Tomide

Introduction
Tomide belongs to a group of medicines called diuretics or water tablets. It is used to reduce the swelling (edema) caused by too much water in the body in people who have heart failure, liver disease or kidney disease. This medicine is also used to treat high blood pressure. Tomide helps your body get rid of extra water and salt through urine. It may be used alone or in combination with other medicines as per the dose advised by your doctor. It can be taken with or without food and should be taken at the same time each day. It is best to avoid taking this medicine within 4 hours of your bedtime to prevent having to get up at night to urinate. It is important to continue taking this medication even if you feel well. If you stop taking it without consulting your doctor, your condition may worsen. Lifestyle changes like reducing stress, restricting salt intake and stopping smoking may help this medicine work better. Common side effects of this medicine include headache, dizziness, dehydration, decreased blood pressure and stomach upset. These are usually mild and disappear after a short time. Consult your doctor if they bother you or do not go away. Before taking this medicine, let your doctor know if you have any liver problems. Pregnant or breastfeeding women should also consult their doctor before taking it. Regular monitoring of kidney function tests and electrolyte levels is important while using this medicine. It may reduce the potassium level in your blood so your doctor may ask you to add potassium-rich foods to your diet (such as bananas, coconut water, etc.) or prescribe supplements.

_
Uses of Tomide
Hypertension (high blood pressure)
Edema
Side effects of Tomide
Common
Headache
Dizziness
Dehydration
Constipation
Decreased blood pressure
Upset stomach
How to use Tomide
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Tomide may be taken with or without food, but it is better to take it at a fixed time.
How Tomide works
Tomide is a diuretic. It removes extra water and certain electrolytes from the body by increasing the amount of urine produced.
What if you forget to take Tomide?
If you miss a dose of Tomide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
Take it in the morning with breakfast to avoid getting up at night to urinate.
Monitor your blood pressure after starting Tomide, and notify your doctor if it does not lower down.
Consult your doctor if you experience dizziness, tiredness, or muscle weakness that does not go away.
Take potassium supplements or potassium-rich diet (banana, spinach, coconut water, etc.) as Tomide can decrease your potassium levels and lead to dehydration.
You may be asked to get regular blood tests done to monitor your kidney function.
Brief Description
Indication
Oedema, Hypertension, Chronic heart failure
Administration
May be taken with or without food.
Adult Dose
Oral Hypertension Adult: 2.5-5 mg once daily. Max: 5 mg daily. Oedema in patients with hepatic cirrhosis Adult: Initially, 5-10 mg once daily, given together with an aldosterone antagonist or a potassium-sparing diuretic, titrated upwards until the desired diuretic response is obtained. Max: 40 mg daily. Oedema Adult: 5 mg once daily, increased to 20 mg once daily if necessary. Max: 40 mg/day.

_
Contraindication
Hypersensitivity to sulfonylureas, renal failure with anuria, hepatic coma and pre-coma, hypotension, cardiac arrhythmias. Pregnancy and lactation.
Mode of Action
Torasemide, a sulfonylurea loop diuretic, acts from within the lumen of the thick ascending portion of the loop of Henle, where it inhibits the Na+/K+/2CI–carrier system.
Precaution
Risk of hyperuricaemia, gout and DM. Correct electrolyte distubances and disorders of micturition before treatment. Monitor electrolyte balance, glucose, uric acid, creatinine and lipids regularly. May impair ability to drive or operate machinery.
Side Effect
Electrolyte disturbances e.g. hypokalaemia, dehydration, dry mouth, headache, dizziness, hypotension, weakness, drowsiness, confusional states, loss of appetite, cramps, increased serum uric acid, glucose, lipids, urea and creatinine, increase in LFT, metabolic alkalosis, tinnitus and hearing loss.
Interaction
Increased risk of severe hypokalaemia with amphotercin B, corticosteroids, carbenoxolone, hypokalaemia-causing medications. Increased risk of lithium toxicity. Increased potential for ototoxicity and nephrotoxicity with nephrotoxic or ototoxic medications e.g. aminoglycosides. High dose salicylates may increase the risk of salicylate toxicity. Increased risk of toxicity with digoxin. Reduced diuretic effect with NSAIDs. Increased risk of hypotension with antihypertensives.