Bumetanide

Brand names

• Bumex
• Burinex

Usage

To reduce the accumulation of fluid (containing salts and water) that leads to edema (swelling) and breathlessness in patients with heart disease, cirrhosis of the liver, and kidney disease.

How it works

Loop diuretics work on a specific portion of the kidney (the loop of Henle) to increase the excretion of both water and sodium in the urine.

Side effects

Serious

Rapid or irregular heartbeat, dry mouth, increased thirst, mood or mental changes, muscle cramps or pain, nausea or vomiting, unusual fatigue, black and tarry stools, buzzing or ringing in ears, hearing loss, skin rash.

Common

Muscle cramps. Fluid depletion can cause dizziness when the patient rises from a sitting or lying position. Minor potassium depletion can cause mild weakness and rapid or irregular heartbeat.

Less common

Gout, increased blood sugar (glucose) levels, hearing loss.

Possible interactions

Other medicaments:

Bumetanide may increase the effects of:

• antihypertensive medicaments. Careful decreases in dose are needed to prevent excessive lowering of the blood pressure.

Bumetanide taken concurrently with:

• ACE inhibitors may result in severe lowering of blood pressure on standing (postural or orthostatic hypotension).
• aminoglycoside antibiotics (amikacin, gentamicin, kanamycin, neomycin, streptomycin, tobramycin, viomycin) increases the risk of hearing loss.
• cephalosporins may increase risk of kidney toxicity.
• cortisone-related medicaments may cause excessive potassium loss and also blunted therapeutic benefits.
• digitalis-related medicaments requires very careful monitoring to prevent serious disturbances of heart rhythm.
• lithium (Lithobid, others) may increase lithium toxicity risk.

The following medicaments may decrease the effects of bumetanide:

• indomethacin (Indocin) or other NSAIDs may reduce its diuretic effect.

Foods:

Salt restriction and a high potassium diet maybe needed.

Herbal medicines or minerals:

Ginseng may increase blood pressure, blunting the benefits of this medicine. Hawthorn, saw palmetto, ma huang, goldenseal and licorice may also cause increased blood pressure. Calcium and garlic may help lower blood pressure. Dandelion root has diuretic properties. Talk to your doctor before combining any herbals with this medicine.

Alcohol:

Alcohol can exaggerate the blood pressure lowering effect of this medicament and cause orthostatic hypotension.

Occurrence of unrelated illness:

Report vomiting or diarrhea promptly to your doctor.

Discontinuation:

It may be advisable to stop this medicament 5 to 7 days before major surgery. Ask your doctor for help.

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