Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Burinex; Belgium: Burinex; Cyprus: Bumetanid; Denmark: Bumetanid, Burinex; France: Burinex; Germany: Burinex; Greece: Bumetanide, Burinex; Ireland: Burinex; Luxembourg: Burinex; Netherlands: Bumetanide, Burinex; Spain: Bumetanida, Fordiurán; Sweden: Burinex; UK: Bumetanide, Burinex.

North America

Canada: Bumex, Burinex; USA: Bumetanide, Bumex.

Latin America

Brazil: Burinax; Mexico: Drenural, Miccil.


Japan: Lunetoron.

Drug combinations


Bumetanide: C~17~H~20~N~2~O~5~S. Mw: 364.42. (1) Benzoic acid, 3-(aminosulfonyl)-5-(butylamino)-4-phenoxy-; (2) 3-(Butylamino)-4-phenoxy-5-sulfamoylbenzoic acid. CAS-28395-03-1 (1976).

Pharmacologic Category

Loop Diuretics. (ATC-Code: C03CA02).

Mechanism of action

Decreases electrolyte reabsorption by inhibiting the active chloride and sodium transport systems in the ascending limb of the loop of Henle. Increases urinary excretion of water, sodium, chloride, potassium, hydrogen, calcium, magnesium, ammonium, phosphate and bicarbonate. Increases potassium secretion in the distal renal tubule in a dose-related manner secondary to increased sodium load in the tubule. Decreases uric acid excretion and increases serum uric acid concentration. Produces renal vascular dilation and substantially increases renal blood flow. Increases plasma renin activity. Produces hypotensive effects and decreases body weight resulting from decreased plasma volume. Reduces mean pulmonary venous pressure, left ventricular end-diastolic pressure, mean pulmonary artery pressure, and mean right atrial pressure in valvular heart disease. Reduces cardiac output, cardiac index, stroke volume, stroke index, and diastolic pressures in coronary artery disease.

Therapeutic use

Management of edema secondary to congestive heart failure or hepatic or renal disease. May be used alone or in combination with antihypertensives in the treatment of hypertension. Can be used in furosemide-allergic patients. Elimination of drugs or toxic substances following intoxication.

Pregnancy and lactiation implications

Limited clinical experience with bumetanide in pregnant women to date has not revealed evidence of harm to the fetus. However, bumetanide should be used during pregnancy only when the potential benefits justify the possible risks to the fetus. Use with caution during lactation.

Unlabeled use

Postoperative or premenstrual edema. Edema associated with disseminated carcinoma.


Hypersensitivity to bumetanide, any component of the formulation, or sulfonylureas. Anuria. Increasing azotemia. Marked increases in BUN or serum creatinine concentration or development of oliguria during treatment of progressive renal disease. Hepatic coma or states of severe electrolyte depletion until the condition improves or is corrected. Pregnancy.

Warnings and precautions

May lead to profound diuresis with fluid and electrolyte loss. Rapid I.V. administration, renal impairment, excessive doses, and concurrent use of other ototoxins is associated with ototoxicity. Use in sulfonylurea allergy is specifically contraindicated. In cirrhosis, avoid electrolyte and acid/base imbalances that might lead to hepatic encephalopathy. Co-administration of antihypertensives may increase the risk of hypotension. Bumetanide is a potent displacer of bilirubin (avoid use in neonates at risk for kernicterus). May decrease lithium excretion. Loop diuretics (e.g. bumetanide, ethacrynic acid, furosemide, torsemide) are diuretics of choice for most patients with congestive heart failure. Possible effects on glucose metabolism should be considered (potassium depletion has been associated with impaired insulin secretion). Blood dyscrasias (especially thrombocytopenia), liver damage, or idiosyncratic reactions reported occasionally. Diuretics, including bumetanide, can increase serum total cholesterol concentrations in some patients (increases in low-density lipoprotein cholesterol and/or very low-density lipoprotein cholesterol subfractions). It is not known whether bumetanide is mutagenic or carcinogenic in humans.



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