Classes
DEA Class; Rx
Common Brand Names; Bumex, Burinex
- Diuretics, Loop
Description
Oral and parenteral loop diuretic related to furosemide with a diuretic potency is about 40 times greater; useful in patients unresponsive to other diuretics.
Indications
Indicated for the treatment of peripheral edema or edema associated with heart failure or nephrotic syndrome.
Contraindications
Documented hypersensitivity to bumetanide or sulfonamides
Severe uncorrected electrolyte depletion, anuria, hepatic coma
Adverse Effects
- Hyperuricemia (18%)
- Hypochloremia (15%)
- Hypokalemia (15%)
- Azotemia (11%)
- 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%)
- Asterixis
- Dehydration
- Hypotension
- Orthostatic hypotension
- Pruritus
- Rash
- Renal failure
- Serious skin reactions (ie, Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Vertigo
- Vomiting
Warnings
Risk of electrolyte imbalance, alterations in glucose metabolism, blood dyscrasias, development of oliguria or increased blood urea nitrogen (BUN) or creatinine, hepatic disease, hyperuricemia, hypomagnesemia, hypovolemia, neonates at risk for kernicterus
Hypokalemia may occur; close medical supervision and dose evaluation required; may need potassium supplementation and/or use of potassium-sparing diuretics to prevent hypokalemia; loop diuretics can also decrease serum calcium levels; electrolyte disturbances can predispose a patient to serious cardiac arrhythmias
Risk of ototoxicity with rapid IV administration
Fluid status and renal function should be monitored to prevent oliguria, increased creatinine and BUN, and azotemia
Avoid use in neonates at risk for kernicterus; drug is a potent displacer of bilirubin in neonates
If given the morning of surgery, drug may render patient volume depleted and blood pressure may be labile during general anesthesia
Use with caution in patients with cirrhosis
Coadministration with antihypertensive agent may increase risk of hypotension
Pregnancy and Lactation
Pregnancy category: C
Lactation: Unknown whether drug is excreted in breast milk; use with caution
Maximum Dosage
10 mg/day PO, IV, or IM.
10 mg/day PO, IV, or IM.
Safety and efficacy have not been established; however, doses up to 0.1 mg/kg/dose PO, IV, or IM have been used off-label (Max adult dose: 10 mg/day).
Safety and efficacy have not been established; however, doses up to 0.1 mg/kg/dose PO, IV, or IM have been used off-label (Max adult dose: 10 mg/day).
Safety and efficacy have not been established; however, doses up to 0.1 mg/kg/dose PO, IV, or IM have been used off-label.
Safety and efficacy have not been established; however, doses up to 0.06 mg/kg/dose IV have been used off-label for oliguria.
How supplied
Bumetanide
injectable solution
- 0.25mg/mL
tablet
- 0.5mg
- 1mg
- 2mg
