Kondreddy Naveen at 23:29, 1 February 2024

2024-02-01T23:29:01Z

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== '''What is Bumetanide?''' ==

* Bumetanide ('''Bumex''') is '''a [[loop diuretic]]''' used to treat [[edema]] caused by various medical problems, including heart, kidney, and liver disease.

[[File:Bumetanide structure.svg|thumb|Bumetanide structure]]

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== '''What are the uses of this medicine?''' ==

* Bumetanide ('''Bumex''') is used for the treatment of [[edema]] associated with [[congestive heart failure]], hepatic and renal disease, including the [[nephrotic syndrome]].

[[File:Bumetanide ball-and-stick.png|thumb|Bumetanide ball-and-stick]]

== '''How does this medicine work?''' ==

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* Bumetanide is '''a [[loop diuretic]]''' with a rapid onset and short duration of action.
* The '''major site of bumetanide action is the ascending limb of the loop of Henle'''.
* Bumetanide '''inhibits sodium reabsorption''' in the ascending limb of the loop of Henle, as shown by marked reduction of free-water clearance (CH2O) during hydration and tubular free-water reabsorption (TCH2O) during hydropenia.
* '''Reabsorption of chloride in the ascending limb is also blocked''' by bumetanide, and bumetanide is somewhat more chloruretic than natriuretic.
* '''Potassium excretion is also increased''' by bumetanide, in a dose-related fashion.
* Bumetanide may have an additional action in the proximal tubule.
* Since phosphate reabsorption takes place largely in the proximal tubule, phosphaturia during bumetanide induced diuresis is indicative of this additional action.
* '''Bumetanide decreases uric acid excretion and increases serum uric acid'''.

[[File:Bumetanide Structural Formula V1.svg|thumb|Bumetanide Structural Formula V1]]

== '''Who Should Not Use this medicine ?''' ==

This medicine cannot be used in patients with:
* [[anuria]]
* renal disease
* hepatic [[coma]]
* severe electrolyte depletion
* hypersensitive to this drug

== '''What drug interactions can this medicine cause?''' ==

* Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
Be sure to mention the following:
* medications for high blood pressure
* [[Aminoglycoside antibiotic|aminoglycoside antibiotics]] such as amikacin, gentamicin (Garamycin), or tobramycin (Bethkis, Tobi); corticosteroids (e.g., prednisone), digoxin (Lanoxin)
* [[indomethacin]] (Indocin, Tivorbex)
* [[lithium]] (Lithobid)
* [[probenecid]] (Probalan, Probenemid)

== '''Is this medicine FDA approved?''' ==

* Bumetanide (bue met' a nide) is a potent [[loop diuretic]] that was approved for use in the United States in 1983 and continues to be used for the treatment of [[edema]].

== '''How should this medicine be used?''' ==

'''Recommended dosage:'''
'''Oral Administration'''
* The usual total daily dosage of bumetanide tablets is 0.5 mg to 2 mg and in most patients is given as a single dose.
* If the diuretic response to an initial dose of bumetanide tablets is not adequate, in view of its rapid onset and short duration of action, a second or third dose may be given at 4- to 5- hour intervals up to a maximum daily dose of 10 mg.

'''Parenteral Administration:'''
* Bumetanide injection may be administered parenterally ([[intravenously]] and [[intramuscularly]]) to patients in whom gastrointestinal absorption may be impaired or in whom oral administration is not practical.
* The usual initial dose is 0.5 to 1 mg intravenously or intramuscularly.
* Intravenous administration should be given over a period of 1 to 2 minutes. If the response to an initial dose is deemed insufficient, a second or third dose may be given at intervals of 2 to 3 hours, but should not exceed a daily dosage of 10 mg.

'''Administration:'''
* Bumetanide comes as a tablet to take by mouth.
* It usually is taken once a day.
* When used to treat edema, a second or third dose may be given every 4 to 5 hours depending on the amount of swelling.

== '''What are the dosage forms and brand names of this medicine?''' ==

This medicine is available in fallowing doasage form:
* As tablet for oral administration contains 0.5 mg, 1 mg or 2 mg of bumetanide
* 4 mL and 10 mL vials for intravenous or intramuscular injection

This medicine is available in fallowing brand namesː
* '''Bumex'''

=='''What side effects can this medication cause?'''==

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The most common side effects of this medicine include:
* muscle cramps
* [[dizziness]]
* [[hypotension]]
* headache
* [[nausea]]
* [[encephalopathy]] (in patients with pre-existing liver disease)

* Serious skin reactions (i.e., [[Stevens-Johnson syndrome]], [[toxic epidermal necrolysis]]) have been reported.

Less frequent side effects to bumetanide are:
* impaired hearing
* [[pruritus]]
* [[electrocardiogram]] changes
* weakness
* [[hives]]
* abdominal pain
* [[arthritic]] pain
* [[musculoskeletal]] pain
* rash
* vomiting

==''' What special precautions should I follow?''' ==

* The dose of bumetanide should be adjusted to the patient’s need. Excessive doses or too frequent administration can lead to profound water loss, electrolyte depletion, [[dehydration]], reduction in blood volume and [[circulatory collapse]].
* [[Hypokalemia]] can occur as a consequence of bumetanide administration. Treatment in such patients is best initiated in the hospital with small doses and careful monitoring of the patient’s clinical status and electrolyte balance. Supplemental [[potassium]] and/or [[spironolactone]] may prevent hypokalemia and [[metabolic alkalosis]] in these patients.
* Patients allergic to sulfonamides may show [[hypersensitivity]] to bumetanide.
* Since there have been rare spontaneous reports of [[thrombocytopenia]] from postmarketing experience, patients should be observed regularly for possible occurrence of thrombocytopenia.
* Serum potassium should be measured periodically and potassium supplements or [[Potassium sparing diuretic|potassium sparing diuretics]] added if necessary. Periodic determinations of other electrolytes are advised in patients treated with high doses or for prolonged periods, particularly in those on low-salt diets.
* [[Diuretics]] have been shown to increase the urinary excretion of [[magnesium]]; this may result in [[hypomagnesemia]].
* It is not known whether this drug is excreted in human milk.
* Clinically apparent acute liver injury due to the loop diuretics is exceeding rare, if it occurs at all.

== '''What to do in case of emergency/overdose?''' ==

Symptoms of overdosage may include:
* acute profound water loss
* volume and electrolyte depletion
* [[dehydration]]
* reduction of blood volume
* [[circulatory collapse]] with a possibility of vascular thrombosis
* [[embolism]]

* Electrolyte depletion may be manifested by weakness, [[dizziness]], mental confusion, [[anorexia]], [[lethargy]], vomiting and cramps.

'''Management of overdosage:'''
* {{overdose}}
* Treatment consists of replacement of fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels.

== '''Can this medicine be used in pregnancy?''' ==

* There are no adequate and well-controlled studies in pregnant women.
* Bumetanide should be given to a pregnant woman only if the potential benefit justifies the potential risk to the fetus.

=='''Can this medicine be used in children?'''==

* Safety and effectiveness in pediatric patients below the age of 18 have not been established.

== '''What are the active and inactive ingredients in this medicine?''' ==

'''Active ingredient:'''
* BUMETANIDE

'''Inactive ingredients:'''
* ANHYDROUS LACTOSE
* MICROCRYSTALLINE CELLULOSE
* D&C YELLOW NO. 10
* FD&C BLUE NO. 1
* FD&C RED NO. 40
* MAGNESIUM STEARATE
* STARCH, CORN
* TALC

== '''Who manufactures and distributes this medicine?''' ==

'''Manufactured by:'''
* [[Sandoz Incorporated|Sandoz Inc.]]
* Princeton, NJ

== '''What should I know about storage and disposal of this medication?''' ==

* Store at 20° to 25°C (68° to 77°F).
* Dispense contents in a tight, light-resistant container as defined in the USP with a child-resistant closure, as required.

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Bumetanide - Revision history

Kondreddy Naveen at 23:29, 1 February 2024