Generic
Bumetanide
7 brands available in the market
At a glance
Bumetanide is a loop diuretic used in the treatment of hypertension, heart failure, edema, and nephrotic syndrome. It induces diuresis by inhibiting reabsorption of water and electrolytes (sodium and chloride) in the ascending loop of Henle.
Description
Bumetanide is a potent loop diuretic that induces diuresis by inhibiting reabsorption of water and electrolytes (sodium and chloride) in the ascending loop of Henle and proximal renal tubule.
Bumetanide is used in the treatment of hypertension, heart failure, edema, and nephrotic syndrome. It removes excess water and salt from the body, lowering blood pressure and reducing edema.
Indications
- Hypertension
- Heart failure (edema)
- Edema
- Nephrotic syndrome
Therapeutic class
Diuretic
Pharmacological class
Loop Diuretic
Pharmacology
Bumetanide is a potent loop diuretic that inhibits the Na⁺/K⁺/2Cl⁻ co-transporter in the ascending loop of Henle and proximal renal tubule, preventing reabsorption of sodium and chloride. This increases water and electrolyte excretion in the distal tubule, producing powerful diuresis, lowering blood pressure, and reducing edema.
Mechanism of action
Bumetanide inhibits the Na⁺/K⁺/2Cl⁻ co-transporter in the ascending loop of Henle, preventing reabsorption of sodium, chloride, and potassium, resulting in increased excretion of water and electrolytes from the body.
Dosage
Adults (Oral, Edema): 1 mg once daily. Give 2nd dose 6-8 hours later if necessary.
Refractory edema: Initially 5 mg/day, increased by 5 mg every 12-24 hours as required (high doses divided into 2-3 doses). Max: 10 mg/day.
Hypertension: 0.5-1 mg daily. Max: 5 mg/day.
Parenteral (Emergency cases of edema): 0.5-1 mg slow IV/IM injection, then adjust dose according to response.
Pulmonary edema (IV): 1-2 mg IV, repeated 20 minutes later if necessary; or 2-5 mg in 500 mL infusion fluid over 30-60 minutes.
Elderly: 0.5 mg daily.
Hepatic disease: Risk of encephalopathy (caution in pre-existing liver disease).
Renal impairment: Contraindicated in progressive renal failure and anuria.
Administration
May be taken with or without food. May be taken with meals to reduce GI discomfort. Swallow tablets whole; do not chew or crush. Follow the dose and duration as advised by your physician.
Missed dose
If you miss a dose, take it as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not double the dose.
Side effects
>10%: Hyperuricemia (18%), Hypochloremia (15%), Hypokalemia (15%), Azotemia (11%).
1-10%: Hyponatremia (9%), Hyperglycemia (7%), Increased serum creatinine (7%), Variations in phosphorus (5%), Variations in CO₂ content (4%), Variations in bicarbonate (3%), Variations in calcium (2%), Dizziness (1%), Muscle cramps (1%), Ototoxicity (1%).
<1%: Asterixis, Dehydration, Hypotension, Orthostatic hypotension, Pruritus, Rash, Renal failure, Serious skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), Vertigo, Vomiting.
Potentially Fatal: Encephalopathy (in patients with pre-existing liver disease).
Precautions & warnings
- Caution during pregnancy and lactation (Category C).
- Regular monitoring of serum electrolytes (especially potassium, calcium, magnesium). In case of hypokalemia, potassium supplements/potassium-sparing diuretics added.
- Monitor blood glucose, BUN, creatinine levels, and blood counts.
- Sulfonamide allergy.
- Caution in CHF patients on digitalis, K-losing nephropathy, hepatic cirrhosis and ascites, diarrheal states.
- Risk of encephalopathy in patients with liver disease.
Contraindications
- Hypersensitivity
- Progressive renal failure and anuria
- Hepatic coma
- Severe electrolyte depletion
Drug interactions
- Probenecid: Reduces diuretic and natriuretic actions.
- Indomethacin: Blunts bumetanide action.
- Concurrent use with antihypertensives: May increase risk of orthostatic hypotension.
- Ototoxic drugs (aminoglycosides) and nephrotoxic drugs: Avoid concurrent use (potentially fatal).
- Lithium: Reduces lithium excretion via kidneys.
Food interactions
No specific food restrictions (may be taken with or without food; take with meals to reduce GI discomfort).
Use in pregnancy
May be unsafe during pregnancy (Category C). Limited human studies available; animal studies have shown harmful effects on the developing baby. Your doctor will weigh benefits and risks before prescribing.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Unknown whether drug is excreted in human breast milk; use with caution.
Pediatric use
Safety and effectiveness in pediatric patients have not been established.
Geriatric use
Elderly dose: 0.5 mg daily (lower than adult dose).
Renal / hepatic impairment
Hepatic impairment: Risk of encephalopathy in patients with pre-existing liver disease; caution required.
Overdose effects
Overdose may cause severe electrolyte imbalance, dehydration, hypotension, ototoxicity. Consult your doctor immediately if overdose is suspected.
Storage conditions
Store below 30°C, away from light and moisture. Keep out of reach of children.
Chemical structure
Bumetanide (Loop Diuretic)