Bumetanide

Oral
Oedema

Parenteral
Emergency cases of oedema

May be taken with or without food. May be taken w/ meals to reduce GI discomfort.

Anuria, hepatic coma, severe electrolyte depletion. Concurrent use w/ lithium.

Patient w/ sulfonamide allergy, prostatic hypertrophy. Hepatic (i.e. cirrhosis and ascites) and renal impairment. Elderly. Pregnancy and lactation.

Abdominal pain, vomiting, dyspepsia, diarrhoea, stomach and muscle cramps, arthralgia, dizziness, fatigue, hypotension, headache, nausea, fluid and electrolyte depletion, encephalopathy (in patients w/ pre-existing liver disease), dehydration, hyperuricaemia, increased BUN and serum creatinine, hyperglycaemia, abnormal serum hepatic enzymes, skin rash, pruritus, urticaria, thrombocytopenia, gynaecomastia and painful breasts. Rarely, reversible hearing disturbance.

IV/Parenteral/PO: C

Monitor BP, serum electrolytes, renal function, fluid status.

Symptoms: Profound water loss, volume and electrolyte depletion (manifested by weakness, dizziness, mental confusion, anorexia, lethargy, vomiting and cramps), dehydration, reduction of blood volume and circulatory collapse w/ possible thrombosis and embolism. Management: Supportive and symptomatic treatment, including fluid and electrolyte replacement. Perform gastric lavage or emesis.

Reduced diuretic and natriuretic effect w/ probenecid. May potentiate the effects of antihypertensive agents. Decreased effect when used w/ indometacin. May increase risk of digitalis toxicity. Increased risk of ototocixity when used w/ aminoglycosides or other ototoxic drugs (e.g. cisplatin). Increased risk of nephrotoxicity when used w/ nephrotoxic agents.
Potentially Fatal: May increase risk of lithium toxicity.

Description: Bumetanide inhibits Na and Cl reabsorption in the loop of Henle and proximal renal tubule, interfering w/ the Cl-binding cotransport system, thus inducing excretion of water and electrolytes.
Onset: 0.5-1hr (oral, IM); 2-3 min (IV).
Duration: 4-6 hr (oral); 2-3 hr (IV).
Pharmacokinetics:
Absorption: Almost completely and rapidly absorbed from the GI tract; completely absorbed (IM). Bioavailability: Approx 80-95%. Time to peak plasma concentration: 0.5-2 hr (oral).
Distribution: Volume of distribution: 9-25 L. Plasma protein binding: 94-96%.
Metabolism: Partially metabolised in the liver via oxidation of the N-butyl side chain to form alcohol metabolites.
Excretion: Via urine (approx 75-80%, w/ 50% as unchanged drug); faeces (approx 10%) Elimination half-life: 1-1.5 hr.

Source: National Center for Biotechnology Information. PubChem Database. Bumetanide, CID=2471, https://pubchem.ncbi.nlm.nih.gov/compound/Bumetanide (accessed on Jan. 22, 2020)

Store between 15-30°C. Protect from light.

Diuretics

C03CA02 - bumetanide ; Belongs to the class of high-ceiling sulfonamide diuretics.

Anon. Bumetanide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/08/2016.

Buckingham R (ed). Bumetanide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/08/2016.

Bumetanide Inj, Solution (Hospira, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/08/2016.

Bumetanide Tablet (Edenbridge Pharmaceuticals, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/08/2016.

Joint Formulary Committee. Bumetanide. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/08/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Bumetanide. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 03/08/2016.