Bumetanide
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Bumetanide
Bumex
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Summary
Classes
Common uses
Volume overload in heart failure0, Acute pulmonary edema0, Hepatic edema/ascites0, Edema in CKD0
Pharmacy
Starting dose
0.5-1 mg PO/IV once or twice daily; titrate to clinical response. Approximate equipotency: bumetanide 1 mg ≈ furosemide 40 mg ≈ torsemide 20 mg
Preparations
0.5, 1, 2 mg tablets; 0.25 mg/mL IV
US FDA Max
~10 mg/d typical
Pharmacology
Routes
Oral, IV, IM
Onset
PO 30-60 minutes; IV minutes
Duration
4-6 hours
Half-life
1-1.5 hours[1]
Bioavailability
~80-95% (oral; more reliable than furosemide, comparable to torsemide)[1]
Pregnancy
Avoid where possible; class concerns as for other loop diuretics.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Bumetanide blocks the Na+/K+/2Cl- cotransporter (NKCC2) on the apical membrane of thick ascending limb cells, producing brisk natriuresis, kaliuresis, and free-water clearance; the more predictable oral bioavailability relative to furosemide makes it preferred where reliable absorption is essential.0 Ototoxicity, hypokalemic metabolic alkalosis, hyperuricemia, and gout flare are the characteristic class adverse effects. Use of bumetanide as a research tool to probe NKCC1-mediated chloride homeostasis in CNS conditions (epilepsy, autism) is an active investigational area[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Bumex (bumetanide), Validus, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/018225s033lbl.pdf