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托拉塞米

Torsemide

Pyridyl sulfonylurea

環利尿劑POIV狗貓

別名: Demadex · Torem · Unat · Torasemide · AC-3525 · AC 4464 · BM02.015 · JDL-464

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

0.2-0.3 mg/kgPO· q12-24h
— 🐕

劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
Adjunctive treatment of refractory congestive heart failure0.2-0.3 mg/kgPOq12-24h—🌎 NA
Congestive heart failure0.2 mg/kgPOonce a day to three times a day—🌎 NA
  • Adjunctive treatment of refractory congestive heart failure: When other diuretics have become ineffective

貓

適應症劑量途徑頻次療程地區
Adjunctive treatment of refractory congestive heart failure0.2-0.3 mg/kgPOq12-24h—🌎 NA
Congestive heart failure0.2 mg/kgPOonce a day to three times a day—🌎 NA
  • Adjunctive treatment of refractory congestive heart failure: When other diuretics have become ineffective

劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。

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概覽

​托拉塞米 (Torsemide)​ 是一種強效的​環利尿劑​，在獸醫學中主要用作犬貓​充血性心衰竭 (CHF)​ 的「救援」或輔助治療。

  • ​效力​：效力約為呋塞米 (Furosemide) 的 ​10 倍​。
  • ​作用時間​：作用時間較長（約 12 小時），可減少給藥頻率。
  • ​保鉀作用​：在犬隻中，其排鉀量低於呋塞米，但仍需密切監測。

​臨床重點​：當病患對呋塞米產生​利尿劑抗性​時，托拉塞米越來越受到青睞，有助於控制嚴重的肺水腫和腹水。

作用機轉

Torsemide acts on the thick ascending limb of the loop of Henle in the kidneys.

  • It reversibly binds to and inhibits the Na⁺/K⁺/2Cl⁻ (NKCC2) cotransporter at the chloride-binding site → prevents the reabsorption of sodium and chloride.
  • This disruption abolishes the hypertonic medullary interstitium → prevents the concentration of urine → results in profound diuresis (excretion of water).
  • It also increases the renal excretion of potassium, calcium, magnesium, hydrogen, ammonium, and bicarbonate. In dogs, its potassium-wasting effect is notably less severe than that of furosemide.

安全性與警告

禁忌症

  • Known hypersensitivity to torsemide or other sulfonylureas
  • Anuric patients

不良反應

  • Fluid and electrolyte abnormalities (hyponatremia, hypocalcemia, hypokalemia, hypomagnesemia)
  • Prerenal azotemia (secondary to dehydration)
  • Gastrointestinal disturbances
  • Hematologic effects (anemia, leukopenia)
  • Weakness
  • Restlessness
  • Ototoxicity (rare, associated with rapid IV administration)

注意事項

Use cautiously in patients with significant hepatic dysfunction, hyperuricemia (may increase serum uric acid), or diabetes mellitus (may increase serum glucose).

Note: IV injection should be administered slowly over a period of 2 minutes to minimize the risk of ototoxicity.

藥物交互作用

ACE Inhibitors (e.g., enalapril, benazepril)

Increased risks for hypotension, particularly in patients who are volume or sodium depleted secondary to diuretics

Aminoglycosides (gentamicin, amikacin, etc.)

May increase the ototoxic or nephrotoxic risks of aminoglycosides

Amphotericin B

May increase the risk for nephrotoxicity development

Digoxin

Can increase the area under the curve of torsemide by 50%; torsemide-induced hypokalemia may increase the potential for digoxin toxicity

Lithium

Torsemide may reduce lithium clearance

NSAIDs

Some NSAIDs may reduce the natriuretic effects of torsemide

Probenecid

Can reduce the diuretic efficacy of torsemide

Salicylates

Torsemide can reduce the excretion of salicylates

監測

  • Serum electrolytes (especially potassium, sodium, calcium, magnesium)
  • BUN and creatinine
  • Blood glucose (if diabetic)
  • Hydration status
  • Blood pressure (if indicated)
  • Clinical signs of edema and patient weight

藥物動力學

半衰期

貓Peak diuresis occurs about 4 hours post-dose and persists for 12 hours狗About 8 hours

吸收

Oral bioavailability is between 80-100% in dogs and cats.

分佈

Limited information available.

代謝

Limited information available.

排除

Renal excretion.

過量

In dogs, the oral LD50 is >2 grams/kg. Fluid and electrolyte imbalance is the most likely risk associated with an overdose.

  • Consider gut emptying protocols for very large or quantity unknown ingestions.
  • Acute overdoses should generally be managed by observation with fluid, electrolyte, and acid-base monitoring.
  • Supportive treatment should be initiated if required.

可用產品

劑型

  • Oral tablets
  • Injection (no longer marketed in USA)

人用標示

  • Torsemide Oral Tablets: 5 mg, 10 mg, 20 mg, & 100 mg (Demadex, generic)

各地核准狀態

暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Torsemide tablets should be stored below 40°C; preferably between 15-30°C (59-86°F).

飼主須知

​托拉塞米​是一種強效的「水丸」（利尿劑），用於幫助您的寵物排出體內多餘的水分，通常用於嚴重心臟病。

  • ​排尿習慣​：您的寵物排尿頻率和尿量會大幅增加。請確保牠們隨時有新鮮的飲用水，以防脫水。
  • ​給藥時間​：因為會增加排尿，除非獸醫指示，否則盡量不要在睡前給藥。
  • ​注意事項​：如果您發現脫水或電解質失衡的跡象，請立即聯繫獸醫，例如：
    • 極度口渴或嗜睡
    • 虛弱或步態不穩
    • 嘔吐或食慾不振
    • 焦躁不安或心跳過快

​注意​：未經獸醫同意，切勿自行更改劑量或停藥，否則液體可能會迅速積聚在肺部。

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