Bumetanide, Oral Tablet

Medically reviewed by University of Illinois-Chicago, Drug Information Group on February 8, 2017Written by University of Illinois-Chicago, Drug Information Group on November 7, 2017

Highlights for bumetanide

  1. Bumetanide oral tablet is only available as a generic drug. There is no brand-name version.
  2. Bumetanide comes in two forms: oral tablet, and intramuscular and intravenous (IV) injection, which is only given by a healthcare provider.
  3. Bumetanide oral tablet is used to treat swelling caused by congestive heart failure, liver disease, and kidney disease.

Important warnings

FDA warning: Water and electrolyte loss

  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
  • Bumetanide is a strong diuretic. When taken in high doses, it can make you urinate more. This could cause severe water and electrolyte loss. Your doctor will check you closely and decide your dosage based on how your body responds to this drug.

Other warnings

  • Sulfa allergy warning: If you’re allergic to a class of medications called sulfonamides, you might also be allergic to bumetanide. Tell your doctor about your sulfa allergy before taking this drug.
  • Hearing problems warning: Using bumetanide at high doses can cause hearing problems. Your doctor will monitor you closely. They may adjust your dosage if you have trouble hearing or ringing in your ears.

What is bumetanide?

Bumetanide is a prescription drug. It comes in two forms: oral tablet, and intramuscular and intravenous (IV) injection, which is only given by a healthcare provider.

Bumetanide is only available as a generic drug. Generic drugs usually cost less than brand-name versions.

Why it's used

Bumetanide is used to treat swelling that’s caused by congestive heart failure or liver disease, or by kidney disease, including a condition called nephrotic syndrome.

How it works

Bumetanide belongs to a class of drugs called loop diuretics. Diuretics are also known as water pills. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Bumetanide works in your kidneys by removing extra water from your system. This leads to decreased swelling.

Bumetanide works very quickly, but its effects don’t last long. Bumetanide starts to work within 30–60 minutes of when you take it. It usually stops working after 4–6 hours, especially if you’re taking doses equal to or greater than 2 mg.

Bumetanide side effects

Bumetanide oral tablet doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

Some of the more common side effects that can occur with use of bumetanide include:

  • muscle cramps
  • dizziness
  • low blood pressure
  • headache
  • nausea

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Serious skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis. Symptoms can include:
    • skin rash
    • fever
    • itching or burning eyes
    • patches of painful skin
    • blistering
    • bruising
    • sores
    • swelling
    • crusting or scabs on areas of moist skin
  • Severe electrolyte loss. Symptoms can include:
    • weakness
    • dizziness
    • confusion
    • loss of energy
    • vomiting
    • muscle cramps
    • being unable to eat

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Bumetanide may interact with other medications

Bumetanide oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with bumetanide are listed below.

Bipolar disorder and mania drugs

Bumetanide reduces how quickly certain bipolar disorder and mania drugs are cleared from your body. This can increase your risk of toxicity. In general, these drugs shouldn’t be taken with bumetanide. Examples of bipolar disorder and mania drugs include:

  • lithium

Blood pressure drugs

Taking bumetanide with certain blood pressure medications can increase the effects of those drugs. This can cause blood pressure that’s lower than normal. It can also cause increased side effects. Your doctor may lower the dosage of your blood pressure drug if you’ll be taking it with bumetanide.

Examples of these blood pressure drugs include:

  • angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril
    • captopril
    • enalapril
    • enalaprilat
  • angiotensin receptor blockers (ARBs), such as:
    • irbesartan
    • losartan
    • olmesartan
  • beta-blockers, such as:
    • acebutolol
    • atenolol
    • betaxolol
    • bisoprolol
  • calcium channel blockers, such as:
    • amlodipine
    • felodipine
    • nicardipine
    • nifedipine
  • direct renin inhibitors, such as:
    • aliskiren
  • loop diuretics, such as:
    • furosemide
    • indapamide
    • torsemide
  • potassium-sparing diuretics, such as:
    • eplerenone
    • spironolactone
    • triamterene
  • thiazide diuretics, such as:
    • chlorothiazide
    • chlorthalidone
    • hydrochlorothiazide
    • metolazone

Gout drugs

You shouldn’t take bumetanide with certain drugs used to treat gout. These gout drugs can reduce some effects of bumetanide. This means that it won’t work as well to decrease your swelling. Taking these drugs together may also increase your risk of side effects from bumetanide.

Examples of these gout drugs include:

  • probenecid

Pain drugs

You should not take bumetanide with certain pain medications. These pain drugs may reduce some of the effects of bumetanide. This means that it won’t work as well to decrease your swelling. Examples of these pain drugs include:

  • COX-2 inhibitors, such as:
    • celecoxib
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
    • diclofenac
    • ibuprofen
    • indomethacin
    • ketorolac
    • meloxicam
    • naproxen

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Bumetanide warnings

This drug comes with several warnings.

Allergy warning

Bumetanide can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with kidney disease: Bumetanide is removed from your body by your kidneys. If your kidneys aren’t working well, you may have more side effects from this drug. Your doctor should check your kidney function while you’re taking this medication. If your kidney function gets worse, you may need to stop taking this drug.

For people with liver disease: Bumetanide can worsen the symptoms of the liver condition hepatic coma. If you have this condition, you shouldn’t take this drug.

For people with severe electrolyte loss: You shouldn’t take this drug if you have very low levels of electrolytes. Bumetanide can cause you to lose even more electrolytes. This can lead to serious medical problems.

Warnings for other groups

For pregnant women: Bumetanide is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk.

If you become pregnant while taking this drug, call your doctor right away.

For women who are breastfeeding: It isn’t known if bumetanide passes into breast milk. If it does, it may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: Older adults may process drugs more slowly. A normal adult dosage may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dosage or a different treatment schedule.

How to take bumetanide

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Dosage for swelling (edema) caused by heart failure or liver or kidney disease

Generic: Bumetanide

  • Form: oral tablet
  • Strengths: 0.5 mg, 1 mg, 2 mg

Adult dosage (ages 18–64 years)

The typical dosage is 0.5–2 mg taken once per day. Your doctor may have you take a second or third dose every 4–5 hours, up to a total of 10 mg taken per day.

The safest and most effective way to control swelling with this drug is to take it on an intermittent dosing schedule. This means that the drug is given on alternate days or given for 3–4 days, followed by a 1–2-day period where you don’t take the drug. Your doctor can tell you more.

Child dosage (ages 0–17 years)

It hasn’t been established that this drug is safe and effective for use in children younger than 18 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Take as directed

Bumetanide oral tablet is used for short- or long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all: Your swelling may get worse. This may worsen the symptoms of your heart failure or other condition.

If you stop taking it suddenly: Don’t stop taking bumetanide without talking to your doctor. Your swelling may get worse. Your symptoms of heart failure or other condition may also get worse.

If you don’t take it on schedule: This drug may not work as well if you don’t take it on schedule. Your swelling may not improve as much.

If you take too much: Taking too much bumetanide can lead to severe water and electrolyte loss. Symptoms can include:

  • weakness
  • dizziness
  • confusion
  • loss of energy
  • vomiting
  • muscle cramps
  • being unable to eat

If you think you’ve taken too much of this drug, call your doctor or local poison control center.

If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause dangerous side effects.

How to tell if the drug is working: You should have a decrease in swelling.

Important considerations for taking bumetanide

Keep these considerations in mind if your doctor prescribes bumetanide for you.

General

  • You can take bumetanide with or without food.
  • You should take bumetanide in the morning. This drug makes you urinate more, and may make you get up more often during the night if you take it at bedtime.
  • You can cut or crush this drug.

Storage

  • Store bumetanide at room temperature between 68°F and 77°F (20°C and 25°C).
  • Keep this drug away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

During treatment with bumetanide, your doctor may check your:

  • potassium and other electrolyte levels
  • blood pressure
  • weight to check for fluid buildup
  • kidney function

Your diet

Your doctor may have you follow a high-potassium diet while you take this drug. Foods rich in potassium include prunes, bananas, orange juice, squash, and dark leafy green vegetables.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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