Skip to main content
Log in

Torasemide versus furosemide in cirrhosis: a long-term, double-blind, randomized clinical study

  • Clinical Pharmacology
  • Published:
The clinical investigator Aims and scope Submit manuscript

Summary

The effects of long-term therapy (70 days) with torasemide (20 mg/day), a new loop diuretic, were compared with those of furosemide (50 mg/day) in a randomized double-blind trial. Both drugs were administered in association with spironolactone (200 mg/day) in 28 nonazotemic cirrhotic patients with controlled ascites. The treatments did not modify creatinine clearance and exhibited a similar effect on body weight, urinary volume, and fractional excretion of uric acid, sodium, and chloride. The effect of torasemide on fractional potassium excretion was lower than that of furosemide. Torasemide showed higher sparing effect than furosemide on calcium, inorganic phosphate, and magnesium excretion and stronger action on free water clearance. No changes in serum parameters were induced by either treatment. Two episodes of hepatic encephalopathy occurred in the torasemide group. In view of its effects on sodium and water excretion and on other urinary parameters, torasemide can represent an alternative tool for the long-term treatment of ascites.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Achammer I, Hacker W, Glocke M (1988)Efficacy and safety of torasemide in patients with chronic heart failure. Arzneimittelforschung 38:184–187

    Google Scholar 

  2. Ambroes Y, Ronflette I, Dodion L (1986) Diuretic activity, safety and pharmacokinetics of torasemide during chronic treatment in normal subjects. Eur J Pharmacol 31 [Suppl]:1–7

    Google Scholar 

  3. Arroyo V, Epstein M, Gallus G, Gentilini P, Ring-Larsen H, Salerno F (1989) Refractory ascites in cirrhosis: mechanism and treatment. Gastroenterol Int 2:195–207

    Google Scholar 

  4. Broekhuysen J, Deger F, Douchamps J, Ducarne H, Herchueltz A (1986) Torasemide, a new potent diuretic. Doubleblind comparison with furosemide. Eur J Clin Pharmacol 31 [Suppl]:29–34

    Google Scholar 

  5. Burke TJ, Robinson RR, Clapp JR (1972) Determinants of the effect of furosemide on the proximal tubule. Kidney Int 1:12–18

    Google Scholar 

  6. Classen W, Khartabil T, Imm ST, Kindler J (1988) Torasemide for diuretic treatment of advanced chronic renal failure. Arzneimittelforschung 38:209–211

    Google Scholar 

  7. Elia GF, Ferrari C, Degli Antoni A, Penna A, Fiaccadori F (1989) A short-term clinical study of a new loop diuretic, torasemide, in cirrhosis. Ital J Gastroenterol 21:324–328

    Google Scholar 

  8. Epstein M (1988) Diuretic therapy in liver disease. In: Epstein M (ed) The kidney in liver disease, 3rd edn. Williams and Wilkins, Baltimore, pp 537–550

    Google Scholar 

  9. Frommer JP, Wesson DE, Eknoyan G (1986) Side effects and complications of diuretic therapy. In: Eknoyan G, Martinez-Maldonado M (eds) The physiological basis of diuretic therapy in clinical medicine. Grime and Stratton, Orlando, pp 293–309

    Google Scholar 

  10. Gerbes AL, Bertheau U, Falkner C, Jungst D, Paumgartner G (1991) Advantages of torasemide vs furosemide in patients with liver cirrhosis and ascites (abstract). Gastroenterology 100: A746

    Google Scholar 

  11. Kult J, Hacker W, Glocke M (1988) Comparison of efficacy and tolerance of different oral doses of torasemide and furosemide in patients with advanced chronic renal failure. Arzneimittelforschung 38:212–214

    Google Scholar 

  12. Laffi G, Marra F, Buzzelli G, Azzena G, Meacci E, De Feo ML, La Villa G, Gentilini P (1991) Comparison of the effects of torasemide and furosemide in nonazotemic cirrhotic patients with ascites: a randomized, double-blind study. Hepatology 13:1101–1105

    Google Scholar 

  13. Lesne M (1988) Comparison of the pharmacokinetics and pharmacodynamics of torasemide and furosemide in healthy volunteers. Arzneimittelforschung 38:160–163

    Google Scholar 

  14. Perez-Ayuso RM, Arroyo V, Planas R, Gaya J, Bory F, Rimola A, Rivera F, Rodés J (1984) Randomized comparative study of efficacy of furosemide versus spironolactone in non-azotemic cirrhosis with ascites. Gastroenterology 84:961–968

    Google Scholar 

  15. Seldin DW, Eknoyan G, Suky WN, Rector FC jr (1966) Localization of diuretic action from the pattern of water and electrolyte excretion. Ann NY Acad Sci 139:328–343

    Google Scholar 

  16. Spannbrucker N, Achammer I, Metz P, Glocke M (1988) Comparative study on the antihypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Arzneimittelforschung 38:190–193

    Google Scholar 

  17. Spieker C, Zidek W, Hacker W, Schmidt W, Vetter H (1988) Assessment of intracellular sodium and calcium in essential hypertension during diuretic treatment. Arzneimittelforschung 38:188–190

    Google Scholar 

  18. Steele H, Oppenheimer S (1969) Factors affecting urate excretion following diuretic administration in man. Am J Med 47:564–574

    Google Scholar 

  19. Wittner M, Di Stefano A, Wangemann P, Greger R (1991) How do loop diuretics act? Drugs 41 [Suppl 3]: pp 1–13

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fiaccadori, F., Pedretti, G., Pasetti, G. et al. Torasemide versus furosemide in cirrhosis: a long-term, double-blind, randomized clinical study. Clin Investig 71, 579–584 (1993). https://doi.org/10.1007/BF00208486

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00208486

Key words

Navigation