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Bumetanide

    Brands

    DEA Class; Rx

    Common Brand Names; Bumex, Burinex

    • Diuretics, Loop

    Oral and parenteral loop diuretic related to furosemide with a diuretic potency is about 40 times greater; useful in patients unresponsive to other diuretics.

    Indicated for the treatment of peripheral edema or edema associated with heart failure or nephrotic syndrome.

    For the treatment of hypertension.
    For the acute treatment of hypercalcemia associated with neoplastic disease in combination with intravenous saline.
    For the treatment of ascites.
    For the treatment of oliguria associated with acute renal failure in premature neonates.

    Documented hypersensitivity to bumetanide or sulfonamides

    Severe uncorrected electrolyte depletion, anuria, hepatic coma

    • Hyperuricemia (18%)
    • Hypochloremia (15%)
    • Hypokalemia (15%)
    • Azotemia (11%)
    • Hyponatremia (9%)
    • Hyperglycemia (7%)
    • Increased serum creatinine (7%)
    • Variations in phosphorus (5%)
    • Variations in CO2 content (4%)
    • Variations in bicarbonate (3%)
    • Variations in calcium (2%)
    • Dizziness (1%)
    • Muscle cramps (1%)
    • Ototoxicity (1%)
    • Asterixis
    • Dehydration
    • Hypotension
    • Orthostatic hypotension
    • Pruritus
    • Rash
    • Renal failure
    • Serious skin reactions (ie, Stevens-Johnson syndrome, toxic epidermal necrolysis)
    • Vertigo
    • Vomiting

    Risk of electrolyte imbalance, alterations in glucose metabolism, blood dyscrasias, development of oliguria or increased blood urea nitrogen (BUN) or creatinine, hepatic disease, hyperuricemia, hypomagnesemia, hypovolemia, neonates at risk for kernicterus

    Hypokalemia may occur; close medical supervision and dose evaluation required; may need potassium supplementation and/or use of potassium-sparing diuretics to prevent hypokalemia; loop diuretics can also decrease serum calcium levels; electrolyte disturbances can predispose a patient to serious cardiac arrhythmias

    Risk of ototoxicity with rapid IV administration

    Fluid status and renal function should be monitored to prevent oliguria, increased creatinine and BUN, and azotemia

    Avoid use in neonates at risk for kernicterus; drug is a potent displacer of bilirubin in neonates

    If given the morning of surgery, drug may render patient volume depleted and blood pressure may be labile during general anesthesia

    Use with caution in patients with cirrhosis

    Coadministration with antihypertensive agent may increase risk of hypotension

    Pregnancy category: C

    Lactation: Unknown whether drug is excreted in breast milk; use with caution

    Adults

    10 mg/day PO, IV, or IM.

    Geriatric

    10 mg/day PO, IV, or IM.

    Adolescents

    Safety and efficacy have not been established; however, doses up to 0.1 mg/kg/dose PO, IV, or IM have been used off-label (Max adult dose: 10 mg/day).

    Children

    Safety and efficacy have not been established; however, doses up to 0.1 mg/kg/dose PO, IV, or IM have been used off-label (Max adult dose: 10 mg/day).

    Infants

    Safety and efficacy have not been established; however, doses up to 0.1 mg/kg/dose PO, IV, or IM have been used off-label.

    Neonates

    Safety and efficacy have not been established; however, doses up to 0.06 mg/kg/dose IV have been used off-label for oliguria.

    Bumetanide

    injectable solution

    • 0.25mg/mL

    tablet

    • 0.5mg
    • 1mg
    • 2mg