Adverse Effects

Azotaemia: An increase in renal blood parameters and insufficiency are commonly observed during treatment (CEVA Animal Health, 2019; Vetoquinol, 2015)).
Electrolyte derangements: In cases of prolonged treatment, electrolyte deficiency (including hypokalaemia, hypochloraemia, and hypomagnesaemia) and dehydration may occur (CEVA Animal Health, 2019; Vetoquinol, 2015).
Gastrointestinal signs: Possible signs include nausea, emesis, and reduced or absent faeces. In rare cases, transient and mild episodes of soft faeces occur, but withdrawal of the treatment is not usually necessary (Vetoquinol, 2015).
Skin Changes: Erythema of the inner pinnae may occur (Vetoquinol, 2015).
Ototoxicity: High doses in laboratory animals have induced cytotoxicity, but this was reduced compared to Furosemide equivalence.

Contraindications

Renal Failure: Avoid use (CEVA Animal Health, 2019; Vetoquinol, 2015).
Severe Dehydration: Avoid use (CEVA Animal Health, 2019; Vetoquinol, 2015).
Hypovolaemia: Avoid use (CEVA Animal Health, 2019; Vetoquinol, 2015).
Hypotension: Avoid use (CEVA Animal Health, 2019; Vetoquinol, 2015).
Furosemide: Do not use concomitantly with other loop diuretics (CEVA Animal Health, 2019; Vetoquinol, 2015).
Hypersensitivity: Do not use in case of hypersensitivity to the active substance or any of the excipients (CEVA Animal Health, 2019; Vetoquinol, 2015).

Reproductive Safety

Pregnancy: Use is not recommended (CEVA Animal Health, 2019; Vetoquinol, 2015).
Lactation: Use is not recommended (CEVA Animal Health, 2019; Vetoquinol, 2015).
Male Fertility: Use is not recommended (CEVA Animal Health, 2019; Vetoquinol, 2015).
Female Fertility: Use is not recommended (CEVA Animal Health, 2019; Vetoquinol, 2015).
Neonates: Use is not recommended (CEVA Animal Health, 2019; Vetoquinol, 2015).

Interactions

Antibacterial interactions: Concomitant use with aminoglycosides or cephalosporins may increase the risk of nephrotoxicity and ototoxicity. Torasemide may increase the risk of sulfonamide allergy (CEVA Animal Health, 2019; Vetoquinol, 2015).
Antihypertensive Medicines: The effect of antihypertensive drugs, especially angiotensin-converting enzyme (ACE)-inhibitors, may be potentiated when co-administered with torasemide (CEVA Animal Health, 2019; Vetoquinol, 2015).
Cardiac Support Medicines: When combined with cardiac treatments (e.g. ACE inhibitors, digoxin), the dose regimen may need to be modified depending on the animal’s response to therapy (CEVA Animal Health, 2019; Vetoquinol, 2015).
Electrolyte Disruptors: Use alongside additional medicines that influence electrolyte balance (corticosteroids, amphotericin B, cardiac glycosides, and other diuretics), which requires careful monitoring (CEVA Animal Health, 2019; Vetoquinol, 2015).
Loop Diuretics: Co-administration can decrease natriuretic response (CEVA Animal Health, 2019; Vetoquinol, 2015).
Metabolism, Competitors: Concomitant administration of torasemide with other drugs metabolised by cytochrome P450 families 3A4 (e.g., enalapril, buprenorphine, doxycycline, cyclosporine) and 2E1 (isoflurane, sevoflurane, theophylline) may decrease their clearance from the systemic circulation (CEVA Animal Health, 2019; Vetoquinol, 2015).
NSAIDs: Co-administration can decrease natriuretic response.
Concurrent use of drugs that increase the risk of renal injury or renal insufficiency should be avoided (Vetoquinol, 2015).
Protein-Bound Medicines: Since protein binding facilitates the renal secretion of torasemide, a decrease in binding due to displacement by another drug may cause diuretic resistance. Exercise care when administering torasemide with other highly plasma protein-bound drugs (CEVA Animal Health, 2019; Vetoquinol, 2015).
Salicylates: Torasemide can reduce the renal excretion of salicylates, leading to an increased risk of toxicity (CEVA Animal Health, 2019; Vetoquinol, 2015).