Bumetanide

Bumetanide

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Questions & Answers

Side Effects & Adverse Reactions

Volume and Electrolyte Depletion

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 with the possibility of vascular thrombosis and embolism, particularly in elderly patients.

Hypokalemia

Hypokalemia can occur as a consequence of bumetanide administration. Prevention of hypokalemia requires particular attention in the following conditions: patients receiving digitalis and diuretics for congestive heart failure, hepatic cirrhosis and ascites, states of aldosterone excess with normal renal function, potassium-losing nephropathy, certain diarrheal states, or other states where hypokalemia is thought to represent particular added risks to the patient, i.e., history of ventricular arrhythmias.

In patients with hepatic cirrhosis and ascites, sudden alterations of electrolyte balance may precipitate hepatic encephalopathy and coma. 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.

Ototoxicity

In cats, dogs and guinea pigs, bumetanide has been shown to produce ototoxicity. In these test animals bumetanide was 5 to 6 times more potent than furosemide and, since the diuretic potency of bumetanide is about 40 to 60 times furosemide, it is anticipated that blood levels necessary to produce ototoxicity will rarely be achieved. The potential exists, however, and must be considered a risk of intravenous therapy, especially at high doses, repeated frequently in the face of renal excretory function impairment. Potentiation of aminoglycoside ototoxicity has not been tested for bumetanide. Like other members of this class of diuretics, bumetanide probably shares this risk.

Allergy to Sulfonamides

Patients allergic to sulfonamides may show hypersensitivity to bumetanide.

Thrombocytopenia

Since there have been rare spontaneous reports of thrombocytopenia from postmarketing experience, patients should be observed regularly for possible occurrence of thrombocytopenia.

Legal Issues

There is currently no legal information available for this drug.

FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.

Uses

Bumetanide Injection is indicated for the treatment of edema associated with congestive heart failure, hepatic and renal disease, including the nephrotic syndrome.

Almost equal diuretic response occurs after oral and parenteral administration of bumetanide. Therefore, if impaired gastrointestinal absorption is suspected or oral administration is not practical, bumetanide should be given by the intramuscular or intravenous route.

Successful treatment with bumetanide following instances of allergic reactions to furosemide suggests a lack of cross-sensitivity.

History

There is currently no drug history available for this drug.

Other Information

Bumetanide is a loop diuretic, available as 4 mL vials and 10 mL vials (0.25 mg/mL) for intravenous or intramuscular injection as a sterile solution.

Each mL contains bumetanide 0.25 mg, sodium chloride 8.5 mg and ammonium acetate 4 mg as buffers, edetate disodium 0.1 mg and benzyl alcohol 10 mg as preservative in Water for Injection. pH adjusted to 6.8 – 7.8 with sodium hydroxide.

Chemically, bumetanide is 3-(butylamino)-4-phenoxy-5-sulfamoylbenzoic acid. It is a practically white powder, slightly soluble in water, soluble in alkaline solutions, having the following structural formula:

Structural formula

C17H20N2O5S      Molecular weight: 364.42

Bumetanide Manufacturers


  • West-ward Pharmaceutical Corp.
    Bumetanide Injection [West-ward Pharmaceutical Corp.]
  • Avkare, Inc.
    Bumetanide (Bumetanide) Tablet [Avkare, Inc.]
  • Baxter Healthcare Corporation
    Bumetanide Injection [Baxter Healthcare Corporation]
  • Eon Labs, Inc.
    Bumetanide Tablet [Eon Labs, Inc.]
  • Cardinal Health
    Bumetanide Injection [Cardinal Health]
  • Cardinal Health
    Bumetanide Injection [Cardinal Health]
  • West-ward Pharmaceutical Corp.
    Bumetanide Injection [West-ward Pharmaceutical Corp.]
  • Physicians Total Care, Inc.
    Bumetanide Tablet [Physicians Total Care, Inc.]
  • Ncs Healthcare Of Ky, Inc Dba Vangard Labs
    Bumetanide Tablet [Ncs Healthcare Of Ky, Inc Dba Vangard Labs]
  • Unit Dose Services
    Bumetanide Tablet [Unit Dose Services]
  • Unit Dose Services
    Bumetanide Tablet [Unit Dose Services]
  • Mylan Institutional Inc.
    Bumetanide Tablet [Mylan Institutional Inc.]
  • Lake Erie Medical Dba Quality Care Products Llc
    Bumetanide Tablet [Lake Erie Medical Dba Quality Care Products Llc]
  • Cardinal Health
    Bumetanide Injection, Solution [Cardinal Health]
  • Teva Pharmaceuticals Usa Inc
    Bumetanide Tablet [Teva Pharmaceuticals Usa Inc]
  • Cardinal Health
    Bumetanide Tablet [Cardinal Health]
  • Aidarex Pharmaceuticals Llc
    Bumetanide Tablet [Aidarex Pharmaceuticals Llc]
  • Cardinal Health
    Bumetanide Injection, Solution [Cardinal Health]
  • St Marys Medical Park Pharmacy
    Bumetanide Tablet [St Marys Medical Park Pharmacy]
  • Bryant Ranch Prepack
    Bumetanide Tablet [Bryant Ranch Prepack]
  • Hospira, Inc.
    Bumetanide Injection, Solution [Hospira, Inc.]
  • Hospira, Inc.
    Bumetanide Injection, Solution [Hospira, Inc.]
  • St Marys Medical Park Pharmacy
    Bumetanide Tablet [St Marys Medical Park Pharmacy]
  • Cardinal Health
    Bumetanide Injection, Solution [Cardinal Health]
  • Edenbridge Pharmaceuticals, Llc
    Bumetanide Tablet [Edenbridge Pharmaceuticals, Llc]

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