bumetanide


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bumetanide

 [bu-met´ah-nīd]
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.

bumetanide

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.

Action

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.

Availability

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.

Hypertension

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

Contraindications

• Hypersensitivity to drug or sulfonamides

• Uncorrected electrolyte imbalances

• Hepatic coma

• Anuria and oliguria

Precautions

Use cautiously in:

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

• elderly patients

• pregnant or breastfeeding patients

• children younger than age 18.

Administration

• 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

Interactions

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.

bumetanide

(byo͞o-mĕt′ə-nīd′)
n.
A diuretic, C17H20N2O5S2, used in the treatment of edema associated with congestive heart failure, hepatic cirrhosis, and renal disease.

bumetanide

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.

bumetanide

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.

bumetanide

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.
References in periodicals archive ?
The rationale for considering an alternative loop diuretic in this patient hinges on bioavailability, which is "highly variable" for oral furosemide, at 10%-100%, while by contrast, torsemide and bumetanide have a very consistent bioavailability of 80%-100%, according to Dr.
- US-based pharmaceutical company Upsher-Smith Laboratories, LLC has received US Food and Drug Administration approval of its abbreviated new drug application for Bumetanide Tablets, USP, 0.5 mg, 1 mg, and 2 mg, the company said.
Generic medication company Upsher-Smith Laboratories LLC reported on Tuesday the receipt of approval from the US Food and Drug Administration (FDA) for its abbreviated new drug application (ANDA) for Bumetanide Tablets, USP in 0.5 mg, 1 mg and 2 mg for treating fluid retention in the body.
(79) The players alleged that the NFL knew that a certain product contained the banned substance bumetanide and failed to disclose this fact to the players.
* Loop diuretics, such as bumetanide (Bumex), furosemide (Lasix), and torsemide (Demadex)
*** Medications: corticosteroids (prednisone, prednisolone, cortisone and dexa-methasone), glucocorticoids (decrease blood levels of hormones), anticonvulsants (phenobarbitol, phenytoin and carbamaze-pine/liver conversion vitamin D), thyroid meds (levothroid, levoxyl and synthroid), diuretics (furosemide, bumetanide, etha-crynic acid and torsemide), and blood thinners (heparin and Coumadin)
Bumetanide inhibition of the blood-brain barrier Na-K-Cl cotransporter reduces edema formation in the rat middle cerebral artery occlusion model of stroke.
Contract awarded for Furosemide or bumetanide 1mg 40mg tablet oral road.
Names: bumetanide, furosemide, hydrochlorothiazide, metolazone, triamterene ERECTILE DYSFUNCTION (ED) Grapefruit and grapefruit DRUGS: Increase blood flow juice can block ED drugs from into the penis to encourage leaving the body, which can erections during intercourse.
Substances investigated for their inhibitory potential were adipic acid (Sigma Aldrich), suberic acid (Sigma Aldrich), glycolic acid (Sigma Aldrich), citric acid (Merck), 3-hydroxyisobutyrate (Fluka), cis-aconitic acid (Sigma Aldrich), homovanillic acid (Sigma Aldrich), indomethacin (Sigma Aldrich), sitagliptin (Santa Cruz Biotechnologies), miglitol (Santa Cruz Biotechnologies), captopril (Sigma Aldrich), enalapril (Sigma Aldrich), furosemide (Sigma Aldrich), and bumetanide (Sigma Aldrich).
Her medications included bumetanide, clonazepam, colchicine .6 mg BID, a therapeutic dose of cyclosporine, flurazepam, gabapentin, levothyroxine, mirtazapine, oxycodone, prednisone, and premarin.
Bumetanide is a loop diuretic used to treat heart failure--it also potentiates the action of gamma-aminobutyric acid, she noted.