Uses

What is bumetanide used for?

Bumetanide is a diuretic, also called a water pill, that is commonly used to reduce edema (fluid retention) caused by the following conditions.

  • Congestive heart failure, which is a condition where the heart is not pumping as well as it should
  • Liver disease, such as cirrhosis, which can lead to a buildup of fluid in the abdomen (ascites)
  • Kidney disease, including protein in the urine (nephrotic syndrome)

Bumetanide may also be used for other conditions as determined by your healthcare provider.

How does bumetanide work (mechanism of action)?

Bumetanide works by increasing how much you pee. It does this by helping the kidneys remove electrolytes, such as sodium (salt), and water from the body.

How is bumetanide supplied (dosage forms)?

Bumetanide is available as Bumex and generic bumetanide in the following dosage forms that are taken by mouth.

  • 0.5 mg oral tablets
  • 1 mg oral tablets
  • 2 mg oral tablets

Bumetanide is also available in injectable forms.

How should I store bumetanide?

Bumetanide should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep tightly closed. Protect from light.  

Side Effects

What are the most common side effects of bumetanide?

The most common bumetanide side effects are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Muscle cramps
  • Dizziness
  • Low blood pressure (hypotension)
  • Headache
  • Nausea

There may be other side effects of bumetanide that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of bumetanide?

While less common, the most serious side effects of bumetanide are described below, along with what to do if they happen.

Severe Skin Reactions. Bumetanide can cause severe skin reactions called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) that can lead to death if not treated. If you develop a rash, stop bumetanide and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Low Blood Pressure with Worsening Kidney Function.  Water loss from bumetanide can lower your blood pressure too much and cause dehydration. Both may lead to problems that are more serious than light-headedness.  Poor blood flow to important organs such as your kidneys can occur, especially if you are elderly. Drink enough water to stay hydrated, especially if you have excess sweating, vomiting, or diarrhea. Get out of bed or from a seated position slowly. Tell your healthcare provider right away if you have any of the following symptoms.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired
  • Reduced need to pee
  • Sudden weight gain
  • Increased thirst
  • Dark or strong-smelling pee
  • Dry mouth
  • Sunken eyes
  • Headache
  • Fast heartbeat

Electrolyte Changes and Increased Blood Sugar. Bumetanide may increase your blood sugar (glucose) levels and cause changes to the levels of certain minerals in your body, called electrolytes. For example, it may cause low potassium levels (hypokalemia), low sodium levels (hyponatremia), low magnesium levels (hypomagnesemia), low calcium levels (hypocalcemia), low chloride levels (hypochloremia), or high glucose levels (hyperglycemia). These changes can be serious. Your healthcare provider will do bloodwork to check your glucose and electrolyte levels, especially if you take certain other medicines. Keep your appointments to have your blood checked. Call your healthcare provider if you have any of the following symptoms. 

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation
  • Nausea, vomiting, or loss of appetite
  • Dizziness
  • Restlessness or irritability
  • Difficulty breathing
  • Confusion or decreased alertness
  • Abnormal heart rhythm
  • Seizures

Hearing Loss. Bumetanide may be associated with hearing loss, which is also called ototoxicity. Tell your healthcare provider right away if you have hearing loss or if you hear a ringing or roaring sound in your ears while taking bumetanide.

Severely Low Platelet Levels. Bumetanide can cause you to have a severely low number of platelets in your blood, also called thrombocytopenia. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Tell your healthcare provider if you have any of the following symptoms of low platelet levels.

  • Easy bruising or bleeding
  • Bleeding that does not stop
  • Nosebleeds

Severe Allergic Reactions. Bumetanide may cause allergic reactions, which can be serious. Stop using bumetanide and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use bumetanide?

Allergies to Ingredients. People who are allergic to any of the following should not take bumetanide.

  • Bumetanide
  • Bumex
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific bumetanide products they stock.

No Urine Production. Do not take bumetanide if you are making very little to no pee. This condition is also called anuria.

Very Low Electrolytes. If you have low electrolytes, including low sodium or potassium, bumetanide may not be safe to use. Your healthcare provider may measure your electrolytes before starting bumetanide. Low electrolytes are not usually something you can feel, so it is important to make it to your scheduled blood work appointments.  

What should I know about bumetanide before using it?

Do not take bumetanide unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share bumetanide with other people, even if they have the same condition as you. It may harm them.

Keep bumetanide out of the reach of children.

Bumetanide can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how bumetanide affects you.

People who are age 65 or older can be at greater risk for some side effects from bumetanide. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using bumetanide?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if bumetanide is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart failure
  • Liver problems
  • Kidney problems
  • Persistent or severe diarrhea or vomiting, which can lead to dehydration
  • Low electrolytes, including potassium and sodium
  • Abnormal heart rhythm (arrhythmias)
  • Diabetes 
  • Gout

Sulfa Allergy. Some people who have a sulfa allergy may also be allergic to bumetanide. A sulfa allergy is a rash or more serious reaction to sulfa, or sulfonamide, medicines. Sulfa medicines include sulfamethoxazole, sulfadiazine silver, or sulfasalazine. Tell your healthcare provider if you have any allergies to medicines. Your healthcare provider can help you decide if it is safe for you to take bumetanide.

Other Medicines and Supplements. Bumetanide may interact with other medicines and supplements. Before using bumetanide, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how bumetanide could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take bumetanide while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if bumetanide passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.

Interactions

Does bumetanide interact with foods or drinks?

There are no known interactions between bumetanide and foods or drinks. However, since bumetanide affects electrolytes, it is important to discuss your intake of electrolytes, including sodium and potassium, with your healthcare provider. 

It is unknown if drinking alcohol will affect bumetanide. The risk of dizziness may be increased if you drink alcohol while taking bumetanide.

Does bumetanide interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using bumetanide.

  • Any aminoglycoside antibiotic, such as neomycin or gentamicin, which is a medicine usually given by injection to treat infections
  • Lithium, which is a medicine commonly used for certain mental health conditions
  • Probenecid, which is a medicine commonly used for gout
  • Indomethacin, which is a nonsteroidal anti-inflammatory drug (NSAID)
  • Any medicine that lowers blood pressure
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Any other diuretic, or water pill
Does Bumetanide interact with other drugs you are taking?
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Overdose/Missed Dose

What should I do if I accidentally use too much bumetanide?

If you or someone else has used too much bumetanide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of bumetanide?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

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