Bumetanide

Bumex

Loop diuretic

Inhibits the Na-K-2Cl cotransporter in the thick ascending limb → potent diuresis. ~40× more potent than furosemide (1 mg bumetanide ≈ 40 mg furosemide).

Indications

•Edema/volume overload (HF, renal, hepatic)
•Diuretic-resistant states
•Better oral bioavailability than furosemide

Dosing

Context	Adult	Pediatric
IV	0.5–1 mg IV (max ~10 mg/day); 1 mg ≈ 40 mg furosemide	—

Pharmacokinetics

Onset minutes IV. Half-life ~1–1.5 h. More reliable oral absorption than furosemide.

Side effects

!Hypokalemia, hypomagnesemia, hypovolemia, metabolic alkalosis
!Ototoxicity (less than furosemide)
!Hyperuricemia

Contraindications

×Anuria
×Severe electrolyte depletion
×Sulfonamide allergy (relative)

Clinical pearls

★1 mg bumetanide ≈ 40 mg furosemide — the conversion to know.
★More predictable oral absorption → used when furosemide's gut absorption is unreliable (gut edema in HF).

Other drugs in Diuretics

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