Toras Uses

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What is Toras?

Toras injection provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, eye or vision problems, lupus, skin conditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis. Toras is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.

Toras is available only with your doctor's prescription.

Toras indications

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Intra-articular

Anti-inflammatory or immunosuppressive

Adult: As Toras acetate: 4-10 mg (small joints); 10-40 mg (medium joints); 20-80 mg (large joints). May be repeated every 1-5 wk depending on patient’s response.

Intralesional

Corticosteroid-responsive dermatoses

Adult: As Toras acetate: 20-60 mg; 1-4 inj may be given at intervals depending on the type of lesion and the duration of improvement from the initial inj.

Intralesional

Anti-inflammatory or immunosuppressive

Adult: As Toras acetate: 20-60 mg every 1-5 wk depending on patient’s response.

Intramuscular

Anti-inflammatory or immunosuppressive

Adult: As methyprednisolone Na succinate: 10-80 mg once daily. As Toras acetate: 10-80 mg every 1-2 wk.

Child: As Toras Na succinate: 0.5-1.7 mg/kg daily or 5-25 mg/m2 daily in divided doses 6-12 hrly. "Pulse" therapy: 15-30 mg/kg/dose over ≥30 min given once daily for 3 days.

Intravenous

Anti-inflammatory or immunosuppressive

Adult: As Toras Na succinate: 10-500 mg daily. Doses ≤250 mg are given by inj over at least 5 min while doses >250 mg are given slowly over at least 30 min.

Child: As Toras Na succinate: 0.5-1.7 mg/kg daily or 5-25 mg/m2 daily in divided doses 6-12 hrly. “Pulse” therapy: 15-30 mg/kg/dose over ≥30 min given once daily for 3 days.

Intravenous

Status asthmaticus

Adult: As Toras Na succinate: 40 mg, repeated according to patient’s response.

Child: As Toras Na succinate: 1-4 mg/kg daily for 1-3 days.

Intravenous

Acute allograft rejection in organ transplant recipients

Adult: As Toras Na succinate: 0.5-1 g daily; continue until the patient has stabilised, usually not beyond 48-72 hr.

Child: As Toras Na succinate: 10-20 mg/kg daily for up to 3 days. Max: 1,000 mg daily.

Oral

Allergic conditions

Adult: 24 mg on day 1 (8 mg before breakfast, 4 mg after lunch, 4 mg after supper, and 8 mg at bedtime) or 24 mg as a single or in 2-3 divided doses upon initiation (regardless of time of day); 20 mg on day 2 (4 mg before breakfast, 4 mg after lunch, 4 mg after supper, and 8 mg at bedtime); 16 mg on day 3 (4 mg before breakfast, 4 mg after lunch, 4 mg after supper, and 4 mg at bedtime); 12 mg on day 4 (4 mg before breakfast, 4 mg after lunch, and 4 mg at bedtime); 8 mg on day 5 (4 mg before breakfast and 4 mg at bedtime); 4 mg on day 6, given before breakfast.

Oral

Anti-inflammatory or immunosuppressive

Adult: Initially, 2-60 mg daily in 1-4 divided doses, depending on the disease being treated.

Child: As Toras Na succinate: 0.5-1.7 mg/kg daily or 5-25 mg/m2 daily in divided doses 6-12 hrly. "Pulse" therapy: 15-30 mg/kg/dose over ≥30 min given once daily for 3 days.

Topical/Cutaneous

Corticosteroid-responsive dermatoses

Adult: As 0.1% Toras aceponate oint, cream or lotion: Apply thinly to affected area once daily for up to 12 wk.

Child: As 0.1% Toras aceponate oint, cream or lotion: Apply thinly to affected area once daily for up to 4 wk.

How should I use Toras?

Use Toras suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Toras suspension.

Uses of Toras in details

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Toras is used to treat pain and swelling that occurs with arthritis and other joint disorders. This medication may also be used to treat various conditions such as blood disorders, severe allergic reactions, certain cancers, eye conditions, skin/intestinal/kidney/lung diseases, and immune system disorders. It decreases your immune system's response to these conditions and reduces symptoms such as swelling, pain, and allergic-type reactions. Talk to your doctor about the risks and benefits of Toras, especially if it is to be injected near your spine (epidural). Rare but serious side effects may occur with epidural use. Toras is a corticosteroid hormone.

Toras may also be used with other medications in hormone disorders.

How to use Toras injection

Shake this medication well before using. This medication is usually injected into a joint as directed by your doctor. Toras may also be injected into a muscle or into abnormal skin tissue. Follow your doctor's directions carefully. The dosage is based on your medical condition and response to treatment. Do not increase your dose or use this drug more often than prescribed without consulting your doctor. Your condition will not improve any faster, and your risk of side effects will increase.

If you are using this medication at home, learn all preparation and usage instructions from your health care professional. This medication should appear milky white. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

If this medication is injected into a joint, be careful how much pressure you put on that joint, even if it is feeling better. Ask your doctor how much you can move/use the joint while it is healing.

Do not stop using this medication without consulting your doctor. Some conditions may worsen or you may experience withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness) when this drug is suddenly stopped. To prevent these withdrawal symptoms when stopping Toras, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details and report any withdrawal reactions right away. See also Precautions section.

Tell your doctor if your condition does not improve or if it worsens.

Toras description

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Toras Sodium Succinate (Solu-Toras) is available in several strengths and packages for intravenous or intramuscular administration.

Act-O-Vial System (Single-Dose Vial): 125 mg/2 mL Vial: Each vial approximately contains Methylprednisolone sodium succinate equivalent to 125 mg Toras, 2 mg sodium phosphate, 20 mg dibasic sodium phosphate, and sufficient quantity of sodium hydroxide, and water for injection. Diluent contains water for injection.

40 mg/mL Vial: Each vial approximately contains Methylprednisolone sodium succinate equivalent to 40 mg Toras, 2 mg sodium phosphate, 18 mg dried dibasic sodium phosphate, 25 mg lactose, and sufficient quantity of sodium hydroxide and water for injection. Each mL of the diluent approximately contains 9 mg benzyl alcohol and sufficient quantity of water for injection.

Vial: 500 mg Vial with 8 mL Vial Diluent: Each vial approximately contains Methylprednisolone sodium succinate equivalent to 500 mg Toras, 7 mg sodium phosphate, 80 mg dibasic sodium phosphate, and sufficient quantity of 10% sodium hydroxide solution, and water for injection. Each mL of the diluent approximately contains 9 mg benzyl alcohol and sufficient quantity of water for injection.

1 gram Vial with 15.6 mL Vial Diluent: Each vial approximately contains Methylprednisolone sodium succinate equivalent to 1 gram Toras, 15 mg monobasic sodium phosphate monohydrate, 140 mg dibasic sodium phosphate, and sufficient quantity of 10% sodium hydroxide solution, and water for injection. Each mL of the diluent approximately contains 9 mg benzyl alcohol and sufficient quantity of water for injection.

Solu-Toras Sterile Powder contains Methylprednisolone sodium succinate as the active ingredient. Toras sodium succinate USP, occurs as a white, or nearly white, odourless hygroscopic, amorphous solid, it is very soluble in water and in alcohol. It is insoluble in chloroform and is very slightly soluble in acetone.

The chemical name for Toras sodium succinate is pregna-1, 4-diene-3, 20-dione, 21-(3-carboxy-1-oxopropoxyl-11, 17-dihydroxy-6-methyl monosodium salt, (6α, 11β).

Toras sodium succinate is so extremely soluble in water that it may be administered in a small volume in situations in which high blood levels of Toras are required rapidly.

Toras dosage

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Adult : PO Anti-inflammatory or immunosuppressive Initial: 2-60 mg/day, depending on the disease being treated. Allergic conditions 24 mg on day 1; 20 mg on day 2; 16 mg on day 3; 12 mg on day 4; 8 mg on day 5; 4 mg on day 6. All doses to be given as a single or in divided doses. IV As Toras Na succinate: Anti-inflammatory or immunosuppressive 10-500 mg/day. Acute allograft rejection in organ transplant recipients 0.5-1 g/day. Status asthmaticus 40 mg, repeated according to patient’s response. IM Anti-inflammatory or immunosuppressive As methyprednisolone Na succinate: 10-80 mg once daily. As Toras acetate: 10-80 mg every 1-2 wk. Intra-articular Anti-inflammatory or immunosuppressive As Toras acetate: 4-10 mg (small joints); 10-40 mg (medium joints); 20-80 mg (large joints). May be repeated every 1-5 wk. Intralesional Anti-inflammatory or immunosuppressive As Toras acetate: 20-60 mg every 1-5 wk. Corticosteroid-responsive dermatoses As Toras acetate: 20-60 mg, may repeat up to 4 inj at intervals depending on the type of lesion and patient’s response to the initial inj.

Topical

Corticosteroid-responsive dermatoses As 0.1% Toras aceponate oint, cream or lotion: Apply thinly to affected area once daily for up to 12 wk.

Toras interactions

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What other drugs will affect Toras?

The pharmacokinetic interactions listed below are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and Toras; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. convulsions have been reported with concurrent use of Toras and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin, and rifampin may increase the clearance of Toras and may require increased in Toras dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of Toras and thus decrease its clearance. Therefore, the dose of Toras should be titrated to avoid steroid toxicity.

Toras may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when Toras is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.

The effect of Toras on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

Toras side effects

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What are the possible side effects of Toras?

Applies to Toras: oral tablet

Other dosage forms:

In addition to its needed effects, some unwanted effects may be caused by Toras (the active ingredient contained in Toras Dose Pack). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking Toras:

More common:

Incidence not known:

Minor Side Effects

Some of the side effects that can occur with Toras may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

Incidence not known:

Toras contraindications

See also:
What is the most important information I should know about Toras?

You should not use this medication if you are allergic to Toras, or if you have a fungal infection anywhere in your body.

Before taking Toras, tell your doctor about all of your medical conditions, and about all other medicines you are using. There are many other diseases that can be affected by steroid use, and many other medicines that can interact with steroids.

Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. Do not receive a "live" vaccine while using Toras. The vaccine may not work as well during this time, and may not fully protect you from disease.

Do not stop using Toras suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Wear a medical alert tag or carry an ID card stating that you take Toras. Any doctor, dentist, or emergency medical professional who treats you should know that you take steroid medication.



Active ingredient matches for Toras:

Methylprednisolone in Indonesia.

Atorvastatin in India.


Unit description / dosage (Manufacturer)Price, USD
Toras 10mg TAB / 10
10 mg x 10's
Toras 4 mg x 10 x 10's$ 30.01
Toras 8 mg x 10 x 10's$ 48.15
Toras / vial 125 mg/2 mL x 1's$ 7.44
TORAS tab 10 mg x 10's (Chandra Bhagat Pharma)

List of Toras substitutes (brand and generic names):

Toralip 10mg TAB / 10 (Sigman Wellness)$ 0.54
TORCAD tab 10 mg x 10's (Cadomed)$ 0.48
TORCAD tab 20 mg x 10's (Cadomed)$ 0.54
Tablet; Oral; Atorvastatin Calcium Trihydrate 10 mg (Trima)
Tablet; Oral; Atorvastatin Calcium Trihydrate 20 mg (Trima)
Tablet; Oral; Atorvastatin Calcium Trihydrate 40 mg (Trima)
Tablets; Oral; Atorvastatin Calcium Trihydrate 10 mg (Trima)
Tablets; Oral; Atorvastatin Calcium Trihydrate 20 mg (Trima)
Tablets; Oral; Atorvastatin Calcium Trihydrate 40 mg (Trima)
10 mg x 10's (Pax Healthcare)$ 0.54
Torp 10mg TAB / 10 (Pax Healthcare)$ 0.54
TORP tab 10 mg x 10's (Pax Healthcare)$ 0.54
Torp 10mg TAB / 10 (Pax Healthcare)$ 0.54
TORSA Capsule/ Tablet / 20mg / 10 units (Comed Chemicals Pvt Ltd)$ 0.96
TORSA Capsule/ Tablet / 10mg / 10 units (Comed Chemicals Pvt Ltd)$ 0.54
Torsa 10mg TAB / 100 (Comed Chemicals Pvt Ltd)$ 5.87
Torsa 20mg TAB / 100 (Comed Chemicals Pvt Ltd)$ 10.43
10 mg x 100's (Comed Chemicals Pvt Ltd)$ 5.87
20 mg x 100's (Comed Chemicals Pvt Ltd)$ 10.43
Torsa 10 mg Tablet (Comed Chemicals Pvt Ltd)$ 0.06
Torsa 20 mg Tablet (Comed Chemicals Pvt Ltd)$ 0.10
TORSA 10MG TABLET 1 strip / 10 tablets each (Comed Chemicals Pvt Ltd)$ 0.56
TORSA tab 10 mg x 10's (Comed Chemicals Pvt Ltd)$ 0.59
TORSA tab 20 mg x 10's (Comed Chemicals Pvt Ltd)$ 1.04
Torsa 10mg TAB / 100 (Comed Chemicals Pvt Ltd)$ 5.87
Torsa 20mg TAB / 100 (Comed Chemicals Pvt Ltd)$ 10.43
Torsa 10mg Tablet (Comed Chemicals Pvt Ltd)$ 0.06
Torsa EZ 10+10 Tablet (Comed Chemicals Pvt Ltd)$ 0.11
Tortin 10 mg Tablet (Klokter Life Sciences)$ 0.06
Tablet, Film-Coated; Oral; Atorvastatin Calcium Trihydrate 10 mg (Zentiva (Czech Republic, Hungary, Poland, Russia, Ukraine))
Tablet, Film-Coated; Oral; Atorvastatin Calcium Trihydrate 20 mg (Zentiva (Czech Republic, Hungary, Poland, Russia, Ukraine))
Tablet, Film-Coated; Oral; Atorvastatin Calcium Trihydrate 40 mg (Zentiva (Czech Republic, Hungary, Poland, Russia, Ukraine))
Tablets, Film-Coated; Oral; Atorvastatin Calcium Trihydrate 10 mg (Zentiva (Czech Republic, Hungary, Poland, Russia, Ukraine))

References

  1. DailyMed. "METHYLPREDNISOLONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "AMLODIPINE BESYLATE; ATORVASTATIN CALCIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. PubChem. "methylprednisolone". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Toras are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Toras. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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