Bumetanide

General

• 80-100% oral bioavailability as opposed to furosemide

Administration

• Type: Loop diuretic
• Dosage Forms: injectable solution, tablet
• Dosage Strengths: injectable solution: 0.25mg/mL; tablet: 0.5, 1, 2mg
• Routes of Administration: IV, PO
• Common Trade Names: Bumex, Burinex

Adult Dosing

40mg furosemide = 20mg torsemide = 1mg bumetanide = 50 mg ethacrynic acid

• 0.5 to 1 mg IV or 0.5-2mg PO. If inadequate response, repeat q2-3 hours to maximum of 10 mg per day

Pediatric Dosing

Safety/efficacy not established

Special Populations

• Pregnancy Rating: C
• Lactation risk: Infant risk cannot be ruled out
• Renal dosing: no adjustment
• Hepatic dosing: use lowest dose necessary, titrate slowly

Contraindications

• Allergy to class/drug
• Anuria
• Hepatic coma
• Severe electrolyte depletion

Adverse Reactions

Serious

• SJS
• Encephalopathy
• Thrombocytopenia

Common

• Hypotenchion
• Hypouricemia, hypokalemia, hypochloremia
• Cramps
• Dizziness, headache
• Nausea

Pharmacology

• Rapid onset
• Half-life: 1-6 hours
• Metabolism: Partially metabolized in liver
• Excretion: Mostly renal

Mechanism of Action

• Inhibits the reabsorption of sodium and chloride in the ascending limb of the loop of Henle

See Also

• Antihypertensives
• Diuretics