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What is bumetanide, and how does it work (mechanism of action)?
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 (for example, sodium, potassium, magnesium, and calcium). Therefore, careful medical supervision is necessary during treatment. Bumetanide was approved for use by the FDA in 1983.
Is bumetanide available as a generic drug?
Do I need a prescription for bumetanide?
What are the side effects of bumetanide?
Potent diuretics like bumetanide can cause low blood levels of potassium, magnesium, sodium and calcium. Additionally, fluid losses can occur leading to dehydration.
The symptoms of dehydration may include:
- dry mouth,
- reduced kidney function,
- heart arrhythmias,
- muscle aches and pains,
- nausea, and
Toxicity to the inner ear in the form of tinnitus (ringing in the ear) and hearing loss have been associated with 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.
What is the dosage for bumetanide?
The dose for most patients is 0.5 to 2 mg daily by mouth. Doses may be increased every 4 to 5 hours to a maximum dose of 10 mg daily. Intravenous (IV) or intramuscular (IM) injections may be used in place of tablets when oral administration is not possible. The IV dose is 1 mg initially followed by 0.5 to 2 mg/hour, and the IM dose is 0.5 to 10 mg daily. Dosing of bumetanide and other loop diuretics varies greatly among patients, and doses are carefully adjusted by physicians. Bumetanide may be taken with or without food.
Which drugs or supplements interact with bumetanide?
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 (Lithobid, Eskalith) 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 (for example furosemide) and it probably can do the same with bumetanide. Other nonsteroidal anti-inflammatory drugs, for example, ibuprofen (Motrin), naproxen (Naprosyn) may interact similarly.
Is bumetanide safe to take if I'm pregnant or breastfeeding?
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.
It is not known if bumetanide is excreted into breast milk. Thus, it should be used in women who are breastfeeding only if its potential benefits outweigh the unknown risks.
What else should I know about bumetanide?
What preparations of bumetanide are available?
Tablets: 0.5, 1, and 2 mg. Injection: 0.25 mg/ml
How should I keep bumetanide stored?
Tablets should be stored at room temperature, between 15 C - 30 C (59 F - 86 F).
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Daily Health News
Bumetanide, Bumex (discontinued brand) is a "loop diuretic" medication prescribed for the management of edema associated with congestive heart failure, liver and kidney disease, and off-label treatment for high blood pressure. Side effects, dosage, drug interactions, and pregnancy safety information should be reviewed prior to taking this medication.
Related Disease Conditions
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin (jaundice), itching, and fatigue. The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
Congestive Heart Failure (CHF)
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Edema is the swelling of tissues as a result of excess water accumulation. Peripheral edema occurs in the feet and legs. There are two types of edema, non-pitting edema and pitting edema. Causes of pitting edema is caused by systemic diseases (most commonly involving the heart, liver, and kidneys), and medications. Local conditions that cause edema are thrombophlebitis and varicose veins. Edema or swelling of the legs, feet, ankles, and face are common during pregnancy. Idiopathic edema is edema in which the cause is not known. Pitting edema is scored on pitting edema measurement scales. Edema is generally treated with medication.
Pulmonary edema (swelling or fluid in the lungs) can either be caused by cardiogenic causes (congestive heart failure, heart attacks, abnormal heart valves) or noncardiogenic causes such as ARDS, kidney failure, high altitude, pneumothorax, pleural effusion, aspirin overdose, pulmonary embolism, and infections. The treatment of pulmonary edema depends on the cause of the condition.
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Treatment & Diagnosis
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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.
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