{"id":1684,"date":"2023-06-25T17:31:26","date_gmt":"2023-06-25T17:31:26","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/bumetanide\/"},"modified":"2023-06-25T19:47:59","modified_gmt":"2023-06-25T19:47:59","slug":"bumetanide","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/bumetanide\/","title":{"rendered":"Bumetanide"},"content":{"rendered":"

<\/p>\n

Bumetanide<\/h1>\n

CLINICAL USE<\/h3>\n

Loop diuretic<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n
  • Oral: 1\u201310 mg daily, may be given in 2 divided doses<\/li>\n
  • Injection: IV 1\u20132 mg repeated after 20 minutes; IM if necessary, 1 mg then adjust according to response<\/li>\n
  • IV infusion : 2\u20135 mg over 30\u201360 minutes
    \n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :364.4<\/li>\n
  • %Protein binding                           :95<\/li>\n
  • %Excreted unchanged in urine     : 50<\/li>\n
  • Volume of distribution (L\/kg)       :0.2\u20130.5<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :0.75\u20132.6\/1.5
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           : Dose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Not dialysed. Dose as in normal renal function<\/li>\n
  • HD                     :Not dialysed. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :Unknown dialysability. Dose as in normal renal function<\/li>\n
  • CAV\/VVHD      :Not dialysed. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Analgesics: increased risk of nephrotoxicity with NSAIDs; antagonism of diuretic effect with NSAIDs<\/li>\n
  • Anti-arrhythmics: risk of cardiac toxicity with anti-arrhythmics if hypokalaemia occurs; effects of lidocaine and mexiletine antagonised<\/li>\n
  • Antibacterials: increased risk of ototoxicity with aminoglycosides, polymyxins and vancomycin; avoid concomitant use with lymecycline<\/li>\n
  • Antidepressants: increased risk of hypokalaemia with reboxetine; enhanced hypotensive effect with MAOIs; increased risk of postural hypotension with tricyclics<\/li>\n
  • Anti-epileptics: increased risk of hyponatraemia with carbamazepine<\/li>\n
  • Antifungals: increased risk of hypokalaemia with amphotericin<\/li>\n
  • Antihypertensives: enhanced hypotensive effect; increased risk of first dose hypotensive effect with alpha-blockers; increased risk of ventricular arrhythmias with sotalol if hypokalaemia occurs<\/li>\n
  • Antipsychotics: increased risk of ventricular arrhythmias with amisulpride, sertindole or pimozide if hypokalaemia occurs \u2013 avoid with pimozide; enhanced hypotensive effect with phenothiazines<\/li>\n
  • Atomoxetine: increased risk of ventricular arrhythmias if hypokalaemia occurs<\/li>\n
  • Cardiac glycosides: increased toxicity if hypokalaemia occurs<\/li>\n
  • Lithium: risk of toxicity
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral, IV, IM<\/p>\n

    Rate of Administration<\/h4>\n

    IV infusion<\/h4>\n

    : 2\u20135 mg in 500 mL of infusion fluid over 30\u201360 minutesIV bolus: 1\u20132 mg over 3\u20134 minutes<\/p>\n

    Comments<\/h4>\n

    Compatible with glucose 5% or sodium chloride 0.9%<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • 1 mg bumetanide \u2261 40 mg furosemide at low doses, but avoid direct substitution at high doses<\/li>\n
  • In patients with severe chronic renal failure given high doses of bumetanide there are reports of musculoskeletal pain and muscle spasm<\/li>\n
  • Orally: diuresis begins within 30 minutes, peaks after 1\u20132 hours, lasts 3 hours<\/li>\n
  • IV: diuresis begins within few minutes and ceases in about 2 hours<\/li>\n
  • Use with caution in patients receiving nephrotoxic or ototoxic drugs<\/li>\n
  • Smaller doses may be sufficient in the elderly and cirrhotics (500 micrograms)<\/li>\n
  • Use twice daily for higher doses .<\/li>\n","protected":false},"excerpt":{"rendered":"

    Bumetanide CLINICAL USE Loop diuretic DOSE IN NORMAL RENAL FUNCTION<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1684","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1684","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1684"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1684\/revisions"}],"predecessor-version":[{"id":2874,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1684\/revisions\/2874"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1684"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1684"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1684"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}