Bumetanide

It is a loop diuretic causing diuresis by acting on the Na+ K+ 2Cl- cotransporters in the thick ascending limb of loop of Henle. It useful in pulmonary edema. It may be used in patients not reponding to frusemide.

Bumetanide vs Frusemide

• 40 times more potent
• Hypocalcemic, hypokalemic, hyperglycemic effects are less
• less chance of ototoxicity
• may induce myopathy
• more lipid soluble
• 80-100% oral bioavailability (compared to 60% for frusemide).

It is partly metabolised and partly excreted unchanged in urine. Plasma T1/2 (half life) is approximately 60 minutes (prolonged in renal and hepatic insufficiency).