Bumetamide

Comprehensive article on the diuretic drug Bumetamide

Bumetamide, commonly known by its trade name Bumex, is a potent loop diuretic used primarily to treat edema associated with congestive heart failure, liver disease, and renal disease. It is also used in the management of hypertension. Bumetamide is chemically related to furosemide but is approximately 40 times more potent.

Pharmacology

Bumetamide acts on the ascending limb of the loop of Henle in the nephron of the kidney. It inhibits the sodium-potassium-chloride symporter, leading to a decrease in sodium reabsorption. This results in increased excretion of sodium, chloride, and water, thereby reducing fluid overload in the body.

Mechanism of Action

Bumetamide binds to the chloride-binding site of the sodium-potassium-chloride symporter, effectively blocking the reabsorption of these ions. This action disrupts the osmotic gradient in the renal medulla, leading to diuresis.

Pharmacokinetics

Bumetamide is rapidly absorbed from the gastrointestinal tract, with a bioavailability of 80–90%. It is highly protein-bound (95%) and is metabolized in the liver. The elimination half-life of bumetamide is approximately 1 to 1.5 hours, and it is primarily excreted in the urine.

Clinical Uses

Bumetamide is indicated for the treatment of:

• Edema associated with congestive heart failure
• Edema due to liver cirrhosis
• Edema due to renal disease, including nephrotic syndrome
• Hypertension (as an adjunctive therapy)

Adverse Effects

Common side effects of bumetamide include:

• Electrolyte imbalance (e.g., hypokalemia, hyponatremia)
• Dehydration
• Hypotension
• Dizziness
• Headache

Serious adverse effects may include:

• Ototoxicity (hearing loss)
• Severe electrolyte disturbances
• Renal impairment

Contraindications

Bumetamide is contraindicated in patients with:

• Anuria
• Severe electrolyte depletion
• Hypersensitivity to bumetamide or sulfonamides

Drug Interactions

Bumetamide may interact with:

• Aminoglycosides and other ototoxic drugs, increasing the risk of ototoxicity
• Lithium, increasing the risk of lithium toxicity
• Nonsteroidal anti-inflammatory drugs (NSAIDs), which may reduce the diuretic effect

Also see

• Furosemide
• Diuretics
• Congestive heart failure
• Hypertension

External links

• Drugs.com: Bumetanide
• Mayo Clinic: Bumetanide