Six-week study of torsemide in patients with congestive heart failure.

A double-blind, randomized, multicenter study compared treatment with 10 mg torsemide, 20 mg torsemide, and 40 mg furosemide, once daily, in 70 patients with congestive heart failure who had been maintained on 40 mg furosemide daily for at least 2 weeks. All three treatment groups showed statistically significant decreases in body weight, ranging from 1 to 3 kg at week 6. The decreases in body weight were significantly greater in the 20-mg torsemide group than in the furosemide group at weeks 4 and 6 and in the 10-mg torsemide group than in the furosemide group at week 4. The 20-mg torsemide group showed a statistically significant reduction in edema. Both the 10-mg and 20-mg torsemide groups showed statistically significant improvement in heart size. Pulmonary congestion decreased with treatment in each group. At week 6, both edema and pulmonary congestion were significantly less in the 20-mg torsemide group than in the 10-mg torsemide or 40-mg furosemide groups. Torsemide was well tolerated. Small, clinically insignificant decreases in serum potassium and increases in creatinine and uric acid were observed with both torsemide and furosemide. In conclusion, 20 mg torsemide was more effective than 40 mg furosemide in reducing body weight and improving symptoms of congestive heart failure.