Bioavailability, pharmacokinetics, and pharmacodynamics of torsemide in patients with cirrhosis.

Abstract

The bioavailability, pharmacokinetics, and pharmacodynamics of torsemide (10 mg orally and intravenously) were determined in a randomized crossover clinical trial with 12 patients with ascites caused by cirrhosis. Torsemide was rapidly absorbed with a bioavailability of 96.3% (confidence interval, 84% to 109%). Compared with healthy subjects, patients with cirrhosis exhibit a decrease in nonrenal clearance and increases in bioavailability, volume of distribution, renal clearance, elimination half-life, and percentage of the dose excreted into the urine. A greater proportion of the dose is delivered to the site of action over a more prolonged period of time. In spite of a shift of the pharmacodynamic curve to the right in patients with cirrhosis, there was no significant difference in natriuresis. Pharmacokinetic changes of torsemide in cirrhosis therefore compensate for the pharmacodynamic abnormality.

• Authors: S Schwartz, D C Brater, D Pound, P K Green, W G Kramer, D Rudy
• Journal: Clinical pharmacology and therapeutics (Clin Pharmacol Ther) Vol. 54 Issue 1 Pg. 90-7 (Jul 1993) ISSN: 0009-9236 [Print] United States
• PMID: 8330470 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Diuretics
• Sulfonamides
• Torsemide

Topics

• Administration, Oral
• Adult
• Aged
• Ascites (drug therapy, etiology)
• Biological Availability
• Diuretics (administration & dosage, pharmacokinetics, pharmacology)
• Female
• Half-Life
• Humans
• Injections, Intravenous
• Liver Cirrhosis (complications, metabolism)
• Male
• Middle Aged
• Sulfonamides (administration & dosage, pharmacokinetics, pharmacology)
• Torsemide