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DrugsLevel 4 LocalisationS3TABEML

Torasemide

SulphonamideHigh ceiling diuretic

Indications

Registered South African indications:

  • Hypertension
  • Oedema
  • Pulmonary oedema

Cautions

Contraindications

  • Hypersensitivity to the active ingredient or any of its excipients
  • Hypersensitivity to sulphonylureas
  • Pregnancy
  • Breastfeeding
  • Renal failure with absence of urine production (anuria)
  • Hepatic pre-coma and coma
  • Hypovolaemia
  • Hyponatraemia, hypokalaemia
  • Severe disorders of micturition (e.g. prostate hypertrophy)
  • Should not be used in children of 12 years or younger

Cautions

  • Disorders of micturition
  • Risk factors for hyperuricaemia or gout
  • Diabetes mellitus
  • Glucose intolerance
  • Lapp lactase deficiency 
  • Gluclose-galactose malabsorption
  • May impair ability to drive and operate machinery

Adult dosage

Forms avail. in SA and covered in this monograph: tab

Hypertension

  • Oral (tab): Initial: 2.5mg, dly; Maintenance: 2.5-5mg, dly

Peripheral oedema
Pulmonary oedema

  • Oral (tab): Initial: 5mg, dly; Titrate slowly by doubling dose; Max: 40mg/24hrs

Paediatric dosage

Not to be used in children of 12 years or younger (See contraindications)

Special populations

Pregnancy

  • Contraindicated

Breastfeeding

  • Contraindicated

Renal Impairment

  • Renal failure with absence of urine production (anuria): Contraindicated

Hepatic Impairment

  • Hepatic pre-coma and coma: Contraindicated

Elderly

Porphyria Information

Drugs in Sport

  • Prohibited - At all times

Adverse reactions

Central Nervous System Disorders

  • Headache
  • Dizziness
  • Cerebral ischaemia
  • Parenthesia
  • Confusional state
  • Fatigue
  • Asthenia

Cardiovascular Disorders

  • Acute myocardial infarction
  • Myocardial ischaemia
  • Angina pertoris
  • Syncope
  • Hypotension
  • Embolism

Gastrointestinal Disorders

  • Loss of appetite
  • Abdominal pain
  • Nausea and vomiting
  • Diarrhoea
  • Constipation
  • Dry mouth
  • Pancreatitis

Hepatobiliary Disorders

  • Increased hepatic enzyme

Genitourinary Disorders

  • Urinary retention
  • Bladder dilatation

Endocrine and Metabolic Disorders

  • Metabolic alkalosis
  • Fluid and electrolyte imbalance

Musculoskeletal Disorders

  • Muscle spasms

Skin and Subcutaneous Tissue Disorders

  • Allergic skin reactions
  • Photosensitivity reaction
  • Serious skin reactions
  • Toxic epidermal necrolysis

Immune, Blood and Lymphatic System Disorders

  • Thrombocytopenia
  • Leukopenia
  • Anaemia

Sensory Disorders

  • Tinnitus
  • Deafness
  • Visual impairment

Interactions

  • Cardiac glycosides
  • Mineralocorticoids 
  • Glucocorticoids
  • Laxatives
  • Antihypertensive agents
  • Aminoglycosides 
  • Cisplatin
  • Cephalosporins
  • Lithium
  • Curare-containing muscle relaxants
  • Theophylline
  • Salicylates
  • Antidiabetic drugs
  • Angiotensin-converting enzyme inhibitors
  • Adrenaline
  • Noradrenaline
  • Non-steroidal anti-inflammatory drugs
  • Probenecid
  • Colestyramine

Monitoring

None routine. Specific cases may require

  • Electrolytes
  • Blood glucose 
  • Uric acid
  • Renal function
  • Hepatic function
  • Lipid profile

Mechanism of action

Torasemide is a loop diuretic that produces a dose dependant, high ceiling effect, through its ability to inhibit renal sodium and chloride reabsorption in the ascending loop of Henle.

Dosage forms

  • Tablet

Formulation

Tablet 2.5mg

  • ToraHexal (Sandoz)
  • Torsinat 2.5mg (Austell Laboratories)
  • Unat 2.5 (Mylan) originator

Tablet 5mg

  • Risat (Aurobindo)
  • ToraHexal (Sandoz)
  • Torasemide Biotech (Biotech)
  • Torsinat 5mg (Austell Laboratories)
  • Unat 5 (Mylan) originator

Tablet 10mg

  • Risat (Aurobindo)
  • ToraHexal (Sandoz)
  • Torasemide Biotech (Biotech)
  • Torsinat 10mg (Austell Laboratories)
  • Unat 10 (Mylan) originator

References

1. https://www.medicines.org.uk/emc/medicine/22289 1 Novemer 2016 Meda 2.5mg tablet 2. https://www.medicines.org.uk/emc/medicine/22292 1 November 2016 Meda 5mg tablet 3. https://www.medicines.org.uk/emc/medicine/22290 1 November 2016 Meda 10mg tablet 4. SAMF_Page 149 5. https://drive.google.com/drive/folders/1xgVksjHHySlygBX9wqLz-jNQKRzCej6u (14/05/2012_Meda_Unat_2.5,5,10mg_tab) 6. AfriTox: Torasemide; Last accessed online: 09/12/2020 [https://www.afritox.co.za/hp/SingleToxin/SingleToxin.aspx?SingleToxinID=9748] [https://drive.google.com/drive/folders/1xgVksjHHySlygBX9wqLz-jNQKRzCej6u] 7. PI - Approved-for-Torasemide-Biotech - Biotech Laboratories - Date of revision of text - 05 February 2024 - Accessed on SAHPRA 07 January 2025.pdf [https://pi-pil-repository.sahpra.org.za/wp-content/uploads/2024/03/1.3.1.1-pi-Approved-for-Torasemide-Biotech.pdf]

Brands & products

14 products · stale NAPPI snapshot · refreshed 5/28/2026 · 159 days old

tabletGeneric· 13 products

from R8.57/unit
ProductStrengthPackSchedSEPUnitDisp feeNAPPI
Torsinat 2,5Mg2.5 mg30S3R257.06R8.57R95.933003208001
Torsinat 5Mg5 mg30S3R257.06R8.57R95.933003209001
Torasemide biotech5 mg30S3R263.54R8.78R97.71723757001
Risat 5Mg5 mg30S3R272.27R9.08R100.113000185001
Torahexal - mg30S3R279.74R9.32R102.17707189001
Torasemide biotech10 mg30S3R282.80R9.43R103.01723758001
Torsinat 10Mg10 mg30S3R296.92R9.90R106.893003210001
Risat 10Mg10 mg30S3R300.89R10.03R107.983000186001
Torahexal 5 Mg5 mg30S3R321.46R10.72R113.64707190001
Torahexal 10 mg30S3R328.58R10.95R115.60707191001
Unat- mg30S3R357.71R11.92R123.62820369004
Unat5 mg30S3R391.90R13.06R133.02820377007
Unat10 mg30S3R421.96R14.07R141.29820385018

injectionGeneric· 1 product

from R17.62/unit
ProductStrengthPackSchedSEPUnitDisp feeNAPPI
Unat 2Ml10 mg/2ml5S3R88.08R17.62R42.36820393002
Trade names (8)
  • Risat
  • ToraHexal
  • Torasemide Biotech
  • Torsinat
  • Unat
  • Unat 2.5
  • Unat 5
  • Unat 10

Medical aid coverage

data not yet integrated
Discovery Health
not yet integrated
  • Comprehensive Series—
  • Executive Plan—
  • KeyCare Series—
  • Priority Series—
  • Saver Series—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

Bonitas Medical Fund
not yet integrated
  • BonClassic—
  • BonComprehensive—
  • BonEssential—
  • BonFit Select—
  • BonSave—
  • BonStart—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

GEMS — Government Employees Medical Scheme
not yet integrated
  • Beryl—
  • Emerald—
  • Onyx—
  • Ruby—
  • Sapphire—
  • Tanzanite One—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

POLMED — Police Medical Aid Scheme
not yet integrated
  • Aquarium Option—
  • Efficiency Option—
  • Marine Option—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

Interacts with 5 known drugs

Check against other drugs →
NeoHealth® ID 16597 · updated 1/7/2025