Torsemide: A Comprehensive Review

摘要

Torsemide (l-isopropyl-3-{[4-(3-methyl-phenylamino)pyridine]-3-sulfonyl} urea), a lipophilic anilinopyrimidine sulfonylurea derivative and one of the high-ceiling loop diuretics, is effective in the treatment of both acute and chronic congestive heartfailure (HF). Its mechanism of diuretic action is blockade of the Na+/K+/2CF co-transporter in the thick ascending loop of Henle. Despite its similar site of action to other loops diuretics (e.g., furosemide), torsemide it not structurally related. Torsemide's unique chemical structure is responsible for its pharmacokinetic/pharmacodynamic properties, including: a long half-life, antifibrotic effects, potassium sparing effects, and anti-aldosterone/mineralocorticoid effects. Torsemide has been evaluated in murine and canine models of heart disease (failure) as well as spontaneous HF in humans, dogs, cats and horses. Given the potential beneficial effects of torsemide and unique pharmacokinetic properties a comprehensive understanding of this drug andits current and potential clinical uses is essential.