Dogs

Helps manage pulmonary edema in dogs with congestive heart failure caused by myxomatous mitral valve disease (MMVD). Torsemide has a chemical structure different than furosemide — leading to a longer half-life, higher bioavailability, and greater potency and duration of diuretic action as compared to furosemide. In a study, torsemide achieved higher owner compliance because of its once daily dosing. The oral solution allows UpCard-CA1 to be easily titrated for specific dosing.

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.

Vetoquinol

Torsemide 2mg/ml

Sold in 32 ml bottle with 1 ml syringe or 96 ml bottle with a 10 ml syringe.

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.

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:UpCard-CA1 is not indicated for dogs presenting in acute crisis with pulmonary edema, pleural effusion, and/or ascites requiring emergency treatment. The use of injectable diuretic therapy should be considered first in dogs presenting in acute crisis before commencing oral therapy with UpCard-CA1.UpCard-CA1 is for use only in stable dogs with congestive heart failure caused by MMVD. A diagnosis of MMVD should be made by means of a comprehensive physical and cardiac examination. Pre-existing electrolyte abnormalities and/or dehydration should be corrected prior to therapy with UpCard-CA1.The safe administration of UpCard-CA1 relies on regular assessment of treated dogs for the clinical signs of pulmonary edema and potential treatment-related adverse events. Physical examination, hydration status, BUN, serum creatinine, and serum electrolytes should be assessed prior to the initiation of therapy or dose adjustment, and at 24 hours and 48 hours after the start of therapy or dose adjustment. These parameters should be monitored on a monthly basis until they are stable.Carefully monitor the electrolyte status in cases of concomitant use with products affecting electrolyte balance (e.g., corticosteroids, amphotericin B, and cardiac glycosides).Concurrent use of drugs that increase the risk of renal injury or renal insufficiency should be avoided. Concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) with UpCard-CA1 may result in a decreased natriuretic response and renal impairment.Concurrent use of aminoglycosides or cephalosporins with UpCard-CA1 may increase the risk of nephrotoxicity and ototoxicity. The safety of UpCard-CA1 has not been evaluated in dogs with heart failure caused by etiologies other than MMVD. The safe use of UpCard-CA1 has not been evaluated in dogs with congenital heart defects.The safe use of UpCard-CA1 has not been evaluated in dogs with diabetes mellitus or other serious metabolic diseases. The safe use of UpCard-CA1 has not been evaluated in dogs used for breeding, or pregnant or lactating bitches.The dose of UpCard-CA1 may need to be adjusted when administering UpCard-CA1 with digoxin. UpCard-CA1 may potentially induce an allergic reaction in dogs with sulfonamide allergy.UpCard-CA1 can reduce renal excretion of salicylates, leading to an increased risk of aspirin toxicity.

Contact your nearest emergency animal hospital.

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