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SOAANZ is a loop diuretic indicated in adults for the treatment of edema associated with heart failure or renal disease. (1)
Discontinuation of therapy due to adverse reactions occurred in 6% of patients treated with SOAANZ (6.1).
• Non-steroidal anti-inflammatory drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment. (7.1)
• CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. Torsemide may affect the efficacy and safety of sensitive CYP2C9 substrates or of substrates with a narrow therapeutic range, such as warfarin or phenytoin. (7.2)
• Cholestyramine: Decreased exposure of SOAANZ. (7.3)
• Organic anion drugs: may decrease diuretic activity of SOAANZ. (7.4)
• Lithium: Risk of lithium toxicity. (7.5)
• Renin-angiotensin inhibitors: Increased risk of hypotension and renal impairment. (7.7)
• Radiocontrast agents: Increased risk of renal toxicity. (7.8)
• Corticosteroids and ACTH: Increased risk of hypokalemia.
Hypotension and worsening renal function: monitor volume status and renal function periodically (5.1)
• Electrolyte and metabolic abnormalities: monitor serum electrolytes and blood glucose periodically. (5.2)
• Ototoxicity (5.3, 7.6)
