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bumetanide (Bumex)
Tradename: Bumex.
Indications:
1) management of edema secondary to:
a) heart failure
1] acute heart failure
2] chronic heart failure
b) hepatic insufficiency
c) renal insufficiency & nephrotic syndrome
2) treatment of hypertension
3) treatment of hypercalcemia
4) investigational prevention & treatment of apoE4-related Alzheimer's disease [3]
Dosage:
1) 0.5-1 mg IV/IM every 4-12 hours
2) 0.5-2 mg PO QD-BID
3) max: 10 mg QD
Tabs: 0.5, 1, 2 mg.
1 mg of bumetanide is roughly equipotent to 40 mg of furosemide.
Pharmacokinetics:
1) onset of action:
a) within 30-60 minutes after oral administration
b) within a few minutes after IV administration
2) duration of action
a) 4 hours with usual doses
b) 6 hours with higher doses
Adverse effects:
1) common (> 10%)
- hyperuricemia, hypochloremia, hypokalemia, azotemia
2) less common (1-10%)
- dizziness, encephalopathy, headache, hyponatremia, muscle cramps, muscle weakness
3) uncommon (< 1%)
- hypotension, rash, pruritus, hyperuricemia, cramps, nausea/vomiting, elevated liver function tests, ototoxicity, increased serum creatinine
4) other
- hypocalcemia
- vasculitis
- reaction to sulfa-drugs
Drug interactions:
1) decreased lithium clearance
2) additive effect with other antihypertensive medications
3) NSAIDs may decrease effect of bumetanide
Mechanism of action: acts at loop of Henle
Interactions
drug interactions
drug adverse effects (more general classes)
monitor with loop diuretics
General
loop diuretic
sulfonamide
Properties
MISC-INFO: elimination route KIDNEY
pregnancy-category C
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Taubes A, Nova P, Zalocusky KA et al
Experimental and real-world evidence supporting the computational repurposing
of bumetanide for APOE4-related Alzheimer's disease.
Nat Aging 2021. 1, 932-947
Not indexed in PubMed
https://www.nature.com/articles/s43587-021-00122-7
- Department of Veterans Affairs, VA National Formulary