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Loop Diuretic

Bumetanide

Brand names: Burinex

Bumetanide is a loop diuretic used for oedema and for fluid overload in heart failure.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Individualize dosage with careful monitoring of patient response. Oral Administration The usual total daily dosage of bumetanide tablets is 0.5 mg to 2 mg and in most patients is given as a single dose. If the diuretic response to an initial dose of bumetanide tablets is not adequate, in view of its rapid onset and short duration of action, a second or third dose may be given at 4- to 5- hour intervals up to a maximum daily dose of 10 mg. An intermittent dose schedule, whereby bumetanide tablets are given on alternate days or for 3 to 4 days with rest periods of 1 to 2 days in between, is recommended as the safest and most effective method for the continued control …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-01-08. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits the sodium-potassium-chloride co-transporter in the ascending loop of Henle, producing a brisk diuresis with loss of sodium, potassium and water.

Prescribing in practice

  • Monitor U&E for hypokalaemia, hyponatraemia and dehydration, which can be marked with vigorous diuresis.
  • It is more reliably absorbed orally than furosemide, making it useful where gut-wall oedema impairs furosemide absorption.
  • Gout can be precipitated, and ototoxicity is a risk with high intravenous doses or rapid administration, particularly in renal impairment.

Monitoring

Monitor renal function, electrolytes (especially potassium and sodium) and fluid/volume status, with closer review during dose titration or intercurrent illness.

Counselling the patient

  • Expect increased passing of urine; take earlier in the day to avoid disturbed sleep.
  • Report muscle cramps, marked weakness, dizziness on standing or significant thirst, which may indicate salt or fluid imbalance.

Evidence & guidelines

Established loop diuretic for oedema and heart failure (NICE NG106).

Reference: ESC Heart Failure Guidelines 2021; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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