Precautions and Warnings With Bumetanide
You can avoid many risks of drug interactions and potential problems by being aware of precautions and warnings with bumetanide. Certain people should not take it, including those who are producing very little urine or who have certain allergies. Precautions and warnings with bumetanide also extend to possible side effects, such as extremely low blood pressure, possible hearing loss, and an electrolyte imbalance.
Bumetanide: What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to taking bumetanide (Bumex®) if you have:
- Liver disease, including cirrhosis
- Kidney disease or kidney failure
- Fluid or electrolyte problems
- Any allergies, including allergies to sulfa drugs, foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or trying to become pregnant (see Bumex and Pregnancy)
- Breastfeeding (see Bumex and Breastfeeding).
Tell your healthcare provider about all of the medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Specific Precautions and Warnings With BumetanideWarnings and precautions to be aware of prior to taking bumetanide include the following:
- If kidney problems seem to be getting worse (especially for those with severe kidney disease), the medication should be stopped because it can make kidney problems worse.
- Bumetanide can cause hearing loss. Sometimes, this hearing loss is permanent. It is more common when high doses of bumetanide are given intravenously or when combined with other medications that can cause hearing loss. Let your healthcare provider know right away if you notice hearing loss or ringing in the ears (tinnitus).
- People who are allergic to sulfonamides ("sulfa" drugs) may also be allergic to bumetanide.
- There are a number of medicines that bumetanide can interact with (see Drug Interactions With Bumetanide).
- The drug may cause extremely low blood pressure in some people. This is more likely to happen when the medicine is first started or the dosage is changed. It is also more likely to happen in people who:
This is why it is important to drink fluids regularly while taking bumetanide. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider right away. If you have fainted, stop taking bumetanide until you have talked to your healthcare provider.Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness until you know how the drug affects you.
- Bumetanide may affect electrolytes in the blood (including sodium, calcium, potassium, magnesium, and chloride). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include:
- Dry mouth
- Muscle pain or muscle cramps
- Low blood pressure (hypotension)
- Decreased urination
- A rapid heart rate (tachycardia) or irregular heart rhythms (arrhythmia)
- Nausea or vomiting.
- Bumetanide is also known to make gout worse.
- The medication may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, even cause diabetes in people without a history of the condition.
- Bumetanide is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of taking it during pregnancy (see Bumex and Pregnancy).
- It is not known if bumetanide passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Bumex and Breastfeeding).