Bumetanide Side Effects

Brand Names: Bumex

Please note - some side effects for Bumetanide may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Bumetanide - for the Consumer

Bumetanide

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Bumetanide:

Dizziness or lightheadedness when sitting up or standing; drowsiness; headache; low blood pressure.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; diarrhea; extreme thirst or dry mouth; loss of appetite; muscle cramps; nausea; pain, redness, or swelling at injection site; rapid or irregular heartbeat; ringing in the ears or hearing loss; stomach cramps; weakness; vomiting.

Bumetanide Tablets

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Bumetanide Tablets:

Dizziness or lightheadedness when sitting up or standing; drowsiness; headache; low blood pressure.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; diarrhea; excessive urination; extreme thirst or dry mouth; hearing loss; kidney failure; loss of appetite; muscle pain or cramps; nausea; rapid or irregular heartbeat; restlessness; ringing in the ears; unusual tiredness or weakness; vomiting.

Bumetanide Side Effects - for the Professional

Bumetanide

The most frequent clinical adverse reactions considered probably or possibly related to Bumetanide are muscle cramps, dizziness (1.1%), hypotension (0.8%), headache (0.6%), nausea (0.6%), and encephalopathy (in patients with preexisting liver disease) (0.6%). One or more of these adverse reactions have been reported in approximately 4.1% of Bumetanide-treated patients.

Less frequent clinical adverse reactions to Bumetanide are impaired hearing (0.5%), pruritus (0.4%), electrocardiogram changes (0.4%), weakness (0.2%), hives (0.2%), abdominal pain (0.2%), arthritic pain (0.2%), musculoskeletal pain (0.2%), rash (0.2%) and vomiting (0.2%). One or more of these adverse reactions have been reported in approximately 2.9% of Bumetanide-treated patients.

Other clinical adverse reactions, which have each occurred in approximately 0.1% of patients, are 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 reported have included hyperuricemia (in 18.4% of patients tested), hypochloremia (14.9%), hypokalemia (14.7%), azotemia (10.6%), hyponatremia (9.2%), increased serum creatinine (7.4%), hyperglycemia (6.6%), and variations in phosphorus (4.5%), CO2 content (4.3%), bicarbonate (3.1%) and calcium (2.4%). Although manifestations of the pharmacologic action of Bumetanide, these conditions may become more pronounced by intensive therapy.

Also reported have been thrombocytopenia (0.2%) and deviations in hemoglobin (0.8%), prothrombin time (0.8%), hematocrit (0.6%), WBC (0.3%) and differential counts (0.1%). There have been rare spontaneous reports of thrombocytopenia from postmarketing experience.

Diuresis induced by Bumetanide may also rarely be accompanied by changes in LDH (1%), total serum bilirubin (0.8%), serum proteins (0.7%), SGOT (0.6%), SGPT (0.5%), alkaline phosphatase (0.4%), cholesterol (0.4%) and creatinine clearance (0.3%). Increases in urinary glucose (0.7%) and urinary protein (0.3%) have also been seen.

Side Effects by Body System

Metabolic

Metabolic side effects, as with other loop diuretics, occur in 7% to 20% of patients, and include hyponatremia, hypokalemia, hypochloremia, and hyperuricemia. These side effects may be more likely in patients with renal insufficiency. Glucose intolerance is reported in up to 14% of elderly patients. Hypokalemia may lead to increased renal tubular bicarbonate reabsorption, resulting in metabolic alkalosis.

Besides acting on the loop of Henle, bumetanide also inhibits phosphate reabsorption in the proximal tubule, resulting in phosphaturia. Since phosphorous is abundant in most diets, bumetanide-induced phosphaturia may not be significant except in malnourished patients, patients on life support, and patients with significant muscle weakness.

Calcium balance appears to remain neutral during treatment with a loop diuretic (i.e., furosemide, bumetanide). Although loop diuretics cause an increase in renal calcium excretion, this appears to be compensated for by a parathyroid-dependent increase in 1,25-dihydroxyvitamin D levels, which increases intestinal calcium absorption. Bone metabolism does not appear to be significantly affected by loop diuretics.

Musculoskeletal

Musculoskeletal complaints include myalgias and muscle stiffness in 1% to 2% of patients. These side effects may be more likely in patients with renal insufficiency.

Renal

Renal insufficiency, manifested as a rise in serum creatinine and BUN, may occur in up to 7% of patients. It is usually due to extracellular fluid volume depletion and is readily reversible.

Cardiovascular

Cardiovascular side effects include hypotension in less than 2% of patients. Patients with a history of cardiac arrhythmias should be monitored closely because of the risk of hypokalemia.

Gastrointestinal

Gastrointestinal side effects occur in less than 2% of patients and include nausea, vomiting, loose stools, constipation. There have been rare reports of hyperamylasemia and pancreatitis associated with bumetanide use.

Nervous system

Nervous system side effects, such as headache, dizziness, deafness, tinnitus, vertigo, and decreased hearing, are reported in less than 2% of patients. Encephalopathy after bumetanide administration is reported in patients with severe liver disease.

Hypersensitivity

Severe hypersensitivity reactions such as Stevens-Johnson syndrome and recurrent urticaria have been reported in rare cases.

Hypersensitivity reactions are rare. Rash is reported in less than 1% of treated patients. Because cross-reactivity with furosemide is rare, bumetanide can be substituted at about a 1:40 dose ratio of bumetanide to furosemide in patients allergic to furosemide.

Dermatologic

Dermatologic side effects are rare. A case of pseudoporphyria has been reported.

Hematologic

Hematologic side effects are extremely rare. Cases of thrombocytopenia, mild anemia, and leukopenia have been reported.

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