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a loop diuretic used in treatment of edema, such as that associated with congestive heart failure or hepatic or renal disease, treatment of hypertension, usually in association with other drugs, and as an adjunct in treatment of acute pulmonary edema; administered orally, intramuscularly, or intravenously.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Bumetanide Injection

Pharmacologic class: Loop diuretic

Therapeutic class: Antihypertensive

Pregnancy risk category C

FDA Box Warning

• Drug is a potent diuretic; excessive amounts may cause profound diuresis with fluid and electrolyte depletion. Give only under careful medical supervision; adjust dosage and dosing schedule to patient's needs.


Inhibits reabsorption of sodium and chloride in distal renal tubules and ascending limb of loop of Henle; increases renal excretion of water, sodium, chloride, magnesium, hydrogen, and calcium. Also reduces increased fluid volume caused by renal vasodilation.


Injection: 0.25 mg/ml

Tablets: 0.5 mg, 1 mg, 2 mg

Indications and dosages

Edema caused by heart failure or hepatic or renal disease; adult nocturia

Adults: 0.5 to 2 mg/day P.O. as a single dose; up to two additional doses may be given q 4 to 5 hours (up to 10 mg/day). Or 0.5 to 1 mg I.V. or I.M., repeated q 2 to 3 hours as needed, up to 10 mg/day.


Adults: 0.5 mg/day P.O. Maximum dosage is 5 mg/day.

Dosage adjustment

• Renal impairment

• Elderly patients

Off-label uses

• Drug-related edema

• Hypercalcemia


• Hypersensitivity to drug or sulfonamides

• Uncorrected electrolyte imbalances

• Hepatic coma

• Anuria and oliguria


Use cautiously in:

• severe hepatic disease, electrolyte depletion, diabetes mellitus, worsening azotemia

• elderly patients

• pregnant or breastfeeding patients

• children younger than age 18.


• Know that oral or I.V. route is preferred, because I.M. administration may cause pain at injection site.

• Be aware that drug may be given alone or with other antihypertensives.

• Dilute with dextrose 5% in water, normal saline solution, or lactated Ringer's injection.

• Give I.V. dose slowly over 2 minutes.

• Give P.O. form with food or milk.

Adverse reactions

CNS: dizziness, headache, insomnia, nervousness, vertigo, weakness, paresthesia, confusion, fatigue, hand-flapping tremor, encephalopathy

CV: hypotension, ECG changes, chest pain, thrombophlebitis, arrhythmias

EENT: blurred vision, nystagmus, hearing loss, tinnitus

GI: nausea, vomiting, diarrhea, constipation, dyspepsia, gastric irritation, dry mouth, anorexia, acute pancreatitis

GU: polyuria, nocturia, glycosuria, premature ejaculation, difficulty maintaining erection, oliguria, renal failure

Hepatic: jaundice

Metabolic: dehydration, hyperglycemia, hyperuricemia, hypokalemia, hypomagnesemia, hypochloremic alkalosis

Musculoskeletal: arthralgia; muscle cramps, aching, or tenderness

Skin: photosensitivity, hives, rash, pruritus, urticaria, diaphoresis

Other: pain, nipple tenderness


Drug-drug. Aminoglycosides, cisplatin: increased risk of ototoxicity

Amphotericin B, corticosteroids, mezlocillin, other diuretics, piperacillin, stimulant laxatives: additive hypokalemia

Anticoagulants, thrombolytics: increased bumetanide effects

Antihypertensives, nitrates: additive hypotension

Cardiac glycosides: increased risk of digoxin toxicity

Lithium: decreased lithium excretion, possible lithium toxicity

Neuromuscular blockers: prolonged neuromuscular blockade

Nonsteroidal anti-inflammatory drugs, probenecid: inhibition of diuretic response

Drug-diagnostic tests. Blood urea nitrogen (BUN), cholesterol, creatinine, glucose, nitrogenous compounds: increased levels

Calcium, magnesium, platelets, potassium, sodium: decreased levels

Drug-herbs. Dandelion: interference with diuretic activity

Ginseng: resistance to diuresis

Licorice: rapid potassium loss

Drug-behaviors. Acute alcohol ingestion: additive hypotension

Patient monitoring

• Weigh patient at start of therapy, and monitor weight throughout therapy.

• Monitor blood pressure regularly.

• Monitor serum electrolyte, uric acid, glucose, and BUN levels.

• Monitor elderly patients for extreme blood pressure changes, orthostatic hypotension, and dehydration.

Patient teaching

• Advise patient to take drug in morning to prevent nocturia, and to take second dose (if required) in late afternoon.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure drop.

• Caution patient to avoid alcohol because of increased risk of hypotension.

• Advise patient to eat foods high in potassium. Provide other dietary counseling as appropriate to help prevent or minimize electrolyte imbalances.

• Instruct patient to weigh himself often to help detect fluid retention.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


A diuretic, C17H20N2O5S2, used in the treatment of edema associated with congestive heart failure, hepatic cirrhosis, and renal disease.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


A potent loop diuretic with a rapid onset but short duration of action, which is used for patients with congestive heart failure who respond poorly to furosemide.
Adverse effects
Hypotension (especially orthostatic), drowsiness, headache.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Bumex® Cardiology A loop diuretic with a rapid onset but short duration of action indicated for Pts with HTN and CHF Contraindications Not indicated due to hypovolemia and fetal hypoxia. See Diuretic, Loop diuretic.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


A quick-acting DIURETIC drug used to relieve the fluid retention (OEDEMA) occurring in HEART FAILURE, kidney disease such as the NEPHROTIC SYNDROME and liver CIRRHOSIS. A brand name is Burinex.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005