A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Bumex Side Effects, and Drug Interactions - Bumetanide
Bumex Side Effects, and Drug Interactions - Bumetanide
SIDE EFFECTS
The most frequent clinical
adverse reactions considered probably or possibly related to bumetanide
are muscle cramps (seen in
1.1% of treated patients), 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 adversdreactions 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%) CO* 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
(1.0%). total serum bilirubin
(0.8%). serum proteins (0.7%),
SGOT (0.6%), SGPT
(0.59/ o), 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.
DRUG INTERACTIONS
1. Drugs with ototoxic
potential (See WARNINGS):
Especially in the presence of impaired renal
function, the use of parenterally administered bumetanide in patients
to whom aminoglycoside
antibiotics are also being given should be avoided, except in life-threatening
conditions.
2. Drugs with nephrotoxic potential: There has been no
experience on the concurrent use of bumetanide with drugs known to have
a nephrotoxic potential. Therefore, the simultaneous administration
of these drugs should be avoided.
3. Lithium: Lithium should generally not be given with
diuretics (such as bumetanide) because they reduce
its renal clearance and add
a high risk of lithium
toxicity.
4. Probenecid: Pretreatment with probenecid
reduces both the natriuresis
and hyperreninemia produced by bumetanide. This antagonistic effect of
probenecid on bu-metanide
natriuresis is not due
to a direct action on sodium
excretion but is probably
secondary to its inhibitory
effect on renal tubular
secretion of bumetanide.
Thus, probenecid should
not be administered concurrently with bumetanide.
5. Indomethacin: Indomethacin blunts the increases in urine
volume and sodium
excretion seen during bumetanide
treatment and inhibits the
bumetanide-induced increase in plasma
renin activity. Concurrent therapy
with bumetanide is thus not recommended.
6. Antihypertensives: Bumetanide may potentiate
the effect of various antihypertensive
drugs, necessitating a reduction
in the dosage of these drugs.
7. Digoxin: Interaction studies in humans have shown no
effect on digoxin blood
levels.
8. Anticoagulants: Interaction studies in humans have shown
bumetanide to have no effect
on warfarin metabolism
or on plasma prothrombin activity.
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