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Torsemide (Demadex)

Diureticprescriptionoral · inferred

Loop diuretic with high and consistent oral bioavailability (~80%) compared to furosemide. Undergoes hepatic metabolism via CYP2C9 with only ~20% renal excretion of unchanged drug, predicting minimal accumulation in renal failure. Longer half-life permits once-daily dosing. Used for hypertension, edema, heart failure. Slightly more potent than furosemide with more predictable effects.

Projected serum levels — 20 mg, once daily

Torsemide (Demadex)
Torsemide (Demadex) modeled serum levels, 20 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 5 10 15 20 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1

Maintenance schedule: 20 mg once daily (oral).

Modeled steady state after ~1 days: peak ≈ 13.1 mg, trough ≈ 0.15 mg body load. Population-based estimate over 15 days for a 20 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Diuretic
Route modeled
Oral
Model confidence
inferred
Half-life
3.5 h
Common dose
20 mg
Suggested maximum
200 mg/day
Reference dose range
10–200 mg (single dose)
Suggested cadence
once daily
Validated against
20 mg oral — Cmax 2 mg/L at 1 h

Documented interactions

  • danger
    Carbamazepine (Tegretol) + Torsemide (Demadex) CYP induction

    Carbamazepine (Tegretol) inducer of CYP2C9 predicted to change Torsemide (Demadex) AUC by ~0.40x

  • danger
    CBD (Cannabidiol) + Torsemide (Demadex) CYP inhibition

    CBD (Cannabidiol) reversible_inhibitor of CYP2C9 predicted to change Torsemide (Demadex) AUC by ~3.33x

  • danger
    Fluconazole + Torsemide (Demadex) CYP inhibition

    Fluconazole reversible_inhibitor of CYP2C9 predicted to change Torsemide (Demadex) AUC by ~3.33x

  • danger
    Fluvoxamine (Luvox) + Torsemide (Demadex) CYP inhibition

    Fluvoxamine (Luvox) reversible_inhibitor of CYP2C9 predicted to change Torsemide (Demadex) AUC by ~3.33x

  • danger
    Levothyroxine (Synthroid) + Torsemide (Demadex) Protein binding

    Torsemide (Demadex) may displace Levothyroxine (Synthroid) from plasma protein binding sites, transiently raising free drug concentration. This drug has a narrow therapeutic index; free concentration…

  • danger
    Metronidazole (Flagyl) + Torsemide (Demadex) CYP inhibition

    Metronidazole (Flagyl) reversible_inhibitor of CYP2C9 predicted to change Torsemide (Demadex) AUC by ~3.33x

Serum checks 159 modeled interaction pairings for torsemide (demadex) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Torsemide: A pyridine-sulfonylurea loop diuretic Blose JS et al. · Annals of Pharmacotherapy, 1995 DOI

    Comprehensive review of torsemide pharmacology showing 80% bioavailability with little first-pass metabolism, hepatic elimination (80%), renal excretion (20%), and clinical efficacy superior to furosemide in CHF.

  2. The pharmacodynamics of torsemide in patients with congestive heart failure Cody RJ et al. · Clinical Therapeutics, 1993 DOI

    Six-week RCT in 70 CHF patients comparing 10 mg and 20 mg torsemide daily vs 40 mg furosemide; 20 mg torsemide showed superior weight reduction and edema improvement by week 6.

  3. Pharmacokinetics of torsemide in patients with decompensated and compensated congestive heart failure Vargo DL et al. · Journal of Clinical Pharmacology, 1998 DOI

    Study demonstrating torsemide maintains consistent pharmacokinetics across CHF stages; bioavailability and clearance minimally affected by heart failure severity, contrasting with furosemide variability.

3 published studies referenced in the app, each with a plain-language summary.