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Bumetanide

Sounds like 'bew-MET-a-nide'

Key points about bumetanide

Bumetanide is a diuretic, which means it helps your body get rid of extra salt (sodium) and water.
Bumetanide is also called Burinex or 'Water' tablet or 'water pill'.
Find out how to take it safely and possible side effects.

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Bumetanide is a diuretic, which means it helps your body get rid of extra salt (sodium) and water. It works by increasing the amount of urine (pee) you make. Bumetanide is used to lessen extra fluid in the body (called oedema) caused by conditions such as heart failure, liver disease, or kidney disease. This can reduce symptoms such as swelling in your ankles or feet, or shortness of breath. In New Zealand bumetanide is available as tablets (1 mg), or as an injection which is usually given in hospital.

The usual dose of bumetanide is half to one tablet (0.5 mg to 1 mg) once a day. Some people may need higher doses.
Your doctor will advise you how long to take bumetanide for.
Always take your bumetanide exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much bumetanide to take, how often to take it, and any special instructions.

Bumetanide is usually taken once a day, in the morning. Some people may need a second dose, at lunchtime.
Because bumetanide will cause you to pass urine often and usually starts working within 1 hour of taking your dose, it is best taken in the morning so it works during the day and your sleep is not disturbed by you needing to get up to go to the toilet during the night.
But, if you want to go out in the morning and don't want to have to find a toilet, you can delay taking your dose until later – usually before mid-afternoon.
You can take bumetanide with or without food.
Limit or avoid drinking alcohol while you are taking bumetanide. Alcohol may increase your chances of getting side effects such as dizziness.
If you forget to take your dose, take it as soon as you remember. But, if it is late in the afternoon, skip the missed dose and continue as usual the next day. Do not take double the dose.

Be careful when taking some pain relief medicines
Taking diuretics together with pain relief medicines called ‘non-steroidal anti-inflammatory drugs’ (NSAIDs), such as ibuprofen and diclofenac and medicines called ACE inhibitors or ARBs can be harmful to your kidneys. Read more about NSAIDs and blood pressure medicines.

Here are some things to know when you're taking bumetanide. Other things may be important as well, so ask your healthcare provider what you should know about.

Bumetanide interacts with some medications, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting bumetanide and before starting any new products.

Be careful when taking some pain relief medicines
Taking diuretics together with pain relief medicines called ‘non-steroidal anti-inflammatory drugs’ (NSAIDs), such as ibuprofen and diclofenac and medicines called ACE inhibitors or ARBs can be harmful to your kidneys. Read more about NSAIDs and blood pressure medicines.

Examples of NSAIDs include:

diclofenac (e.g. Voltaren Rapid)
ibuprofen (e.g. Nurofen)
naproxen (e.g. Naprogesic)
celecoxib (Celebrex).

Taking NSAIDs together with diuretics and medicines called ACE inhibitors or ARBs can be harmful to your kidneys (this combination of medicines is called the triple whammy). If you are taking ACE inhibitors or ARBs and diuretics, tell your doctor or pharmacist before starting NSAIDs.

Examples of ACE inhibitors are captopril, cilazapril, enalapril, lisinopril, perindopril and quinapril.
Examples of ARBs are candesartan, irbesartan, valsartan and losartan.

Before buying NSAIDs for pain relief, check with your pharmacist whether these are safe for you.

Read more about NSAIDs, ACE inhibitors, ARBs and The triple whammy(external link) SafeRx

Like all medicines bumetanide can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Feeling sick (nausea) Stomach upset	These are quite common when you first start taking bumetanide, and usually go away after the first few days Try taking your bumetanide dose with or after food Tell your doctor if troublesome
Dizziness Feeling lightheaded Feeling faint when you stand up	Be careful when getting up from either lying down or sitting to avoid falls. These effects put you at risk of falls and injuries, especially if you are elderly Be careful when driving or using tools until you know how this medicine affects you
Breast pain or muscle pain	Tell your doctor
Trouble with hearing such as ringing in the ears, reduced hearing or deafness (loss of hearing)	Tell your doctor
Signs of dehydration (losing too much salt and water) such as muscle cramps, weakness, dry mouth, thirst or passing unusually reduced amounts of urine	Tell your doctor
Signs of an allergic reaction such as skin rashes, itching, blisters, peeling skin, swelling of the face, lips, mouth or have problems breathing	Tell your doctor immediately or ring HealthLine 0800 611 116
Read more about medicines and side effects and reporting a reaction you think might be a side effect.