Side Effects of Bumex (bumetanide)

Bumex is a diuretic that increases urine output by preventing fluid retention in people with congestive heart failure, liver disease, or kidney disorder. It blocks the reabsorption of sodium and fluid from the kidney’s tubules.

Bumex belongs to a class of diuretics called "loop" diuretics, which also includes furosemide and torsemide. One mg of bumetanide is equivalent to approximately 10-20 mg of torsemide and 40 mg of furosemide.

The diuretic effect of Bumex can cause significant loss of body water and electrolytes, leading to dehydration. Medical supervision is necessary during treatment.

Common side effects of Bumex include low blood levels of potassium, magnesium, sodium, and calcium.

Serious side effects of Bumex include fluid losses that can lead to dehydration, toxicity to the inner ear causing ringing in the ear and hearing loss, and high uric acid concentrations in the blood leading to gouty arthritis attacks.

Drug interactions of Bumex include other diuretics, such as metolazone, hydrochlorothiazide, or chlorthalidone, which can exaggerate the loss of potassium and magnesium.

Concurrent use of Bumex and lithium may decrease the body’s ability to eliminate lithium, leading to increased lithium levels and toxicity. Indomethacin and other nonsteroidal anti-inflammatory drugs may reduce the effects of loop diuretics. Aminoglycosides and Bumex may increase the risk of hearing impairment. Careful consideration must be given before prescribing Bumex to pregnant women, as its effects on the fetus are not well-studied. It is unknown if Bumex is excreted into breast milk.

Important side effects of Bumex (bumetanide)

Diuretics like bumetanide can cause low blood levels of potassium, magnesium, sodium, and calcium. Fluid losses can lead to dehydration, which may present with symptoms such as dry mouth, thirst, weakness, drowsiness, reduced kidney function, heart arrhythmias, muscle aches and pains, nausea, and vomiting.

Loop diuretics like Bumex can cause toxicity to the inner ear, resulting in tinnitus (ringing in the ear) and hearing loss. High uric acid concentrations in the blood can lead to gouty arthritis attacks.

Side effects of Bumex (bumetanide) for healthcare professionals

Common adverse reactions to Bumex include muscle cramps, dizziness, hypotension, headache, nausea, and encephalopathy in patients with preexisting liver disease.

Less frequent adverse reactions include impaired hearing, pruritus, electrocardiogram changes, weakness, hives, abdominal pain, arthritic pain, musculoskeletal pain, rash, and vomiting.

Other rare adverse reactions include vertigo, chest pain, ear discomfort, fatigue, dehydration, sweating, hyperventilation, dry mouth, upset stomach, renal failure, asterixis, itching, nipple tenderness, diarrhea, premature ejaculation, and difficulty maintaining an erection. Laboratory abnormalities may include hyperuricemia, hypochloremia, hypokalemia, azotemia, hyponatremia, increased serum creatinine, hyperglycemia, and variations in phosphorus, CO content, bicarbonate, and calcium.

Thrombocytopenia and deviations in hemoglobin, prothrombin time, hematocrit, WBC, and differential counts have also been reported.

Diuresis induced by Bumex may rarely be accompanied by changes in LDH, total serum bilirubin, serum proteins, SGOT, SGPT, alkaline phosphatase, cholesterol, and creatinine clearance. Increases in urinary glucose and urinary protein have also been seen.

To report suspected adverse reactions, contact Validus Pharmaceuticals, LLC at 1-866-982-5438 (1-866-9VALIDUS) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Drug interactions with Bumex (bumetanide)

Drugs With Ototoxic Potential

Avoid using parenterally administered bumetanide with aminoglycoside antibiotics, especially in the presence of impaired renal function, except in life-threatening conditions.

Drugs With Nephrotoxic Potential

Avoid concurrent use of Bumex with drugs known to have a nephrotoxic potential.

Lithium

Do not give lithium with diuretics like Bumex due to reduced renal clearance and a high risk of lithium toxicity.

Probenecid

Pretreatment with probenecid reduces the natriuresis and hyperreninemia produced by Bumex. Probenecid should not be used concurrently with Bumex.

Indomethacin

Indomethacin inhibits the effects of Bumex on urine volume, sodium excretion, and plasma renin activity. Concurrent therapy with Bumex is not recommended.

Antihypertensives

Bumex may potentiate the effect of various antihypertensive drugs, necessitating a dosage reduction.

Digoxin

No effect on digoxin blood levels has been observed in interaction studies between Bumex and digoxin in humans.

Anticoagulants

Interaction studies in humans have shown no effect of Bumex on warfarin metabolism or plasma prothrombin activity.

Summary

Bumex is a potent diuretic that prevents fluid retention in people with congestive heart failure, liver disease, or kidney disorder. It blocks the reabsorption of sodium and fluid from the kidney’s tubules. Common side effects include low blood levels of potassium, magnesium, sodium, and calcium. The effects of Bumex on pregnant women and breastfeeding mothers are not well-studied.