Acute Porphyria Drug Database

C03CA04 - Torasemide
Possibly porphyrinogenic
PSP

Rationale
Metabolised by CYP2C9. Torasemide is a sulfonamide congener, drug group often incriminated in porphyric attacks. One reference warns against the drug on grounds of insufficient data.
Chemical description
Sulfonamide congener.
Therapeutic characteristics
Sulfonamide loop-diuretic.
Metabolism and pharmakokinetics
Extensively CYP-metabolized in the liver, CYP2C9 is probably the most important isoenzyme. No data pointing to CYP-induction.
Personal communication
None
Published experience
None
IPNet drug reports
Uneventful use reported in 2 patients with acute porphyria.

References

  1. Scientific articles
  2. Friedel HA, Buckley MM. Torasemide. A review of its pharmacological properties and therapeutic potential. Drugs. 1991 Jan;41(1):81-103. PMID 1706990. #1254
  3. Miners JO, Coulter S, Birkett DJ, Goldstein JA. Torsemide metabolism by CYP2C9 variants and other human CYP2C subfamily enzymes. Pharmacogenetics. 2000 Apr;10(3):267-70. PMID 10803683. #4399
  4. Miners JO, Rees DL, Valente L, Veronese ME, Birkett DJ. Human hepatic cytochrome P450 2C9 catalyzes the rate-limiting pathway of torsemide metabolism. J Pharmacol Exp Ther. 1995 Mar;272(3):1076-81. PMID 7891318. #4400

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