Bumetanide

Registered South African indications:

• Oedema

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Severe hepatic impairment
• Severe renal impairment
• Severe electrolyte depletion
• Marked increase in blood urea
• Development of oliguria or anuria during treatment 
• Coadministration with lithium

Cautions

• Pregnancy
• Breastfeeding
• Mild to moderate renal impairment
• Mild to moderate hepatic impairment
• Elderly
• Patients on a low-salt diet
• High dosages

Forms avail. in SA and covered in this monograph: tab

Oedema

• Oral (tab): Initial: 1mg; Titrate as needed; Maintenance: 1-4mg/day, in 1-2 divided doses; Max: 10mg/24hrs

Second dose can be given 6-8hrs after morning dose

Not established for use in children

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Caution; not recommended

Renal impairment

• Mild to moderate: Caution; dose adjustment recommended
• Severe: Contraindicated

Hepatic impairment

• Mild to moderate: Caution; no dose adjustment recommended
• Severe : Contraindicated

Elderly

• Caution; no dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Prohibited - At all times

Central Nervous System Disorders

• Encephalopathy
• Dizziness
• Fatigue
• Headache

Cardiovascular Disorders

• Hypotension

Gastrointestinal Disorders

• Abdominal pain
• Nausea and vomiting
• Dyspepsia
• Diarrhoea
• Stomach cramps
• Pancreatitis

Hepatobiliary Disorders

• Abnormal hepatic enzymes

Genitourinary Disorders

• Elevated blood urea
• Elevated serum creatinine

Endocrine and Metabolic Disorders

• Fluid and electrolyte depletion
• Dehydration
• Hyperuricaemia
• Hyperglycaemia
• Gynaecomastic
• Painful breasts
• Hypokalaemia

Musculoskeletal Disorders

• Muscle cramps
• Muscle spasm
• Arthralgia

Skin and Subcutaneous Tissue Disorders

• Skin rashes
• Pruritis
• Urticaria

Immune, Blood and Lymphatic System Disorders

• Thrombocytopaenia
• Bone marrow depression

Sensory Disorders

• Hearing abnormalities

• Ototoxic agents
• Nephrotoxic agents
• Cardiac glycosides
• Antihypertensive agents
• Non-steroidal anti-inflammatory drugs

• Electrolytes
• Renal function

Specific cases may require

• Blood glucose
• Serum uric acid

Bumetanide is a high ceiling loop diuretic whose primary site of action is the ascending limb of the Loop of Henle where it exerts inhibiting effects on electrolyte reabsorption causing a diuretic and natriuretic action.

Tablet 1mg

• Burinex (Adcock) originator