byū/met’ ə/nīd

Brand Names: Bumex®

  • Generic Available

Common Dosage Forms:

  • Tablets: 0.5 mg, 1 mg and 2 mg
  • Injection: 0.25 mg/mL

FDA Indications/Dosages:

  • Treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease (including the nephrotic syndrome):
    Oral: 0.5 mg to 2 mg daily given in one to two doses. Maximum of 10 mg per day.
    Intermittent dose schedule: Give dose on alternate days or for 3 to 4 days with 1 to 2 day rest periods.
    Parenteral: 0.5 mg to 1 mg I.M. or I.V. (over 1 to 2 minutes). Give a second or third dose at intervals of 2 to 3 hours until desired diuresis occurs. Maximum of 10 mg per day.

Monitor:

K

Pharmacology/Pharmacokinetics:

Bumetanide inhibits reabsorption of sodium and chloride in the ascending limb of the loop of Henle. It also exerts a diuretic action in the proximal tubule, but not noticeably in the distal tubule. The onset of diuresis following oral administration is between 30 and 60 minutes. Peak activity is reached between 1 and 2 hours. The duration of action of diuresis is usually around 4 hours. Intravenous administration speeds up the onset of diuresis to within minutes and peaks between 15 and 30 minutes.

Drug Interactions:

Auditory toxicity is increased when used with aminoglycosides or cisplatin. Electrolyte disturbances may predispose to digitalis-induced arrhythmias.

Contraindications/Precautions:

Contraindicated in patients with anuria and in patients with uncorrected hepatic coma or severe electrolyte depletion. Use with caution in patients hypersensitive to sulfonamides. Excessive doses or too frequent administration can cause volume and electrolyte depletion. Prevention of hypokalemia is important in patients with cirrhosis or ascites, diarrhea, potassium-losing nephropathy, and in patients receiving digitalis therapy. Pregnancy Category C.

Adverse Effects:

DIZZINESS, hypotension, MUSCLE CRAMPS, WEAKNESS, IMPAIRED HEARING, hyperuricemia, hypochloremia, hyponatremia, HYPOKALEMIA, azotemia, and hyperglycemia.

Patient Consultation:

  • May be taken with food or milk if GI upset occurs.
  • Timing of dose is important because of increased diuresis. Usually given in a.m.
  • May cause orthostatic hypotension – use care when standing up.
  • Store in a cool, dry place away from sunlight and children.
  • If a dose is missed, take it as soon as possible. If it is closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.
  • Contact a physician if the above side effects are severe or persistent.