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. Author manuscript; available in PMC: 2022 May 1.
Published in final edited form as: JACC Heart Fail. 2021 Mar 10;9(5):325–335. doi: 10.1016/j.jchf.2021.01.013

Table 1.

Potential Advantages of Torsemide Over Furosemide for Treatment of Heart Failure

Pharmacologic Properties Better Suited for Managing Congestion
  • More predictable and reliable diuretic effect
    • Near 100% bioavailability compared to variable furosemide bioavailability (i.e., 10-100%)
    • Absorption not affected by food
    • 2-4 times more potent than furosemide
    • May be less vulnerable to diuretic resistance

  • Longer half-life (3.5 hours versus 2 hours) and duration of effect (6-16 hours versus 6-8 hours) than furosemide

  • Less prone to hypokalemia

Favorable Effects on Neurohormones
  • Renin-angiotensin-aldosterone system inhibition
    • Decrease aldosterone secretion from adrenal cells
    • Aldosterone antagonist-like blockade of aldosterone receptors
    • Inhibition of downstream effects of angiotensin II

  • Decreased sympathetic activation

Favorable Effects on Cardiac Remodeling

  • Slows or reverses development of myocardial fibrosis

  • Attenuates progressive ventricular dilation and hypertrophy

Adapted with permission from Greene SJ and Mentz RJ.(22)