torsemide

For use with concurrent therapy with pimobendan, spironolactone, and an angiotensin converting enzyme (ACE) inhibitor for the management of pulmonary edema in dogs with congestive heart failure caused by myxomatous mitral valve disease (MMVD).

UpCard®-CA1

UpCard-CA1 is indicated for use with concurrent therapy with pimobendan, spironolactone, and an angiotensin converting enzyme (ACE) inhibitor for the management of pulmonary edema in dogs with congestive heart failure caused by myxomatous mitral valve disease (MMVD).

UpCard®-CA1 (torsemide oral solution)

Do not administer UpCard-CA1 to dogs with renal failure or anuria. Therapy should be discontinued in dogs with progressive renal disease if increasing azotemia and oliguria occur during the therapy. Do not administer UpCard-CA1 to dogs with severe dehydration, hypovolemia or hypotension. Do not administer UpCard-CA1 concomitantly with other loop diuretics (e.g., furosemide). Do not administer UpCard-CA1 to dogs with hypersensitivity to the active substance, torsemide, or to any of the excipients.

UpCard®-CA1 (torsemide oral solution)

User Safety Warnings: Not for use in humans. Keep this and all medications out of the reach of children. Wash hands after use and/or spillage. In case of accidental human ingestion, seek medical advice immediately and show package insert or the label to the physician. Symptoms of exposure to torsemide may include dryness of the mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, nausea, or vomiting. Additionally, exposure may induce hypovolemia and result in hyperglycemia, hypokalemia, shunt thrombosis, syncope, and ventricular tachycardia.

UpCard®-CA1 (torsemide oral solution)

In a multi-site European clinical field study, 251 client-owned dogs suffering from edema secondary to congestive heart failure were treated with at least one dose of a tablet formulation of torsemide (n=126) or furosemide (n=125) for a 3-month treatment period. A greater overall frequency of adverse reactions was recorded in the torsemide group (n=184 events) compared with furosemide treated dogs (n=104 events). The most common adverse reactions associated with torsemide administration involved the urinary system, including polyuria and polydipsia, renal insufficiency, increased BUN and serum creatinine, and urinary incontinence. These findings were noted at greater frequency in torsemide-treated dogs than in the furosemide treatment group. A relative increase in the risk of serious adverse events due to renal insufficiency (including increased BUN, increased serum creatinine, and renal failure) was observed among torsemide-treated dogs compared with furosemide-treated dogs. Median BUN and serum creatinine levels were greater across all time points in torsemide-treated dogs, and were still high in this group on day 84. Electrolyte disturbances, including hypokalemia, hypochloremia, hypercalcemia, and hypomagnesemia, were also associated with torsemide therapy. Diarrhea, vomiting, inappetence, and lethargy were also noted in torsemide-treated dogs. Clinical findings associated with the worsening of congestive heart failure were noted in torsemide-treated dogs, including cough, dyspnea, pulmonary edema, and cardiac arrest. A total of 30 dogs died during the study, 12 in the torsemide group and 18 in the furosemide group. Euthanasia was the most common cause of death with similar frequency between the treatment groups, and was due to progression of renal failure, deterioration of condition, acute pulmonary edema, acute cardiac death, accidental death, death from another disease condition, or unknown cause.

UpCard®-CA1 (torsemide oral solution)

Administer orally once daily at a dose of 0.05 to 0.2 mg/lb (0.11 to 0.44 mg/kg) of bodyweight.

Oral

UpCard®-CA1

UpCard-CA1 should be administered orally once daily at a dose of 0.05 to 0.2 mg/lb (0.11 to 0.44 mg/kg) of bodyweight, corresponding to 0.025 to 0.10 mL/lb (0.055 to 0.22 mL/kg). UpCard-CA1 is intended for long term administration at a dose adapted to the severity of clinical signs of pulmonary edema, results of physical examination, hydration status, and blood urea nitrogen (BUN), serum creatinine, and serum electrolyte levels. Do not exceed a dose of 0.2 mg/lb (0.44 mg/kg) per day, corresponding to 0.1 mL/lb (0.22 mL/kg). UpCard-CA1 may be administered with or without food.

ORAL

UpCard®-CA1 (torsemide oral solution)