What is bumetanide, and how does it work (mechanism of action)?
Bumetanide is a potent diuretic (water pill)
that causes a profound increase in urine output (diuresis) by preventing the
kidney from retaining fluid. Specifically, it blocks the reabsorption of sodium
and fluid from the kidney's tubules. It is in a class of diuretics called "loop"
diuretics which also includes furosemide (Lasix) and torsemide (Demadex). One mg
of bumetanide is approximately equivalent to 10-20 mg of torsemide and 40 mg of
furosemide. The potent diuretic effect of bumetanide can cause the loss of large
amounts of body water leading to dehydration as well as the loss of electrolytes
(for example, sodium, potassium, magnesium, and calcium). Therefore, careful
medical supervision is necessary during treatment. Bumetanide was approved for
use by the FDA in 1983.
Is bumetanide available as a generic drug?
Do I need a prescription for bumetanide?
What are the side effects of bumetanide?
Potent diuretics like bumetanide can cause low blood
levels of potassium, magnesium, sodium and calcium. Additionally, fluid losses
can occur leading to dehydration.
The symptoms of dehydration may include:
- dry mouth,
- reduced kidney function,
- heart arrhythmias,
- muscle aches and pains,
- nausea, and
Toxicity to the inner ear in
the form of tinnitus (ringing in the ear) and hearing loss have been associated
with loop diuretics. High plasma levels of bumetanide are toxic to the inner ear
of animals. These effects on the inner ear are far more common with intravenous
use of the drugs. High uric acid concentrations in the blood leading to attacks
gouty arthritis may occur during diuretic therapy.
What is the dosage for bumetanide?
The dose for most patients is 0.5 to 2 mg daily by mouth.
Doses may be increased every 4 to 5 hours to a maximum dose of 10 mg daily.
Intravenous (IV) or intramuscular (IM) injections may be used in place of
tablets when oral administration is not possible. The IV dose is 1 mg initially
followed by 0.5 to 2 mg/hour, and the IM dose is 0.5 to 10 mg daily. Dosing of
bumetanide and other loop diuretics varies greatly among patients, and doses are
carefully adjusted by physicians. Bumetanide may be taken with or without food.
Salt and sodium are the same.
Which drugs or supplements interact with bumetanide?
Bumetanide can cause low blood potassium, calcium,
and magnesium levels. These changes can increase the risk of toxicity from
digoxin (Lanoxin). Combining bumetanide with other diuretics such as metolazone
hydrochlorothiazide, or chlorthalidone (Hygroton) can exaggerate
the losses of potassium and magnesium.
The body's ability to eliminate lithium
may decrease in patients receiving bumetanide. Therefore, careful monitoring of
lithium levels in blood is recommended when bumetanide and lithium are taken
together in order to prevent increases in lithium levels and lithium toxicity.
Indomethacin (Indocin) can reduce the diuretic and blood pressure-lowering
effects of other loop diuretics (for example furosemide) and it probably can do
the same with bumetanide. Other nonsteroidal anti-inflammatory drugs, for
example, ibuprofen (Motrin), naproxen (Naprosyn) may interact similarly.
Is bumetanide safe to take if I’m pregnant or breastfeeding?
There have been no adequate studies on the effects of
bumetanide on the fetus. Thus, the physician must carefully weigh the potential
but unknown risks and benefits of bumetanide before prescribing it for
It is not known if bumetanide is excreted into breast
milk. Thus, it should be used in women who are
breastfeeding only if its potential benefits
outweigh the unknown risks.
What else should I know about bumetanide?
What preparations of bumetanide are available?
Tablets: 0.5, 1, and 2 mg. Injection: 0.25 mg/ml
How should I keep bumetanide stored?
Tablets should be stored at room temperature, between 15 C – 30 C
(59 F – 86 F).