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Bumetanide is a loop diuretic, which is used to reduce edema due to various causes. So how effective is Bumetanide and what should patients pay attention to when using this product?
1. What is Bumetanide?
What is Bumetanide? Bumetanide is a loop diuretic, with the following dosage forms:
Tablets strength 0.5, 1 and 2mg; Solution for injection with a concentration of 0.25 mg/ml. Bumetanide is a powerful loop diuretic with short duration of action. The site of action of bumetanide is the ascending branch of the loop of Henle, where bumetanide will inhibit the reabsorption of electrolytes and cause diuretic effects as well as increase sodium excretion.
After oral administration, the diuretic effect of bumetanide is noted within 30 minutes with the peak effect between 1 and 2 hours. In clinical practice, Bumetanide has a complete diuretic effect within 3 hours of taking a dose of 1mg Bumetanide.
2. Indications of the drug Bumetanide
Bumetanide is indicated in the following cases:
Bumetanide is mainly indicated for the treatment of edema associated with certain pathologies such as congestive heart failure, renal dysfunction (including syndromes) nephrotic syndrome ) and cirrhosis in adults; Patients with edema due to renal or cardiac causes when high doses of short-acting diuretics are required can take bumetanide at a dose of 5 mg; Bumetanide is also used in the treatment of hypertension, either as monotherapy or in combination with other antihypertensive agents.
3. Contraindications of the drug Bumetanide
Bumetanide drug is contraindicated in the following cases:
Patients with hypersensitivity or allergy to the active ingredient Bumetanide and other ingredients contained in the drug Bumetanide; Oliguria, anuria, or uremia: Although bumetanide is used to induce diuresis in patients with renal insufficiency, any marked increase in blood urea or development of oliguria or anuria due to advanced kidney disease are contraindications or discontinuation of bumetanide therapy; Patients with hepatic coma or severe electrolyte imbalance; Concomitant administration of bumetanide with lithium salts is contraindicated.
4. Dosage of the drug Bumetanide
Bumetanide dosage in adults:
Most cases respond well to a dose of bumetanide 0.5 - 1mg per day, taken once in the morning or evening. Depending on the patient's response, a second dose of bumetanide may be considered after 6-8 hours. In patients who have not responded to bumetanide, the dose may be increased until a diuretic response is achieved to a maximum of 10 mg daily; Potassium supplementation therapy with preparations or in combination with potassium-sparing diuretics (eg, Spironolactone) may be necessary to prevent hypokalemia and/or metabolic alkalosis in some patients receiving the drug. Bumetanide . Bumetanide dosage for children:
Bumetanide is not recommended for children under 12 years of age, because there is little information on safety, efficacy and dosage in this population. Bumetanide dosage for other subjects:
Elderly patients: Adjust dose of Bumetanide according to response, in which Bumetanide dose of 0.5mg daily may have reached the therapeutic target in some elderly patients; Patients with liver failure should use Bumetanide at the minimum effective dose; Renal impairment: Patients who need to reduce edema can take bumetanide orally or by slow intravenous injection. A daily dose of 20mg has been used in some cases. Slow intravenous injection of bumetanide at doses greater than 2 mg may be necessary to achieve a diuretic response in patients with creatinine clearance less than 5 mL/min. Note that patients with severe renal impairment (glomerular filtration rate less than 10 mL/min/m2 skin) may require high doses of bumetanide to induce an adequate diuretic response. How to use Bumetanide:
Prioritize taking bumetanide orally, only for intravenous or intramuscular use in patients who cannot take the drug or have impaired absorption from the gastrointestinal tract; For direct intravenous injection, bumetanide should be injected slowly over a period of 1-2 minutes; For continuous intravenous infusion, bumetanide should be diluted in 5% dextrose, 0.9% sodium chloride or Ringer lactate and must be infused continuously for 24 hours; The diuretic response to bumetanide after oral or parenteral administration is similar, so dosage recommendations for all routes of administration are similar.
5. Bumetanide side effects
Common side effects when taking Bumetanide:
Dehydration; Dizziness, headache; Lower blood pressure ; Nausea; Skin itching (in patients with liver disease); Tired. Some rare side effects of Bumetanide:
Disturbances in water and electrolyte balance; Ear hurt; loose stools; Urticaria; Breast pain or discomfort in the chest; Bone marrow failure associated with bumetanide use, however, has not been conclusively shown to be caused by bumetanide; Hearing loss (reversible). Some adverse effects of the drug Bumetanide have not been determined the frequency of occurrence:
Increased blood uric acid; Increased blood sugar; Hepatic encephalopathy; Stomach spasms, abdominal pain, vomiting, indigestion; Rash, muscle cramps or joint pain.
6. Bumetanide drug interactions
Bumetanide drug interactions that may occur during use are as follows:
Bumetanide should not be used concurrently with Lithium, as it may decrease the clearance rate, thereby leading to increased levels of Lithium in the blood and lead to overdose or poisoning. When bumetanide is used to treat edema in hypertensive patients, consideration should be given to adjusting the dose of antihypertensive agents because bumetanide may lead to excessive hypotension. Consider adjusting the dose of bumetanide when co-administered with cardiac glycosides (such as digitalis), as increased potassium excretion may lead to increased myocardial sensitivity to the toxic effects of glycosides. Some NSAIDS are known to antagonize the effects of diuretics such as bumetanide. Bumetanide should not be used concurrently with certain antibiotics and antifungals, such as Cephaloridine or Amphotericin, as this may lead to increased harmful side effects. In order to avoid bumetanide drug interactions, patients need to inform their doctors about the drugs, herbs, and supplements they are using so that the doctor can consider and prescribe appropriate drugs.
7. Some notes when using Bumetanide drug
During the use of Bumetanide, patients should pay attention to the following issues:
Patients taking high doses of Bumetanide, orally or intravenously may experience sudden changes in their relationship The relationship between pressure and cardiac output leads to circulatory collapse. This condition is more likely to occur in older patients who are treated to remove edema too quickly. Patients with chronic renal failure receiving high doses of bumetanide should be under constant hospital supervision by a specialist. Patients on a salt-restricted diet are at risk of electrolyte imbalance when taking bumetanide. Patients should be tested for serum electrolytes, including sodium, potassium, chloride, and bicarbonate, periodically or as needed for appropriate intervention. Bumetanide may increase the nephrotoxicity or ototoxicity of other drugs, especially in patients with renal impairment. Bumetanide may lead to complications of encephalopathy in patients with pre-existing liver failure. Bumetanide may increase blood uric acid levels and increase blood sugar. Therefore, it is necessary to periodically check blood glucose and uric acid, especially in patients with diabetes or suspected diabetes and patients with gout. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take Bumetanide. Animal studies have shown that bumetanide is not teratogenic, but there are no data on the effects of bumetanide on pregnant women. Therefore, bumetanide should be avoided during pregnancy, especially in the first trimester. There are no data on the use of bumetanide during lactation; therefore, nursing mothers should discontinue bumetanide therapy unless clearly needed. Breastfeeding mothers must take bumetanide, and the infant must be monitored for any side effects. Bumetanide has no influence on the ability to drive or use machines. Bumetanide is a loop diuretic used to reduce edema due to various causes. To ensure effective use, users need to carefully read the instructions and follow the instructions of the doctor or pharmacist. Absolutely do not arbitrarily change the dosage, use in any case to avoid unwanted side effects affecting health.
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