Torsemide interactions

Hyperkalemia occurs commonly (about 10%) when amiloride is used without a kaliuretic diuretic. (Amiloride label, Boxed warning)

Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)

Potassium-Sparing Diuretics Cyclosporine should not be used with potassium-sparing diuretics because hyperkalemia can occur. (Cyclosporine label, Drug interactions)

In the DIAMOND trials, 1252 patients were treated with dofetilide and diuretics concomitantly, of whom 493 died compared to 508 deaths among the 1248 patients receiving placebo and diuretics. (Dofetilide label, Drug interactions)

…• serum creatinine > 2.0 mg/dL in males or >1.8 mg/dL in females, • creatinine clearance < 50 mL/min, or • concomitant administration of potassium supplements or potassium-sparing diuretics (e.g., amiloride, spironolactone, or triamterene) [see Warnings and Precautions (5.1) , Adverse Reactions (6.2) , Drug Interactions (7) , and Clinical Pharmacology (12.3)… (Eplerenone label, Contraindications)

Like other diuretics it may precipitate hepatic coma and death. (Ethacrynic acid label, Warnings)

Avoid concomitant use of torsemide and aminoglycoside antibiotics, if possible. (Torsemide label, Drug interactions)

Diuretics Eplerenone Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)

Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)

Avoid concomitant use of torsemide and aminoglycoside antibiotics, if possible. (Torsemide label, Drug interactions)

…sometimes associated with oliguria and/or progressive azotemia, and rarely with acute renal failure and/or death, include patients with the following conditions or characteristics: heart failure, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis, or severe volume and/or salt depletion of any etiology. (Quinapril label, Warnings)

Sodium bicarbonate injection is contraindicated in patients who are losing chloride by vomiting or from continuous gastrointestinal suction and in patients receiving diuretics known to produce a hypochloremic alkalosis. (Sodium bicarbonate label, Contraindications)

CONTRAINDICATIONS Spironolactone and hydrochlorothiazide tablets are contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, hypercalcemia, hyperkalemia, Addison's disease, and in patients who are allergic to thiazide diuretics or to other sulfonamide-derived drugs. (Spironolactone and hydrochlorothiazide label, Contraindications)

…coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)

Avoid concomitant use of torsemide and aminoglycoside antibiotics, if possible. (Torsemide label, Drug interactions)

Hyperkalemia Abnormal elevation of serum potassium levels (≥5.5 mEq/liter) can occur with all potassium-sparing diuretic combinations, including triamterene and hydrochlorothiazide. (Triamterene and hydrochlorothiazide label, Boxed warning)

Lithium Like other diuretics, torsemide reduces the renal clearance of lithium, inducing a high risk of lithium toxicity. (Torsemide label, Drug interactions)

Diuretics: Use with caution. (Albuterol label, Drug interactions)

Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)

Risk factors for the development of hyperkalemia include renal insufficiency, diabetes, combination use with ARBs or ACEIs [see Contraindications (4) , Warnings and Precautions (5.2) , and Clinical Studies (14.3) ] , NSAIDs, or potassium supplements or potassium sparing diuretics. (Aliskiren label, Warnings and precautions)

Hypersensitivity reactions to allopurinol tablets may be increased in patients with decreased kidney function receiving thiazide diuretics and allopurinol tablets concurrently. (Allopurinol label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Concomitant use of CYP2C9 inducers (e.g., rifampin) increase torsemide clearance and decrease plasma torsemide concentrations. (Torsemide label, Drug interactions)

Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)

There was also a slightly greater proportion of patients on NUVIGIL requiring new or increased use of antihypertensive medications (2.9%) compared to patients on placebo (1.8%). (Armodafinil label, Warnings and precautions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Because of its relative beta 1 selectivity, however, TENORMIN may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Atenolol label, Warnings)

Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)

• Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 ) (Avanafil label, Warnings and precautions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Nonsteroidal Anti-Inflammatory Drugs Because torsemide and salicylates compete for secretion by renal tubules, patients receiving high doses of salicylates may experience salicylate toxicity when torsemide is concomitantly administered. (Torsemide label, Drug interactions)

Because of its relative beta 1 -selectivity, however, BISOPROLOL FUMARATE may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol label, Warnings)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

Concomitant use of CYP2C9 inducers (e.g., rifampin) increase torsemide clearance and decrease plasma torsemide concentrations. (Torsemide label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)

Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Lithium Like other diuretics, torsemide reduces the renal clearance of lithium, inducing a high risk of lithium toxicity. (Torsemide label, Drug interactions)

Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Concomitant use of CYP2C9 inducers (e.g., rifampin) increase torsemide clearance and decrease plasma torsemide concentrations. (Torsemide label, Drug interactions)

Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)

If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Chlorpromazine label, Precautions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

Cholestyramine: Decreased exposure of torsemide. (Torsemide label, Drug interactions)

Elderly patients, patients taking diuretics, and those who are volume depleted may be at greater risk for developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Citalopram label, Warnings and precautions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Codeine label, Drug interactions)

…concomitant use of TONMYA with: MAO inhibitors may be life-threatening [see Contraindications (4) ] , Alcohol, barbiturates, and other CNS depressants may increase the risk of adverse reactions associated with these drugs, Tramadol may increase the seizure risk, Guanethidine or other similar acting drugs may block the antihypertensive action of these drugs. (Cyclobenzaprine label, Drug interactions)

Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Dapagliflozin label, Warnings and precautions)

…Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Desmopressin label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk [see Use in Specific Populations (8.5) and Clinical Pharmacology (12.3) ] . (Desvenlafaxine label, Warnings and precautions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Dexlansoprazole label, Warnings and precautions)

• Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Serum potassium levels should be carefully monitored when digoxin is given to patients at high risk of hypokalemia ( e.g. , those receiving diuretics, corticosteroids, or other drugs that commonly lead to potassium loss; those with gastrointestinal losses through diarrhea, vomiting, or nasogastric suction; or those with potassium-losing endocrinopathies or nephropathies). (Digoxin label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Medications that may increase serum potassium concentration include ACE inhibitors, angiotensin-II receptor antagonists, potassium-sparing diuretics, potassium supplementation, heparin, aldosterone antagonists, and NSAIDS. (Drospirenone and ethinyl estradiol label, Warnings and precautions)

The risk of BP decreases may be greater in patients taking concomitant medications that induce orthostatic hypotension (such as antihypertensives) or are potent CYP1A2 inhibitors [see Warnings and Precautions ( 5.12 ) and Drug Interactions ( 7.1 )] and in patients taking CYMBALTA at doses above 60 mg daily. (Duloxetine label, Warnings and precautions)

Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Empagliflozin label, Warnings and precautions)

Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Empagliflozin and metformin label, Warnings and precautions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

…Precautions (5.6) and Adverse Reactions (6) ]. β-blockers, such as propranolol Cyclopropane or halogenated hydrocarbon anesthetics, such as halothane Antihistamines Thyroid hormones Diuretics Cardiac glycosides, such as digitalis glycosides Quinidine Drugs potentiating hypokalemic effects of epinephrine • Potassium depleting diuretics • Corticosteroids • Theophylline… (Epinephrine label, Drug interactions)

Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Escitalopram label, Warnings and precautions)

• Antihypertensive agents clonidine, guanfacine, or moxonidine: Beta blockers also increase the risk of clonidine-, guanfacine-, or moxonidine-withdrawal rebound hypertension. (Esmolol label, Drug interactions)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Esomeprazole label, Warnings and precautions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

…treatment with Class 1 and Class III antiarrhythmics, 4) treatment with monoamine oxidase inhibitors (MAOI's), 5) concomitant treatment with other drug products known to prolong the QT interval and 6) electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs (e.g., diuretics) that may cause electrolyte imbalance. (Fentanyl label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Fluoxetine label, Warnings and precautions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)

• Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. (Formoterol label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Lithium Like other diuretics, torsemide reduces the renal clearance of lithium, inducing a high risk of lithium toxicity. (Torsemide label, Drug interactions)

…danazol, glucagon, somatropin, protease inhibitors, atypical antipsychotic medications (e.g., olanzapine and clozapine), barbiturates, diazoxide, laxatives, rifampin, thiazides and other diuretics, corticosteroids, phenothiazines, thyroid hormones, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics (e.g., epinephrine, albuterol, terbutaline),… (Glimepiride label, Drug interactions)

…may reduce the glucose-lowering effect of GLUCOTROL XL, leading to worsening glycemic control: atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic… (Glipizide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are at risk for hypotension (e.g., geriatric patients, patients with dehydration, hypovolemia, and concomitantly treated with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Haloperidol label, Warnings and precautions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Hydrocodone and acetaminophen label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Hydromorphone label, Drug interactions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Iloperidone label, Warnings and precautions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Drugs That May Decrease the Blood Glucose Lowering Effect of Insulin Aspart Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g.,… (Insulin aspart label, Drug interactions)

Drugs That May Decrease the Blood Glucose Lowering Effect of Insulin Degludec Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g.,… (Insulin degludec label, Drug interactions)

Drugs That May Decrease the Blood Glucose Lowering Effect of LEVEMIR Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol,… (Insulin detemir label, Drug interactions)

Drugs that May Decrease the Blood Glucose Lowering Effect of Insulin Glargine-yfgn Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents… (Insulin glargine label, Drug interactions)

Drugs That May Decrease the Blood Glucose Lowering Effect of LYUMJEV Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol,… (Insulin lispro label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Diuretics eplerenone The potential increase in plasma concentrations of eplerenone when coadministered with ketoconazole tablets may increase the risk of hyperkalemia and hypotension. (Ketoconazole label, Drug interactions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Lansoprazole label, Warnings and precautions)

Diuretics The ECG changes or hypokalemia that may result from the administration of non-potassium-sparing diuretics (such as loop and thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Levalbuterol label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Levorphanol label, Drug interactions)

Monitor serum sodium levels regularly in the elderly, in patients taking diuretics, and in other patients at risk of hyponatremia and/or SIADH while taking Linezolid injection. (Linezolid label, Warnings and precautions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

Lithium: Risk of lithium toxicity. (Torsemide label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)

Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Nonsteroidal Anti-Inflammatory Drugs Because torsemide and salicylates compete for secretion by renal tubules, patients receiving high doses of salicylates may experience salicylate toxicity when torsemide is concomitantly administered. (Torsemide label, Drug interactions)

Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Meperidine label, Drug interactions)

Nonsteroidal Anti-Inflammatory Drugs Because torsemide and salicylates compete for secretion by renal tubules, patients receiving high doses of salicylates may experience salicylate toxicity when torsemide is concomitantly administered. (Torsemide label, Drug interactions)

Closely monitor patients with risk factors for development of prolonged QT interval (e.g., cardiac hypertrophy, concomitant diuretic use, hypokalemia, hypomagnesemia), a history of cardiac conduction abnormalities, and those taking medications affecting cardiac conduction. (Methadone label, Warnings and precautions)

Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia [see Use in Specific Populations (8.5) ] . (Mirtazapine label, Warnings and precautions)

However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%). (Modafinil label, Warnings and precautions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Morphine label, Drug interactions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Although beta-blockers should be avoided in overt congestive heart failure, if necessary, they can be used with caution in patients with a history of failure who are well-compensated, usually with digitalis and diuretics. (Nadolol label, Warnings)

Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Nalbuphine label, Drug interactions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

Antihypertensive Therapy Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. (Niacin label, Drug interactions)

Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)

…of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)

Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oliceridine label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (Omeprazole label, Warnings and precautions)

Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxycodone label, Drug interactions)

Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxycodone and acetaminophen label, Drug interactions)

Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxymorphone label, Drug interactions)

Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Pantoprazole label, Warnings and precautions)

Geriatric patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Paroxetine label, Warnings and precautions)

Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Pentazocine and naloxone label, Drug interactions)

Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

…hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl mirtazapine Phenelzine sulfate should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result. (Phenelzine label, Warnings)

In addition, when phentermine and topiramate extended-release capsules are used in conjunction with nonpotassium sparing diuretics this may further potentiate potassium-wasting. (Phentermine and topiramate label, Warnings and precautions)

Although beta-blockers should be avoided in overt congestive heart failure, if necessary, pindolol tablets can be used with caution in patients with a history of failure who are well-compensated, usually with digitalis and diuretics. (Pindolol label, Warnings)

Syncopal episodes have usually occurred within 30 to 90 minutes of the initial dose of the drug; occasionally, they have been reported in association with rapid dosage increases or the introduction of another antihypertensive drug into the regimen of a patient taking high doses of prazosin hydrochloride capsules. (Prazosin label, Warnings)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Prochlorperazine label, Precautions)

Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Rabeprazole label, Warnings and precautions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Concomitant use of CYP2C9 inducers (e.g., rifampin) increase torsemide clearance and decrease plasma torsemide concentrations. (Torsemide label, Drug interactions)

Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)

Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)

Concomitant use of CYP2C9 inducers (e.g., rifampin) increase torsemide clearance and decrease plasma torsemide concentrations. (Torsemide label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

• Diuretics: Use with caution. (Salmeterol label, Drug interactions)

Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Sertraline label, Warnings and precautions)

Caution is advised when SILDENAFIL ORAL FILM is co-administered with alpha-blockers or antihypertensives. (Sildenafil label, Warnings and precautions)

Special attention should be given to electrolyte and acid-base balance in patients experiencing severe or prolonged diarrhea or patients receiving concomitant diuretic drugs. (Sotalol label, Warnings and precautions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Nonsteroidal Anti-Inflammatory Drugs Because torsemide and salicylates compete for secretion by renal tubules, patients receiving high doses of salicylates may experience salicylate toxicity when torsemide is concomitantly administered. (Torsemide label, Drug interactions)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (Torsemide label, Drug interactions)

• Hypertension: May require antihypertensive therapy; monitor relevant drug interactions. (Tacrolimus label, Warnings and precautions)

…use of skeletal muscle relaxants and opioids, consider prescribing naloxone for the emergency treatment of opioid overdose [see Dosage and Administration (2.2) , Warnings and Precautions (5.2 , 5.3) ] Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Tapentadol label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Risk of Hypotension with Concomitant Use of Other Antihypertensive Agents and Phospodiesterase Type 5 Inhibitors (PDE5-I): Concomitant administration of TEZRULY with antihypertensives or phosphodiesterase-5 (PDE-5) inhibitors can result in additive blood pressure lowering effects and symptomatic hypotension (5.3). (Terazosin label, Warnings and precautions)

Diuretics The ECG changes and/or hypokalemia that may result from the administration of non-potassium sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Terbutaline label, Precautions)

In patients with hypertension on antihypertensive therapy, KYZATREX® increased the mean systolic/diastolic BP by 3.4/0.7 mm Hg from baseline after 4 months of treatment and 3.1/1.0 mm Hg from baseline after 6 months of treatment. [see Adverse Reactions (6.1) ]. (Testosterone label, Warnings and precautions)

Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Tramadol label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)

Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

• Diuretics: Use with caution. (Umeclidinium and vilanterol label, Drug interactions)

Renin Angiotensin Inhibitors Coadministration of torsemide with ACE inhibitors or angiotensin receptor blockers can increase the risk of hypotension and renal impairment. (Torsemide label, Drug interactions)

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide. (Torsemide label, Warnings and precautions)

Vardenafil hydrochloride tablets can potentiate the hypotensive effects of nitrates, alpha- blockers, and antihypertensives. (Vardenafil label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume-depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Venlafaxine label, Warnings and precautions)

Control patients with milder ventricular dysfunction, if possible, with optimum doses of digitalis and/or diuretics before verapamil treatment is started [see Drug Interactions ( 7.5 )] . (Verapamil label, Warnings and precautions)

Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs [see Use in Specific Populations ( 8.5 )] . (Vilazodone label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume-depleted can be at greater risk. (Vortioxetine label, Warnings and precautions)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Torsemide label, Drug interactions)

Hypokalemia may result from diuretic therapy, diarrhea, and other causes. (Ziprasidone label, Warnings and precautions)

These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel-blocking drugs, and isoniazid. (Acarbose label, Drug interactions)

Patients required intervention with a diuretic, fluid management, or, in some cases, hospitalization for decompensating heart failure. (Ambrisentan label, Warnings and precautions)

In such cases, butorphanol should be discontinued and the hypertension treated with antihypertensive drugs. (Butorphanol label, Warnings)

Hypokalemia and Hypomagnesemia with Potassium-Depleting Diuretics Hypokalemia or hypomagnesemia may occur with concomitant administration of potassium-depleting diuretics. (Dronedarone label, Warnings and precautions)

…clinical studies with acetaminophen, acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives… (Finasteride label, Drug interactions)

Flecainide acetate has been used in a large number of patients receiving diuretics without apparent interaction. (Flecainide label, Drug interactions)

These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid. (Glyburide label, Drug interactions)

Examples: Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Glyburide and metformin label, Drug interactions)

When other potent parenteral antihypertensive drugs, such as diazoxide, are used in combination with hydralazine, patients should be continuously observed for several hours for any excessive fall in blood pressure. (Hydralazine label, Drug interactions)

Weigh patients regularly and manage unexpected rapid weight gain by drug interruption and diuretics. (Imatinib label, Warnings and precautions)

Atypical Antipsychotics (e.g., olanzapine and clozapine), Corticosteroids, Danazol, Diuretics, Estrogens, Glucagon, Isoniazid, Niacin, Oral Contraceptives, Phenothiazines, Progestogens (e.g., in oral contraceptives), Protease inhibitors, Somatropin, Sympathomimetic Agents (e.g., albuterol, epinephrine, terbutaline) and Thyroid Hormones. (Insulin regular (human) label, Drug interactions)

In a study in hypertensive patients, addition of isradipine to existing hydrochlorothiazide therapy did not result in any unexpected adverse effects, and isradipine had an additional antihypertensive effect. (Isradipine label, Drug interactions)

Postmarketing cases of edema and fluid retention occurring within weeks of starting OPSUMIT, some requiring intervention with a diuretic or hospitalization for decompensated heart failure, have been reported [see Adverse Reactions (6.2) ] . (Macitentan label, Warnings and precautions)

Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

Examples: Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Metformin label, Drug interactions)

Drug Interactions When methyldopa is used with other antihypertensive drugs, potentiation of antihypertensive effect may occur. (Methyldopa label, Drug interactions)

The blood pressure effect of SULAR tended to be greater in patients on atenolol than in patients on no other antihypertensive therapy. (Nisoldipine label, Drug interactions)

The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)

These drugs include: aspirin, phenylbutazone, sulfonamides, indomethacin, thiazide diuretics, furosemide and ethacrynic acid. (Penicillin G label, Drug interactions)

Torsemide may affect the efficacy and safety of sensitive CYP2C9 substrates or of substrates with a narrow therapeutic range, such as warfarin or phenytoin. (Torsemide label, Drug interactions)

These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)

Loop and thiazide diuretics increase potassium loss; supplementation is sometimes prescribed alongside them. (NIH Office of Dietary Supplements, Potassium)

Examples: Atypical antipsychotics (e.g., olanzapine and clozapine), calcium channel antagonists, corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol, epinephrine, terbutaline), and… (Repaglinide label, Drug interactions)

Examples: Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Sitagliptin and metformin label, Drug interactions)

There is no information available from adequate drug-drug interaction studies with the following classes of drugs: oral contraceptives, hormone replacement therapies, hypoglycemics, phenytoins, thiazide diuretics, and calcium channel blockers. (Terbinafine label, Drug interactions)

Torsemide may affect the efficacy and safety of sensitive CYP2C9 substrates or of substrates with a narrow therapeutic range, such as warfarin or phenytoin. (Torsemide label, Drug interactions)