What is the dose and frequency of Bumex (Bumetanide)?

From the Guidelines

Bumex (bumetanide) should be dosed at 0.5 to 2 mg once or twice daily for adults with edema or fluid retention, with a maximum dose of 10 mg daily in severe cases, as recommended by the most recent guidelines 1. The dose and frequency of Bumex can be adjusted based on the patient's response to treatment and their individual needs.

• The initial dose is typically 0.5 to 1 mg once daily in the morning, which can be increased as needed to achieve the desired effect.
• The medication should be taken early in the day to prevent nighttime urination disrupting sleep.
• Patients should be monitored for electrolyte imbalances, particularly potassium depletion, as Bumex increases potassium excretion.
• Dose adjustments may be necessary for elderly patients or those with renal impairment, as they may be more susceptible to the effects of the medication.
• The aim of using diuretics like Bumex is to achieve and maintain euvolaemia, with the lowest achievable dose, as stated in the ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 1.
• Patients should maintain adequate hydration while taking Bumex and report symptoms like severe dizziness, muscle cramps, or irregular heartbeat, which could indicate electrolyte disturbances.
• Bumex works by inhibiting sodium and chloride reabsorption in the kidneys' ascending loop of Henle, leading to increased urine output and reduced fluid retention.
• The medication is a potent loop diuretic that works quickly, with effects beginning within 30-60 minutes and lasting 4-6 hours, making it an effective treatment option for patients with edema or fluid retention.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Dosage should be individualized with careful monitoring of patient response. The usual initial dose is 0. 5 to 1 mg intravenously or intramuscularly. If the response to an initial dose is deemed insufficient, a second or third dose may be given at intervals of 2 to 3 hours, but should not exceed a daily dosage of 10 mg

The recommended dose of bumetanide is 0.5 to 1 mg intravenously or intramuscularly, with a maximum daily dose of 10 mg. The dose frequency can be every 2 to 3 hours if the initial response is insufficient 2.

• Initial dose: 0.5 to 1 mg
• Maximum daily dose: 10 mg
• Dose frequency: every 2 to 3 hours if needed

From the Research

Bumex Dose and Frequency

• The dose of Bumex (bumetanide) can vary depending on the patient's condition and the route of administration 3, 4, 5.
• For oral administration, the typical dose range is 0.5 to 2 mg/day, with some patients requiring higher doses of up to 15 mg/day 3.
• For intravenous administration, the dose can range from 0.5 to 1 mg, with a frequency of every 2 to 3 hours as needed 4.
• In patients with chronic renal failure or nephrotic syndrome, higher doses of bumetanide may be required, up to 15 mg/day 3.
• The frequency of administration can also vary, with some studies suggesting that continuous infusion may be more beneficial than intermittent bolus administration in certain patient populations 6.

Administration Routes

• Bumex can be administered orally, intravenously, or intramuscularly 3, 4.
• The pharmacokinetic profile of bumetanide is similar for oral and parenteral formulations, with peak plasma levels achieved approximately 30 minutes after oral administration 4.
• Continuous infusion of bumetanide has been shown to be effective in certain patient populations, such as those with congestive heart failure or renal insufficiency 6.

Special Considerations

• In neonates and infants, the dose of bumetanide is typically lower, ranging from 0.005 to 0.1 mg/kg every 24 hours 5.
• The half-life of bumetanide is longer in neonates than in adults, and the clearance is reduced at birth 5.
• Patients with renal failure or nephrotic syndrome may require higher doses of bumetanide, and should be monitored closely for signs of toxicity 3, 4.