Torsemide

Summary

Torsemide (CHEMBL1148) is an approved small-molecule loop diuretic (ATC C03CA04); indicated across 8 conditions including cardiovascular disorder and heart failure.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: C03CA04
• Indications: 8 conditions
• Clinical trials: 27
• Chemistry: 348.4 Da · C16H20N4O3S

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL1148
Name	Torsemide
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	41781
ChEBI	CHEBI:9637
ATC	C03CA04
Molecular formula	C16H20N4O3S
Molecular weight	348.4
InChIKey	NGBFQHCMQULJNZ-UHFFFAOYSA-N

SMILES: CC1=CC(=CC=C1)NC2=C(C=NC=C2)S(=O)(=O)NC(=O)NC(C)C

IUPAC name: 1-[[4-(3-methylanilino)-3-pyridinyl]sulfonyl]-3-propan-2-ylurea

ChEBI definition: An N-sulfonylurea obtained by formal condensation of [(3-methylphenyl)amino]pyridine-3-sulfonic acid with the free amino group of N-isopropylurea. It is a potent loop diuretic used for the treatment of hypertension and edema in patients with congestive heart failure.

Pharmacological roles (ChEBI): loop diuretic, antihypertensive agent.

Also known as: AC-4464, AC4464, BM-02.015, BM-02015, BM02.015, Demadex, Isemid, Luprac, Soaanz, Torasemida, Torasemide, Torasemide anhydrous

Patent coverage: 3,862 distinct patent families (15,151 SureChEMBL compound mentions), from 3 matched compound structure(s). One matched structure accounts for 15,070 (99%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 6 (assay-derived). Sample: Lysine-specific demethylase 4E, Thromboxane A2 receptor, Cytochrome P450 2C9, Cytochrome P450 3A4, Hypoxia-inducible factor 1-alpha, Heat shock factor protein 1.

Bioactivity

ChEMBL activities: 5 potent at pChembl ≥ 5 of 12 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
CYP3A4	6	Potency	1000	nM	CHEMBL_ACT_4973607
CYP3A4	6	Potency	1000	nM	CHEMBL_ACT_5038868
CYP3A4	6	AC50	1000	nM	CHEMBL_ACT_6049278
HIF1A	5.4	Potency	3981	nM	CHEMBL_ACT_4125687
HIF1A	5.4	Potency	3981	nM	CHEMBL_ACT_4519896

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

8 indications (6 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
cardiovascular disorder	4	MONDO:0004995	EFO:0000319
heart failure	4	MONDO:0005252	EFO:0003144
congestive heart failure	4	MONDO:0005009	EFO:0000373
hypertensive disorder	4	MONDO:0005044	EFO:0000537
myocardial infarction	4	MONDO:0005068	EFO:0000612
stroke disorder	4	MONDO:0005098	EFO:0000712
preeclampsia	2	MONDO:0005081	EFO:0000668
type 2 diabetes mellitus	1	MONDO:0005148	MONDO:0005148

Clinical trials

Total trials: 27.

Phase distribution

Phase	Trials
PHASE4	7
PHASE1	7
Not specified	6
PHASE3	5
PHASE2	2

Top trials by phase / activity

NCT	Phase	Status	Title
NCT06218199	PHASE4	RECRUITING	Diuretics vs. Afterload Reduction for Treatment of HeartLogic Alerts
NCT01942109	PHASE4	UNKNOWN	The Impact of TORasemide oN hemodynAmic and Neurohormonal Stress, and carDiac remOdeling in Heart Failure
NCT02087332	PHASE4	UNKNOWN	Investigator Initiated Randomized Open-label Comparative Study of Britomar (Prolonged Release Torasemide) and Diuver (Torasemide) to Assess Effects on Natriuresis and Central Hemodynamics.
NCT02644616	PHASE4	COMPLETED	The Safety and Efficacy of Tolvaptan for Patients With Tricuspid Regurgitation and Right Heart Failure After Left Heart Valves Replacement
NCT03187509	PHASE4	COMPLETED	Weight-Based Torsemide Dosing in Subjects With Heart Failure
NCT05171686	PHASE4	COMPLETED	Diuretics and Volume Overload in Early CKD
NCT06708611	PHASE4	WITHDRAWN	A Crossover Study of Patients With HF to Compare Natriuretic Effects of IR Torsemide vs. ER Torsemide Over 12 Hrs
NCT03296813	PHASE3	COMPLETED	TRANSFORM-HF: ToRsemide compArisoN With furoSemide FORManagement of Heart Failure
NCT05093621	PHASE3	COMPLETED	Torsemide Comparison With Furosemide for Management of Patients With Stable Heart Failure
NCT06413082	PHASE3	COMPLETED	Pharmacogenetics of Torasemide and Spironolactone in Hypertension Treatment
NCT07015671	PHASE3	COMPLETED	Bioavailability and Bioequivalence Study of ER Torsemide and Spironolactone FDC Tablet in Healthy Subjects
NCT07046975	PHASE3	COMPLETED	Bioavailability and Bioequivalence Study of Extended Release Torsemide and Spironolactone
NCT06670534	PHASE2	RECRUITING	A Dose-finding Study of JMKX003142 in Treatment of Renal Edema
NCT02813551	PHASE2	COMPLETED	ToRsemide for pOstpartum HYpertension
NCT00653549	PHASE1	COMPLETED	Bioavailability Study of Torsemide Tablets Under Fasting Conditions
NCT00654043	PHASE1	COMPLETED	Bioavailability Study of Torsemide Tablets Under Fed Conditions
NCT01276288	PHASE1	COMPLETED	Pharmacodynamics and Pharmacokinetics of Empagliflozin and Torasemide in Patients With Type 2 Diabetes
NCT01558674	PHASE1	TERMINATED	A Study of MK-7145 in Participants With Renal Insufficiency (Part I) and Heart Failure With Renal Insufficiency (Part II) (MK-7145-011)
NCT01788254	PHASE1	COMPLETED	Open Label Study for the Functional Characterization of Drug Metabolism and Transport
NCT01845194	PHASE1	COMPLETED	Repeated Dose Study for the Investigation of Heritability of and Genetic Influences on Drug Pharmacokinetics
NCT06292091	PHASE1	COMPLETED	A Study to Investigate the Effect of Urine Acid-base Disequilibrium on the Pharmacokinetics of Captopril
NCT00602303	Not specified	COMPLETED	Bioequivalency Study of Torsemide Tablets Under Fasting Conditions
NCT00602615	Not specified	COMPLETED	Bioequivalency Study of Torsemide Tablets Under Fed Conditions
NCT01457053	Not specified	TERMINATED	Assessment of Coronary Flow Reserve in Heart Failure Patients After Ultrafiltration Versus Diuretics
NCT06037434	Not specified	UNKNOWN	Study of Innovative Drug Treatment Therapy for Pediatric Mitral Regurgitation
NCT06039540	Not specified	UNKNOWN	Study of Drug Therapy for Pediatric Heart Failure
NCT06039592	Not specified	UNKNOWN	Study of Innovative Drug Strategies in Improving Left Ventricular Function After Mitral Repair

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline, but PharmGKB curates 5 clinical and 10 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).