Bumetanide (bumetanide)

Dosage of bumetanide should be adjusted according to individual requirements and response. Since the diuretic response following oral or parenteral administration is similar, bumetanide dosage is identical for oral, IV, or IM administration. For the management of fluid retention (e.g., edema) associated with heart failure, experts state that diuretics should be administered at a dosage sufficient to achieve optimal volume status and relieve congestion without inducing an excessively rapid reduction in intravascular volume, which could result in hypotension, renal dysfunction, or both. The manufacturer states that, in furosemide-allergic patients, bumetanide may be substituted for furosemide at approximately a 1:40 ratio since cross-sensitivity between the drugs does not appear to occur; however, some clinicians question the safety of bumetanide administration in furosemide-sensitive patients.

Although the manufacturer recommends that maximum oral or parenteral dosage of bumetanide not exceed 10 mg daily, oral or IV dosages up to 20 mg daily have been administered to patients with impaired renal function for the management of edema. Single-dose studies have shown that IV doses greater than 2 mg are needed to achieve a diuretic response in patients with creatinine clearances less than 5 mL/minute.

In patients with impaired hepatic function, bumetanide dosage should be kept to a minimum; if bumetanide dosage must be increased in these patients, it should be adjusted carefully.

No dosing information is available for this tab.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Limited clinical experience with bumetanide in pregnant women to date has not revealed evidence of harm to the fetus; however, the possibility of adverse fetal effects cannot be excluded. Bumetanide should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.

Although there are no adequate and controlled studies to date in humans, bumetanide has been shown to have a slight embryocidal effect in rats when given at a dosage 3400 times the maximum recommended human dosage; evidence of moderate growth retardation and delayed ossification of sternebrae in fetal offspring and maternal weight loss also occurred. Fetotoxic effects were not observed in rats when bumetanide was administered at 1000-2000 times the maximum recommended human dosage. Reproduction studies in mice using dosages up to 3400 times the maximum recommended human dosage have not revealed evidence of teratogenic or embryocidal effects. Bumetanide was not teratogenic in hamsters following oral administration of 0.5 mg/kg daily (17 times the maximum recommended human dosage) or in mice or rats at IV dosages up to 140 times the maximum recommended human dosage. A dose-related decrease in litter size and increase in fetal resorption rate occurred in rabbits receiving oral dosages of 0.1 and 0.3 mg/kg daily (3.4 and 10 times the maximum recommended human dosage, respectively); a slight embryocidal effect occurred in those receiving 0.1 mg/kg daily, and an increased frequency of delayed ossification of the sternebrae also occurred in those receiving 0.3 mg/kg daily. Adverse fetal effects were not observed in rabbits receiving 0.03 mg/kg daily.

Since it is not known if bumetanide is distributed into milk, the manufacturer cautions that nursing should not be undertaken in women receiving the drug.

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