Medications and Drugs
GENERIC NAME: bumetanide
BRAND NAME: Bumex
DRUG CLASS AND MECHANISM: Bumetanide is a potent diuretic (water
pill) that causes a profound increase in urine output (diuresis) by preventing the kidney from retaining fluid. (Specifically, it blocks the reabsorption of sodium and fluid from the kidney's tubules.) It
is in a class of diuretics called "loop" diuretics which also includes furosemide
(Lasix)
and torsemide (Demadex). One mg of bumetanide is approximately equivalent to
10-20 mg of torsemide and 40 mg of furosemide. The potent diuretic effect of
bumetanide can cause the loss of large amounts of body water leading to dehydration as well as the loss of electrolytes (e.g., sodium, potassium, magnesium, calcium. Therefore,
careful medical supervision is necessary during treatment. Bumetanide was
approved for use by the FDA in 1983.
GENERIC AVAILABLE: yes
PRESCRIPTION: yes
PREPARATIONS: Tablets: 0.5mg, 1mg, 2mg.
STORAGE: Tablets should be stored at room temperature,
between 15-30°C (59-86°F).
PRESCRIBED FOR: Bumetanide is used in the treatment of mild to
moderate hypertension (high blood pressure), and in the management of edema (excessive fluid
accumulation) associated with congestive heart failure, renal disease and
liver cirrhosis.
DOSING: Dosing of bumetanide and other loop diuretics vary greatly among patients, and doses are carefully adjusted by physicians. Bumetanide
may be taken with or without food.
DRUG INTERACTIONS: Bumetanide can cause low blood potassium,
calcium, and magnesium levels. These changes can increase the risk of
toxicity from digoxin (Lanoxin). Combining bumetanide with other diuretics such as metolazone
(Zaroxolyn), hydrochlorothiazide, or chlorthalidone (Hygroton) can
exaggerate the losses of potassium and magnesium.
The body's ability to eliminate lithium may decrease in patients receiving
bumetanide. Therefore, careful monitoring of lithium levels in blood
is recommended when bumetanide and lithium are taken together in order to prevent increases in lithium levels and lithium toxicity.
Indomethacin (Indocin) can reduce the diuretic and blood pressure-lowering
effects of other loop diuretics (e.g. furosemide) and it probably can do the same with bumetanide. Other non-steroidal anti-inflammatory drugs, e.g.,
ibuprofen (Motrin), naproxen (Naprosyn) may interact similarly.
PREGNANCY: There have been no adequate studies on the effects of
bumetanide on the fetus. Thus, the physician must carefully weigh the
potential but unknown risks and benefits of bumetanide before prescribing it for pregnant women.
NURSING MOTHERS: It is not known if bumetanide is
excreted into breast milk. Thus, it should be used in nursing women only if its potential
benefits outweigh the unknown risks.
SIDE EFFECTS: Potent diuretics like bumetanide can cause low blood levels of
potassium, magnesium, sodium and calcium. Additionally,
fluid loses can occur leading to dehydration. The symptoms of dehydration
may include dry mouth, thirst, weakness, drowsiness, reduced kidney
function, heart arrhythmias, muscle aches and pains, and/or nausea and
vomiting.
Toxicity to the inner ear in the form of tinnitus (ringing in the ear) and
hearing loss have been associated with other loop diuretics. High plasma
levels of bumetanide are toxic to the inner ear of animals. These effects on the inner ear are far more
common with intravenous use of the drugs.
High uric acid concentrations in the blood leading to attacks of gouty arthritis may occur during diuretic
therapy.
Reference: FDA Prescribing Information
Last Editorial Review: 6/6/1999 5:35:00 PM
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Congestive Heart Failure - Read about congestive heart failure symptoms like fatigue, abdomen, leg and ankle swelling, shortness of breath, sleeplessness, increased urination, nausea, abdominal pain, and decreased appetite.
- furosemide, Lasix - Describes the medication furosemide (Lasix), a drug used to treat excessive fluid accumulation and swelling (edema) of the body caused by heart failure, cirrhosis, chronic kidney failure, and nephrotic syndrome.
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