Lasix (furosemide) vs. Demadex (torsemide): What’s the difference?
- Lasix (furosemide) and Demadex (torsemide) are diuretics (water pills) used to treat edema (water retention) due to congestive heart failure, kidney disease, chronic kidney failure, or liver disease. Lasix and Demadex are also used with other high blood pressure medications to treat high blood pressure (hypertension).
- Lasix is a brand name for furosemide.
- Demadex is a brand name for torsemide.
- Side effects of Lasix and Demadex that are similar include dehydration, nausea, diarrhea, and dizziness.
- Side effects of Lasix that are different from Demadex include low blood pressure, electrolyte depletion, yellowing skin and eyes (jaundice), ringing in the ears, sensitivity to light, rash, pancreatitis, abdominal pain, increased blood sugar, and increased uric acid levels.
- Side effects of Demadex that are different from Lasix include headache, excessive urination, runny nose, weakness, ECG abnormality, cough, constipation, joint pain, stomach upset, sore throat, muscle pain, insomnia, edema, and nervousness.
What are Lasix and Demadex?
Lasix is a potent diuretic (water pill) that is used to eliminate water and salt from the body. In the kidneys, salt (composed of sodium and chloride), water, and other small molecules normally are filtered out of the blood and into the tubules of the kidney. The filtered fluid ultimately becomes urine. Most of the sodium, chloride, and water filtered out of the blood is reabsorbed into the blood before the filtered fluid becomes urine and is eliminated from the body. Lasix works by blocking the absorption of sodium, chloride, and water from the filtered fluid in the kidney tubules, causing a profound increase in the output of urine (diuresis).
Demadex is a diuretic (water pill) used to treat edema (water retention) due to congestive heart failure, kidney disease, chronic kidney failure, or liver disease. It also is used to treat high blood pressure (hypertension). This medicine causes a profound increase in urine output (diuresis) by preventing the kidney from retaining water. Specifically, it blocks the reabsorption back into the blood of sodium and water that has been filtered out of the blood in the kidneys. It is in a class of diuretic drugs called "loop" diuretics, which also includes the drugs Lasix (furosemide) and Bumex (bumetanide).
In the U.S., 1 in every 4 deaths is caused by heart disease.
What are the side effects of Lasix and Demadex?
Common side effects of Lasix are:
Other important side effects include:
- Ringing in the ears (tinnitus)
- Sensitivity to light (photophobia)
- Abdominal pain
Increased blood sugar and uric acid levels also may occur.
Potent medication like Demadex can cause low blood levels of potassium, magnesium, sodium, and calcium. Additionally, fluid losses may lead to dehydration. The symptoms of dehydration may include:
- Dry mouth
- Reduced kidney function
- Heart arrhythmias
- Muscle aches and pains
Possible side effects of this medication reported often include:
- Excessive urination
- Runny nose
- ECG abnormality
- Joint pain
- Stomach upset
- Sore throat
- Muscle pain
Possible serious side effects and adverse effects include:
- Atrial fibrillation
- Chest pain
- Gastrointestinal bleeding
- High blood sugar (hyperglycemia)
- Increased uric acid (hyperuricemia)
- Low blood potassium (hypokalemia)
- Low blood pressure (hypotension)
- Dehydration (symptoms listed previously)
- Shunt thrombosis
- Rectal bleeding
- Ventricular tachycardia
- Serious skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Allergic reactions
- Reduced number of white blood cells and platelets
Demadex can cause dehydration and loss of potassium and other electrolytes. Low potassium levels (hypokalemia) can cause abnormal heartbeats especially in people with heart disease or those taking the medicine digoxin (Lanoxin). Levels of potassium and other electrolytes should be monitored during medical treatment with this medicine.
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What is the dosage of Lasix vs. Demadex?
- The usual starting oral dose for treatment of edema in adults is 20 to 80 mg as a single dose. The same dose or an increased dose may be administered 6 to 8 hours later. Doses may be increased by 20 to 40 mg every 6 to 8 hours until the desired effect occurs. The effective dose may be administered once or twice daily. Some patients may require 600 mg daily.
- The starting oral dose for children is 2 mg/kg. The starting dose may be increased by 1 to 2 mg/kg every 6 hours until the desired effect is achieved. Doses greater than 6 mg/kg are not recommended.
- The recommended dose for treating hypertension is 40 mg twice daily. The dose of other blood pressure medications should be reduced by half when Lasix is added.
- Demadex (torsemide) comes in tablets of 5, 10, 20, and 100 mg. The 10 mg/ml injectable solution has been discontinued.
- Patients can take the tablets at any time without regard to meals. (You can take it on an empty stomach.)
- For the treatment for patients with heart failure, the initial dose is 10 to 20 mg by mouth or injection once daily. The dose may be doubled until the desired diuretic effect is achieved. The maximum dose is 200 mg daily.
- Chronic kidney failure is treated with 20 to 200 mg orally or by injection once daily.
- The dose for treating high blood pressure is 2.5 to 10 mg orally once daily.
- Liver cirrhosis is treated with 5 to 40 mg orally or by injection once daily. It is combined with aldosterone antagonists or potassium-sparing diuretics.
What drugs interact with Lasix and Demadex?
- Administration of Lasix with aminoglycoside antibiotics (for example, gentamicin) or ethacrynic acid (Edecrin, another diuretic) may cause hearing damage.
- Lasix competes with aspirin for elimination in the urine by the kidneys. Concomitant use of Lasix and aspirin may, therefore, lead to high blood levels of aspirin and aspirin toxicity.
- Lasix also may reduce excretion of lithium (Eskalith, Lithobid) by the kidneys, causing increased blood levels of lithium and possible side effects from lithium.
- Sucralfate (Carafate) reduces the action of Lasix by binding Lasix in the intestine and preventing its absorption into the body. Ingestion of Lasix and sucralfate should be separated by two hours.
- When combined with other antihypertensive drugs, there is an increased risk of low blood pressure or reduced kidney function.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) — for example, ibuprofen, indomethacin (Indocin, Indocin-SR) — may interfere with the blood pressure-reducing effect of Lasix.
Several medicines may cause interactions with Demadex.
- Demadex can cause low blood potassium, calcium, and magnesium levels. These changes can increase the risk of toxicity from digoxin (Lanoxin). Combining Demadex with other diuretics — such as metolazone (Zaroxolyn), hydrochlorothiazide, or chlorthalidone (Hygroton) — can exaggerate the losses of potassium and magnesium.
- The body's ability to eliminate lithium (Lithobid, Eskalith) may decrease in patients receiving Demadex. Therefore, careful monitoring of lithium levels in blood is recommended when torsemide and lithium are taken together in order to prevent increases in lithium levels and lithium toxicity.
- Indomethacin (Indocin) can reduce the diuretic and blood pressure-lowering effects of other loop diuretics (for example Lasix) and it probably can do the same with Demadex. Other nonsteroidal anti-inflammatory drugs (NSAIDs) — for example, ibuprofen (Motrin), naproxen (Naprosyn) — may interact similarly.
- Concomitant use of Demadex and aminoglycosides may increase the risk of hearing impairment since both agents can affect hearing.
- Probenecid decreases the diuretic effect of Demadex by reducing secretion of Demadex into the kidney tubules.