Torsemide

Increased risk of renal toxicity when used with torsemide.

Increased risk of hypotension and renal impairment when used concomitantly with torsemide.

Loop diuretics increase ototoxic potential of this ototoxic drug when used concomitantly with torsemide.

Loop diuretics increase ototoxic potential of aminoglycosides; concomitant use of torsemide and gentamycin reported; avoid if possible.

Risk of lithium toxicity with torsemide use.

Loop diuretics increase ototoxic potential; avoid concomitant use with torsemide if possible.

Increased risk of hypotension and renal impairment.

Torsemide may affect phenytoin efficacy and safety as a CYP2C9 substrate with narrow therapeutic range; requires monitoring and possible dose adjustment.

Compete for renal tubular secretion; high-dose salicylates may experience salicylate toxicity when given with torsemide.

Torsemide may affect warfarin efficacy and safety as a CYP2C9 substrate with narrow therapeutic range; requires monitoring and possible dose adjustment.

CYP2C9 inhibitor that decreases torsemide clearance and increases plasma concentrations; monitor diuretic effect and blood pressure.

Torsemide inhibits CYP2C9 metabolism; may affect efficacy and safety of this sensitive CYP2C9 substrate. Monitor and adjust dosages if necessary.

Decreases absorption and exposure of orally administered torsemide. Administer torsemide at least 1 hour before or 4-6 hours after cholestyramine.

Increased risk of hypokalemia when used concomitantly with torsemide.

CYP2C9 inhibitor that decreases torsemide clearance and increases plasma concentrations; monitor diuretic effect and blood pressure.

Partial inhibition of natriuretic effect of torsemide demonstrated under dietary sodium restriction conditions.

CYP2C9 inhibitor that decreases torsemide clearance and increases plasma concentrations; monitor diuretic effect and blood pressure.

CYP2C9 inhibitor that decreases torsemide clearance and increases plasma concentrations; monitor diuretic effect and blood pressure.

Organic anion drug that reduces torsemide secretion into proximal tubule, decreasing diuretic activity. Monitor diuretic effect.

Increased risk of hypokalemia when used concomitantly with torsemide.

CYP2C9 inducer that increases torsemide clearance and decreases plasma concentrations; monitor diuretic effect and adjust dose if necessary.

Since desogestrel is mainly metabolized by the cytochrome P450 2C9 enzyme (CYP 2C9) to form etonogestrel, the active progestin, there is a possibility of interaction with CYP 2C9 substrates or inhibitors (such as: ibuprofen, piroxicam, naproxen, phenytoin, fluconazole, diclofenac, tolbutamide, glipizide, celecoxib, sulfamethoxazole, isoniazid, torsemide, irbesartan, losartan, and valsartan).

Table 3: No observed clinically important drug interactions of Veltassa Angiotensin-converting enzyme (ACE) inhibitors Benazepril, captopril, enalapril, fosinopril, lisinopril, perindopril, quinapril, ramipril, trandolapril Angiotensin II receptor blockers (ARB) Azilsartan, candesartan, irbesartan, losartan, olmesartan, valsartan β-adrenoceptor blockers (β-blocker) Metoprolol Loop diuretics Furosemide, bumetanide, torasemide Mineralocorticoid receptor antagonists (MRA) Eplerenone, finerenone, spironolactone Neprilysin inhibitors Sacubitril Sodium-glucose cotransporter-2 (SGLT-2) inhibitors Canagliflozin, dapagliflozin, empagliflozin Antibiotics Trimethoprim, amoxicillin, cephalexin Anticoagulants Warfarin, apixaban, rivaroxaban Anti-parathyroid agents and Thyroid preparations Cinacalcet Antithrombotic agents Clopidogrel, acetylsalicylic acid Blood glucose lowering drugs Glipizide Calcium channel blockers Amlodipine, verapamil Immunosuppressants Tacrolimus Others Lithium, allopurinol, atorvastatin, digoxin, phenytoin, riboflavin, sevelamer