Bumetanide


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Oedema 1 mg as a single dose, then 1 mg after 6-8 hr if needed. IV/IM Emergency cases of oedema 0.5-1 mg, a 2nd or 3rd dose may be given at 2-3 hr intervals if response is inadequate. Max: 10 mg/day.
Dosage Details
Oral
Oedema
Adult: 1 mg as a single dose, given in the morning or early evening, then 1 mg after 6-8 hr if necessary.
Elderly: 0.5 mg daily.

Parenteral
Emergency cases of oedema
Adult: 0.5-1 mg via IM or slow IV inj over 1-2 min, a 2nd or 3rd dose may be given at 2-3 hr intervals if response is inadequate. Max: 10 mg daily.
Administration
May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
Contraindications
Anuria, hepatic coma, severe electrolyte depletion. Concurrent use w/ lithium.
Special Precautions
Patient w/ sulfonamide allergy, prostatic hypertrophy. Hepatic (i.e. cirrhosis and ascites) and renal impairment. Elderly. Pregnancy and lactation.
Adverse Reactions
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
MonitoringParameters
Monitor BP, serum electrolytes, renal function, fluid status.
Overdosage
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.
Drug Interactions
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.
Action
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.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store between 15-30°C. Protect from light.
MIMS Class
ATC Classification
C03CA02 - bumetanide ; Belongs to the class of high-ceiling sulfonamide diuretics.
Disclaimer: This information is independently developed by MIMS based on Bumetanide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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