Indication: For the treatment of edema associated with congestive heart failure, hepatic and renal disease including the nephrotic syndrome
Pharmacology: Bumetanide, a sulfonamide-type loop diuretic structurally related to furosemide, is used to manage hypertension and edema associated with congestive heart failure, cirrhosis, and renal disease, including the nephrotic syndrome. Bumetanide inhibits sodium reabsorption in the ascending limb of the loop of Henle.
Mechanism Of Action: Bumetanide interferes with renal cAMP and/or inhibits the sodium-potassium possibly sodium in the ascending loop of Henle, altering electrolyte transfer in the proximal tubule. This results in excretion of sodium, chloride, and water and, hence, leads to diuresis.
Interactions:
DrugBank: Interactions for Bumetanide
Interactions for Bumetanide:
1. Drugs with ototoxic potential: Especially in the presence of impaired renal function, the use of
parenterally administered bumetanide in patients to whom aminoglycoside antibiotics are also being given should be
avoided, except in life-threatening conditions.
2. Drugs with nephrotoxic potential: There has been no experience on the concurrent use of
bumetanide with drugs known to have a nephrotoxic potential. Therefore, the simultaneous administration of these
drugs should be avoided.
3. Lithium: Lithium should generally not be given with diuretics (such as bumetanide) because they
reduce its renal clearance and add a high risk of lithium toxicity.
4. Probenecid: Pretreatment with probenecid reduces both the natriuresis and hyperreninemia produced
by bumetanide. This antagonistic effect of probenecid on bu-metanide natriuresis is not due to a direct action on
sodium excretion but is probably secondary to its inhibitory effect on renal tubular secretion of bumetanide. Thus,
probenecid should not be administered concurrently with bumetanide.
5. Indomethacin: Indomethacin blunts the increases in urine volume and sodium excretion seen during
bumetanide treatment and inhibits the bumetanide-induced increase in plasma renin activity. Concurrent therapy with
bumetanide is thus not recommended.
6. Antihypertensives: Bumetanide may potentiate the effect of various antihypertensive drugs,
necessitating a reduction in the dosage of these drugs.
7. Digoxin: Interaction studies in humans have shown no effect on digoxin blood levels.
8. Anticoagulants: Interaction studies in humans have shown bumetanide to have no effect on warfarin
metabolism or on plasma prothrombin activity.
Chemical IUPAC Name: 3-butylamino-4-phenoxy-5-sulfamoyl-benzoic acid
