Generic name: bumetanide (bue-MET-a-nide)
Drug class: Loop diuretics
Bumetanide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required, and dose and dosage schedule have to be adjusted to the individual patient's needs .
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Cardiovascular Agent
Pharmacologic Class: Diuretic, Loop
Uses for bumetanide
Bumetanide belongs to a group of medicines called loop diuretics or "water pills." Bumetanide is given to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney disease, or other medical conditions. It works by acting on the kidneys to increase the flow of urine .
Bumetanide is available only with your doctor's prescription .
Before using bumetanide
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For bumetanide, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to bumetanide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of bumetanide in the pediatric population. Safety and efficacy have not been established .
Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of bumetanide in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment of dosage in patients receiving bumetanide .
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking bumetanide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using bumetanide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using bumetanide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amtolmetin Guacil
- Arsenic Trioxide
- Choline Salicylate
- Flufenamic Acid
- Mefenamic Acid
- Niflumic Acid
- Nimesulide Beta Cyclodextrin
- Salicylic Acid
- Sodium Salicylate
- Tiaprofenic Acid
- Tolfenamic Acid
Using bumetanide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems
The presence of other medical problems may affect the use of bumetanide. Make sure you tell your doctor if you have any other medical problems, especially:
- Anuria (not able to form urine) or
- Liver disease, severe (e.g., hepatic coma)—Should not use in patients with these conditions .
- Dehydration or
- Gout or
- Hyperuricemia (high uric acid in the blood) or
- Hypocalcemia (low calcium in the blood) or
- Hypokalemia (low potassium in the blood) or
- Hypomagnesemia (low magnesium in the blood) or
- Hypovolemia (low blood volume) or
- Thrombocytopenia (low platelets in the blood)—Use with caution. Bumetanide may make these conditions worse .
- Diabetes—Bumetanide may increase the amount of sugar in the blood .
- Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body .
Proper use of bumetanide
The dose of bumetanide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of bumetanide. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For edema:
- Adults—0.5 to 2 milligrams (mg) once a day. Your doctor may adjust your dose if needed.
- Children—Use and dose must be determined by your doctor .
- For edema:
If you miss a dose of bumetanide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions while using bumetanide
It is very important that your doctor check your progress at regular visits to make sure bumetanide is working properly. Blood tests may be needed to check for unwanted effects .
Bumetanide may cause you to lose more potassium from your body than normal. Your doctor will monitor the potassium in your blood while you are taking bumetanide. To prevent the loss of too much water and potassium, tell your doctor if you become sick with severe or continuing nausea, vomiting, or diarrhea. Check with your doctor right away if you have one or more of these symptoms: dry mouth; increased thirst; muscle cramps; or nausea or vomiting .
Bumetanide can lower the number of platelets in your blood. Platelets are necessary for proper blood clotting. Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin .
Bumetanide may cause changes in your blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor .
Bumetanide side effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
- Abdominal pain
- blurred vision
- decreased urine output
- dry mouth
- fast or irregular heartbeat
- flushed, dry skin
- fruit-like breath odor
- increased hunger
- increased thirst
- increased urination
- joint pain, stiffness, or swelling
- loss of appetite
- loss of mental alertness
- lower back, side, or stomach pain
- mood or mental changes
- muscle pain or cramps
- nausea or vomiting
- numbness or tingling in the hands, feet, or lips
- shortness of breath
- swelling of face, hands, feet, ankles, or lower legs
- troubled breathing
- unexplained weight loss
- unusual tiredness or weakness
- weak pulse
- back pain
- black, tarry stools
- bleeding gums
- blood in the urine or stools
- chest pain
- convulsions (seizures)
- deep or fast breathing with dizziness
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
- increase in heart rate
- increased blood pressure
- numbness of feet, hands, and around the mouth
- pinpoint red spots on the skin
- rapid breathing
- stiff neck
- sunken eyes
- trembling, jerking of hands
- unusual bleeding or bruising
- weight gain
- wrinkled skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
- Difficulty breathing
- pain in chest, groin, or legs, especially the calves
- severe, sudden headache
- slurred speech
- sudden loss of coordination
- sudden, severe weakness or numbness in the arm or leg
- sudden, unexplained shortness of breath
- unusual drowsiness, dullness, or feeling of sluggishness
- vision changes
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Decreased interest in sexual intercourse
- difficulty with moving
- ear discomfort
- feeling of constant movement of self or surroundings
- inability to have or keep an erection
- itching skin
- loss in sexual ability, desire, drive, or performance
- muscle or bone pain
- muscle stiffness
- nipple tenderness
- pain, swelling, or redness in joints
- sensation of spinning
- shorter than usual time to ejaculation of semen
- trouble with hearing
- upset stomach
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.