Bumetanide Injection

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For bumetanide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to bumetanide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of bumetanide injection in the pediatric population. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of bumetanide injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney or heart problems, which may require an adjustment of dosage in patients receiving bumetanide injection .

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving bumetanide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using bumetanide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Desmopressin

Using bumetanide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aceclofenac
• Acemetacin
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Bepridil
• Bromfenac
• Bufexamac
• Celecoxib
• Choline Salicylate
• Clonixin
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitoxin
• Dipyrone
• Dofetilide
• Droperidol
• Droxicam
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Foscarnet
• Ibuprofen
• Indomethacin
• Ketanserin
• Ketoprofen
• Ketorolac
• Levomethadyl
• Lithium
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metolazone
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Piketoprofen
• Piroxicam
• Proglumetacin
• Propyphenazone
• Proquazone
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sotalol
• Sulindac
• Tenoxicam
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Valdecoxib

Using bumetanide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alacepril
• Benazepril
• Captopril
• Cilazapril
• Delapril
• Dibekacin
• Enalapril
• Enalaprilat
• Fosinopril
• Germanium
• Ginseng
• Gossypol
• Imidapril
• Kanamycin
• Licorice
• Lisinopril
• Moexipril
• Neomycin
• Pentopril
• Perindopril
• Quinapril
• Ramipril
• Spirapril
• Streptomycin
• Temocapril
• Trandolapril
• Zofenopril

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of bumetanide. Make sure you tell your doctor if you have any other medical problems, especially:

• Anuria (not able to form urine) or
• Liver disease, severe (e.g., hepatic coma)—Should not use in patients with these conditions .

• Dehydration or
• Gout or
• Hearing problems or
• Hyperuricemia (high uric acid in the blood) or
• Hypocalcemia (low calcium in the blood) or
• Hypokalemia (low potassium in the blood) or
• Hypomagnesemia (low magnesium in the blood) or
• Hypovolemia (low blood volume) or
• Thrombocytopenia (low platelets in the blood)—Use with caution. bumetanide may make these conditions worse .

• Diabetes—bumetanide may increase the amount of sugar in the blood .

• Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body .

A nurse or other trained health professional will give you bumetanide. bumetanide is given through a needle placed into one of your veins .

• It is used to get rid of extra fluid.
• It may be given to you for other reasons. Talk with the doctor.

• If you have an allergy to bumetanide or any other part of bumetanide injection.
• If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• If you have any of these health problems: Kidney disease or liver disease.
• If you have electrolyte (like sodium, potassium, phosphate) problems.
• If you are not able to pass urine.
• If you are taking any drugs that can raise the chance of kidney problems. There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
• If you are taking indomethacin or probenecid.
• If you are breast-feeding. Do not breast-feed while you take this medicine.

This is not a list of all drugs or health problems that interact with bumetanide injection.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

• Tell all of your health care providers that you take bumetanide injection. This includes your doctors, nurses, pharmacists, and dentists.
• If you have a sulfa (sulfonamide) allergy, talk with your doctor.
• Avoid driving and doing other tasks or actions that call for you to be alert until you see how this medicine affects you.
• To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
• If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
• Have your blood pressure checked often. Talk with your doctor.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• If you are on a low-salt or salt-free diet, talk with your doctor.
• You may need extra potassium. Talk with your doctor.
• If you are taking bumetanide injection and have high blood pressure, talk with your doctor before using OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, ibuprofen or like products, and some natural products or aids.
• If you are taking lithium, talk with your doctor. You may need to have your blood work checked more closely while you are taking it with this medicine.
• If you are 65 or older, use bumetanide injection with care. You could have more side effects.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine while you are pregnant.

Use bumetanide injection as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• This medicine may cause you to pass urine more often. To keep from having sleep problems, try to take before 6 pm.
• Keep taking this medicine as you have been told by your doctor or other health care provider, even if you feel well.
• It is given as a shot into a muscle or vein.

What do I do if I miss a dose?

• Call your doctor to find out what to do.

This medication is expected to increase urination.

Dizziness, headache, tiredness, nausea, or pain/redness at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may lead the loss of too much body water and minerals (including potassium), causing dehydration. Tell your doctor right away if you have any of these unlikely but serious symptoms of dehydration or mineral loss: muscle cramps/weakness, confusion, severe dizziness, drowsiness, unusual dry mouth/thirst, nausea/vomiting, fast/irregular heartbeat, fainting, seizures.

Tell your doctor right away if you have any serious side effects, including: decreased sexual ability, chest pain, hearing problems (e.g., ringing in the ears, hearing loss), easy bruising/bleeding, stomach/abdominal pain, yellowing eyes/skin, dark urine, sudden loss of consciousness, signs of kidney problems (such as change in the amount of urine).

A very serious allergic reaction to this drug is unlikely, but get medical help right away if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using bumetanide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe kidney disease (an inability to make urine), severe liver disease.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver problems, untreated mineral imbalance (e.g., low blood levels of sodium or potassium), gout, irregular heartbeat (e.g., ventricular arrhythmias), loss of too much body water (dehydration).

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

If you have diabetes, bumetanide may rarely make it harder to control your blood sugar. Monitor your blood sugar levels regularly and share the results with your doctor.

This drug may reduce the potassium levels in your blood. Ask your doctor about adding potassium to your diet. Your doctor may prescribe a potassium supplement.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, the elderly may be more sensitive to the effects of this drug such as dizziness.

Newborn babies, especially those that are severely ill or have a certain liver problem (jaundice), may be at greater risk for serious side effects (brain damage caused by too much bilirubin in the blood - kernicterus) while using this drug. Consult the doctor for more details.

During pregnancy, this drug should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.