Bumetanide (Bumex)

Indications


Pharmacology

  • Sulfonamide Loop Diuretic (see Sulfonamides, [[Sulfonamides]]): inhibition of sodium-potassium-chloride cotransport in the ascending loop of Henle (with minor effect on proximal tubule) -> natriuresis (equal to approximately 20% of filtered load of sodium), calciuria, phosphaturia, and minimal bicarbonaturia
    • Bumetanide is approximately 40 times more potent than furosemide (for patients with normal renal function)
    • Half-Life: 1.2-1.5 hrs

Adverse Effects

Renal Adverse Effects

  • Hyperuricemia (see Hyperuricemia, [[Hyperuricemia]]): 18.4% of cases
  • Hypokalemia (see Hypokalemia, [[Hypokalemia]])
  • Hyponatremia ( (see Hyponatremia, [[Hyponatremia]]): 9.2% of cases
    • Due to natriuresis
  • Hypomagnesemia (see Hypomagnesemia, [[Hypomagnesemia]])

Dermatologic Adverse Effects

Other Adverse Effects

  • Ototoxicity/Hearing Loss
    • Risk is increased in setting of renal failure
    • Probably less risk of ototoxicity than furosemide (as bumetanide is more potent than furosemide and less drug would be given)
  • Myalgias (see Myalgias, [[Myalgias]]): 1.1% of cases
  • Thrombocytopenia (see Thrombocytopenia, [[Thrombocytopenia]]): rare reports

References

  • Pharmacology, therapeutic efficacy, and adverse effects of bumetanide, a new “loop” diuretic. Pharmacotherapy. 1982 Jul-Aug;2(4):213-22 [MEDLINE]