your actual cardiac function. That's why I insist for a review of your recent cardiac ultrasound report.
You also need to check your liver function tests as Amlodipine is mainly metabolized by hepatic enzymatic pathways. It has the advantage of not interfering with renal function status and is generally well tolerated, though it may also show adverse effects too like leg edema.
Discuss with your prescribing doctor about the above mentioned issues (actual cardiac function status, liver function tests, and the recent BP values average), before undergoing any antihypertensive therapy changes.
I remain at your disposal for further discussions. In case of available echo and lab tests data do not hesitate to upload them here for a direct review.
Regards,
Dr. Iliri
My opinion:
Detailed Answer:
Hi again,
You are right about Pioglitazone; it may be the cause of edema and heart failure exacerbation in up to around 30% of patients especially when used concomitantly with insulin or sulfonylurea derivates.
I think that stopping Torasemide and increasing Amlodipine and Hydrochlorothiazide would be an acceptable option for controlling your high blood pressure.
But, first we need to be sure of your actual cardiac function. That's why I insist for a review of your recent cardiac ultrasound report.
You also need to check your liver function tests as Amlodipine is mainly metabolized by hepatic enzymatic pathways. It has the advantage of not interfering with renal function status and is generally well tolerated, though it may also show adverse effects too like leg edema.
Discuss with your prescribing doctor about the above mentioned issues (actual cardiac function status, liver function tests, and the recent BP values average), before undergoing any antihypertensive therapy changes.
I remain at your disposal for further discussions. In case of available echo and lab tests data do not hesitate to upload them here for a direct review.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir,
My prescribing doctor wants me to continue with Torasemide! It is myself who is thinking of reducing one chemical as Torasemide was the last entry in my prescription for reducing edema chiefly. If you also feel that my body is good tolerant to it I don't want to stop taking it. But, I have read on some website that Torasemide can be taken only once a day. I am taking 5mg twice a day!
So, now concluding remarks:
1) Do I make the change (discontinue Torasemide)? (Yes or No).
2) If No, can Torasemide 5 mg taken twice a day (1-0-1)? (Yes or No).
I am a layman, please guide me by answering in Yes / No.
Don't confuse me further. Thanks.
My prescribing doctor wants me to continue with Torasemide! It is myself who is thinking of reducing one chemical as Torasemide was the last entry in my prescription for reducing edema chiefly. If you also feel that my body is good tolerant to it I don't want to stop taking it. But, I have read on some website that Torasemide can be taken only once a day. I am taking 5mg twice a day!
So, now concluding remarks:
1) Do I make the change (discontinue Torasemide)? (Yes or No).
2) If No, can Torasemide 5 mg taken twice a day (1-0-1)? (Yes or No).
I am a layman, please guide me by answering in Yes / No.
Don't confuse me further. Thanks.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello,
Torasemide and Hydrochlorothiazide used concomitantly are not justified when treating a well-controlled hypertension.
If cardiac function (measured by cardiac ECHO) is OK, then Hydrochlorothiazide is chosen; but, if it is decreased Torasemide is a better choice.
That's why I asked you to possibly upload your cardiac ECHO report.
To make it simple for you, I recommend (in the absence of cardiac ECHO report):
(1) Continue Torasemide, but discuss with your doctor to stop Hydrochlorothiazide.
(2) Take Torasemide 10 mg once daily (in the morning).
In case of any further uncertainties, do not hesitate to discuss with me.
Hope to have been helpful with my answer.
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello,
Torasemide and Hydrochlorothiazide used concomitantly are not justified when treating a well-controlled hypertension.
If cardiac function (measured by cardiac ECHO) is OK, then Hydrochlorothiazide is chosen; but, if it is decreased Torasemide is a better choice.
That's why I asked you to possibly upload your cardiac ECHO report.
To make it simple for you, I recommend (in the absence of cardiac ECHO report):
(1) Continue Torasemide, but discuss with your doctor to stop Hydrochlorothiazide.
(2) Take Torasemide 10 mg once daily (in the morning).
In case of any further uncertainties, do not hesitate to discuss with me.
Hope to have been helpful with my answer.
Regards,
Dr. Iliri
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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