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P - Caution when used during pregnancy
L - Caution when used during Lactation
Bumetanide is a loop diuretic of the sulfamyl category to treat heart failure. It is often used in people in whom high doses of furosemide are ineffective.
Bumetanide induces diuresis by inhibiting reabsorption of water and electrolytes (sodium and chloride) in the ascending loop of Henle and proximal renal tubule.
Absorption: Almost completely and rapidly absorbed from the GIT.
Distribution: 95% bound to plasma proteins.
Excretion: Elimination half-life: about 1-2 hr. About 80% excreted in the urine; 50% as unchanged drug.
In Oedema, hypertension and in pulmonary Oedema.
Muscle cramps, dizziness, hypotension, headache, nausea, impaired hearing, pruritus, ECG changes, musculoskeletal pain, rash, chest discomfort, renal failure, premature ejaculation, thrombocytopenia, hypokalaemia, hypomagnesaemia, hyponatraemia, hyperuricaemia, hyperglycaemia, hypocalcaemia.
Potentially Fatal: Encephalopathy (in patients with preexisting liver disease).
Pregnancy, lactation; 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 as well as blood counts. Sulfonamide allergy. CHF patients on digitalis, K losing nephropathy, hepatic cirrhosis and ascitis, diarrhoeal states.
Reduced diuretic and natriuretic actions by probenecid. Indometacin blunts action of bumetanide; concurrent usage with antihypertensives may increase risk of orthostatic hypotension.
Potentially Fatal: Avoid concurrent usage with ototoxic drugs such as aminoglycoides and nephrotoxic drugs. Reduced lithium excretion via kidneys.
Adult: 1 mg once daily. Give 2nd dose 6-8 hr later if necessary.
Elderly: 0.5 mg daily.
Adult: Initially, 5 mg daily increased by 5 mg every 12-24 hr as required. High doses may be divided in 2-3 doses. Max: 10 mg/day.
Adult: 0.5-1 mg daily. Max: 5 mg/day.
Emergency cases of oedema
Adult: 0.5-1 mg via slow IV/IM inj, subsequently adjust dose according to response.
Adult: 1-2 mg IV repeated 20 min later if necessary, or 2-5 mg in 500 ml of a suitable infusion fluid given over 30-60 min.
Overdosage: May result in acute profound water loss, volume and electrolyte depletion, dehydration, reduction of blood volume and circulatory collapse leading to vascular thrombosis and embolism. Electrolyte depletion may be manifested by weakness, dizziness, mental confusion, anorexia, lethargy, vomiting and cramps. Treatment includes replacing fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels.
May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Caution when used during Lactation.
Hypersensitivity, progressive renal failure and anuria, hepatic coma, severe electrolyte depletion.
Information Not Available.