Torsemide

Indications

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).

Dosage and Administration

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. UpCard-CA1 Dose Adjustment: Long term diuretic therapy with UpCard-CA1 should be continued at the lowest effective dose. The dosage should be adjusted to maintain patient comfort, and control clinical signs based on serial physical examination and clinical pathology evaluation performed regularly during the early course of therapy and periodically thereafter (see

Contraindications

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.

Warnings

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. Animal Safety Warnings: Keep UpCard-CA1 in a secure location out of reach of dogs, cats, and other animals to prevent accidental ingestion or overdose. In case of accidental overdose, provide drinking water and monitor electrolytes. Symptomatic therapy (e.g., fluid therapy) should be provided as medically necessary. The administration of UpCard-CA1, a loop diuretic, may lead to excessive diuresis which could result in electrolyte imbalance, dehydration, and reduction of plasma volume enhancing the risk of circulatory collapse, thrombosis, and embolism. Dogs receiving UpCard-CA1 should be observed for signs of fluid depletion with electrolyte imbalance.

Precautions

). The dose of UpCard-CA1 may be increased or decreased within the recommended dose range by increments of 25% of the administered dose under veterinary supervision.

Adverse Reactions

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.

Description

UpCard-CA1 (torsemide oral solution) is a loop diuretic of the pyridyl sulfonylurea class. Loop diuretics mainly inhibit the Na+/2Cl-/K+ carrier in the ascending limb of the loop of Henle. UpCard-CA1 is an oral solution of 0.2% w/v torsemide in an aqueous mixture containing tromethamine, hydroxyethyl cellulose, saccharin sodium, and propylene glycol. Torsemide has the structural formula: Molecular Formula: C 16 H 20 N 4 O 3 S Molecular Weight: 348.42 Chemical Structure

Storage

Store at or below 30°C (86°F). Excursions permitted between 4°C and 40°C (39°F and 104°F). Discard 90 days after opening.

FDA adverse event reports

The FDA Center for Veterinary Medicine publishes the adverse event reports it receives through openFDA. The counts below are the reports naming torsemide as an active ingredient for each species this label names, as returned on 2026-09-16, coded by the VeDDRA reaction term the reporter chose. Reactions are counted per report, so one report can appear under several terms.

These are counts, not rates. Reporting is voluntary, the number of animals treated is not known, and a widely used product accumulates reports for that reason alone. A report records that an event followed a dose; it does not establish that the product caused it. The counts say nothing about how one product compares with another.