Adult Dosing

Edema

• Start: 0.5 to 1mg IV (over 1 to 2 min). Can give a 2nd or 3rd dose at 2-3 hr intervals
• Max: 10 mg/day

Pediatric Dosing

• Safety and effectiveness in pediatric patients below the age of 18 have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Edema associated with congestive heart failure, hepatic disease and renal disease, including the nephrotic syndrome

• Hypersensitivity to bumetanide or sulfonamides
• Hepatic coma
• Anuria or severe electrolyte depletion

• Bumetanide is a potent diuretic which if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Individualize dose and carefully supervise

Renal Dose Adjustment

• Progressive renal disease; development of oliguria or marked increase in BUN/creatinine: Discontinue therapy

Hepatic Dose Adjustment

• Cirrhosis/ascites: Caution advised
• Hepatic coma: Contraindicated

• Excessive doses or too frequent administration can lead to intense diuresis, electrolyte depletion and dehydration, reduction in blood volume with circulatory collapse and possible vascular thrombosis and embolism, especially in elderly patients. Adjust dose according to patient's need
• Bumenatide has been shown to produce ototoxicity. Observe patients for signs/symptoms of ototoxicity, especially if concurrent ototoxic drugs
• In patients with hepatic cirrhosis and ascites, sudden alterations of electrolyte balance may precipitate hepatic encephalopathy and coma
• Monitor for electrolyte imbalance and orthostatic hypotension
• Monitor BUN, serum creatinine, potassium, LFTs, blood sugar (if known/suspected diabetic)

Cautions: Use cautiously in

• Severe hepatic impairment (may precipitate hepatic coma)
• Sensitivity to sulfonamides
• Diabetes mellitus
• Electrolyte depletion
• Arrhythmias
• Acute MI
• SLE
• Hx of gout
• Hx of pancreatitis
• Gestational hypertension
• Geriatric population
• Pediatric population (safety not established)

Pregnancy Category:C

Breastfeeding: Safety unknown, alternate drugs are preferred due to risk of suppression of lactation. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 7 October 2010).

• CNS: Dizziness, headache, nausea, encephalopathy, vertigo
• EENT: Hearing impairment, hearing loss, ear discomfort, tinnitus
• GI: Abdominal pain, diarrhea, dry mouth, nausea, vomiting
• CV: Hypotension, ECG changes
• GU: Excessive urination, increased BUN
• DERM: Photosensitivity, pruritis, rash
• ENDO: Hyperglycemia, hyperuricemia
• HEMA: Thrombocytopenia
• METABOLIC: Dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis
• MUSC: Arthralgia, muscle cramps, myalgia
• MISC: Weakness, hives, fatigue, dehydration, sweating, hyperventilation

• Well absorbed after oral administration
• Partially metabolized by liver; CYP450: 1A2 substrate
• Renally excreted: 81% (45% unchanged); bile: 2%
• Half-life: 1-1.5 hrs

US Availability

bumetanide

• TABS: 0.5, 1, 2 mg

Canadian Trade Name(s)

• Burinex

Canadian Availability

Burinex

• TABS: 1, 5 mg

UK Trade Name(s)

• Burinex

UK Availability

bumetanide

• TABS: 1, 5 mg
• SOLN: 1 mg/5 mL (150 mL)

Burinex

• TABS: 1, 5 mg

Australian Trade Name(s)

• Burinex

Australian Availability

Burinex

• TABS: 1 mg

[Outline]

Cardiovascular

Diuretics

Loop Diuretics

Pricing data from www.DrugStore.com in U.S.A.

• Bumetanide 2 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
  30 mg = $20.99
  60 mg = $35.98
• Bumetanide 0.5 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
  90 mg = $18.99
  180 mg = $27.97
• Bumetanide 1 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
  90 mg = $28.97
  180 mg = $57.94

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Bumetanide 0.5 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Bumetanide 0.5 MG Oral Tablet (Physicians Total Care, Inc.)
• Bumetanide 0.5 MG Oral Tablet (Sandoz Inc.)
• Bumetanide 0.5 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Bumetanide 1 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Bumetanide 1 MG Oral Tablet (Physicians Total Care, Inc.)
• Bumetanide 1 MG Oral Tablet (Sandoz Inc.)
• Bumetanide 1 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Bumetanide 2 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Bumetanide 2 MG Oral Tablet (Physicians Total Care, Inc.)
• Bumetanide 2 MG Oral Tablet (Sandoz Inc.)
• Bumetanide 2 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Bumex 0.5 MG Oral Tablet (Roche Pharmaceuticals)
• Bumex 1 MG Oral Tablet (Roche Pharmaceuticals)
• Bumex 2 MG Oral Tablet (Roche Pharmaceuticals)