Budema
Budema Uses, Dosage, Side Effects, Food Interaction and all others data.
Budema is a loop diuretic with a rapid onset and short duration of action. Pharmacological and clinical studies have shown that 1 mg Budema has a diuretic potency equivalent to approximately 40 mg furosemide. The major site of Budema action is the ascending limb of the loop of Henle.
Budema inhibits sodium reabsorption in the ascending limb of the loop of Henle. Reabsorption of chloride in the ascending limb is also blocked by Budema.
Budema may have an additional action in the proximal tubule. Since phosphate reabsorption takes place largely in the proximal tubule, phosphaturia during Budema induced diuresis is indicative of this additional action. This proximal tubular activity does not seem to be related to an inhibition of carbonic anhydrase. Budema does not appear to have a noticeable action on the distal tubule.
Budema is a loop diuretic of the sulfamyl category to treat heart failure. It is often used in patients in whom high doses of furosemide are ineffective. There is however no reason not to use bumetanide as a first choice drug. The main difference between the two substances is in bioavailability. Budema has more predictable pharmacokinetic properties as well as clinical effect. In patients with normal renal function, bumetanide is 40 times more effective than furosemide.
Trade Name | Budema |
Availability | Prescription only |
Generic | Bumetanide |
Bumetanide Other Names | Bumetanida, Bumetanide, Bumetanidum |
Related Drugs | furosemide, hydrochlorothiazide, spironolactone, Lasix, chlorthalidone, torsemide, triamterene, Bumex, amiloride, ethacrynic acid |
Type | |
Formula | C17H20N2O5S |
Weight | Average: 364.416 Monoisotopic: 364.10929245 |
Protein binding | 97% |
Groups | Approved |
Therapeutic Class | Loop diuretics |
Manufacturer | |
Available Country | Taiwan |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Budema is used for the treatment of edema associated with congestive heart failure, hepatic and renal disease, including the nephrotic syndrome.
Budema is also used to associated treatment for these conditions: Edema
How Budema works
Budema interferes with renal cAMP and/or inhibits the sodium-potassium ATPase pump. Budema appears to block the active reabsorption of chloride and possibly sodium in the ascending loop of Henle, altering electrolyte transfer in the proximal tubule. This results in excretion of sodium, chloride, and water and, hence, diuresis.
Dosage
Budema dosage
Oral1 mg in the morning , repeated after 6-8 hours if necessary, In severe cases , 5 mg daily increased by 5 mg every 12-24 hours according to response. Elderly , 500 micrograms daily may be sufficient.
ParenteralBy IV Injection : 1-2 mg, repeated after 20 minutes if necessary. Elderly, 500 micrograms (1 ml of Bumecard) daily may be sufficient.
By IV Infusion : 2-5 mg over 30-60 minutes.Elderly, 500 micrograms (1 ml of Bumecard) daily may be sufficient.
By IM Injection : 1 mg initially then adjusted according to response , Elderly 500 micrograms (1 ml of Bumecard) daily may be sufficient.
Paediatric use: Safety and effectiveness in paediatric patients below the age of 18 have not been established.
Side Effects
Muscle cramps (1.1%), dizziness (1.1%), hypotension (0.8%), headache (0.6%), nausea (0.6%)Others (ECG changes (0.4 %), musculoskeletal pain (0.2 %), Abdominal pain (0.2 %), renal failure (0.1%), thrombocytopenia (0.2%) etc.
Toxicity
Overdosage can lead to acute profound water loss, volume and electrolyte depletion, dehydration, reduction of blood volume and circulatory collapse with a possibility of vascular thrombosis and embolism. Electrolyte depletion may be manifested by weakness, dizziness, mental confusion, anorexia, lethargy, vomiting and cramps. Treatment consists of replacement of fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels.
Precaution
Serum potassium should be measured periodically and potassium supplements or potassium sparing diuretics added if necessary.
Interaction
Lithium: Lithium should generally not be given with diuretics because they reduce its renal clearance and add a high risk of lithium toxicity.
Probenecid: should not be administered concurrently with Budema.
Indomethacin: Concurrent therapy with Budema is not recommended.
Antihypertensives: Budema may potentiate the effect of various antihypertensive drugs, necessitating a reduction in the dosage of these drugs.
Digoxin: Interaction studies in humans have shown no effect on digoxin blood levels.
Anticoagulants: Interaction studies in humans have shown Budema to have no effect on warfarin metabolism.
Food Interaction
- Take with food. Food reduces irritation.
Budema Alcohol interaction
[Moderate]
Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation.
Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.
Caution and close monitoring for development of hypotension is advised during coadministration of these agents.
Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs.
Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.
Budema Drug Interaction
Moderate: insulin glargine, insulin glargine, metoprolol, metoprolol, metoprolol, metoprololMinor: aspirin, aspirin, aspirin, aspirinUnknown: apixaban, apixaban, clopidogrel, clopidogrel, cyanocobalamin, cyanocobalamin, ascorbic acid, ascorbic acid, cholecalciferol, cholecalciferol
Budema Disease Interaction
Major: anuria, cirrhosis, electrolyte losses, ototoxicity, renal dysfunctionModerate: diabetes, hyperuricemia
Elimination Route
Budema is completely absorbed (80%), and the absorption is not altered when taken with food. Bioavailability is almost complete.
Half Life
60-90 minutes
Clearance
- 0.2 - 1.1 mL/min/kg [preterm and full-term neonates with respiratory disorders]
- 2.17 mL/min/kg [neonates receiving bumetanide for volume overload]
- 1.8 +/- 0.3 mL/min/kg [geriatric subjects]
- 2.9 +/- 0.2 mL/min/kg [younger subjects]
Elimination Route
Oral administration of carbon-14 labeled Bumex to human volunteers revealed that 81% of the administered radioactivity was excreted in the urine, 45% of it as unchanged drug. Biliary excretion of Bumex amounted to only 2% of the administered dose.
Pregnancy & Breastfeeding use
Pregnancy: Pregnancy Category C : There are no adequate and well controlled studies in pregnant woman .Lactation: It is not known wheather this drug is excreted in human milk.
Contraindication
Loop diuretics should be avoided in severe hypokalaemia, severe hyponatraemia, anuria, comatose and precomatose states associated with liver cirrhosis and in renal failure.
Special Warning
Paediatric use: Safety and effectiveness in paediatric patients below the age of 18 have not been established.
Acute Overdose
Overdosage can lead to acute profound water loss, volume and electrolyte depletion, dehydration, reduction of blood volume and circulatory collapse with a possibility of vascular thrombosis and embolism. Treatment consists of replacement of fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels.
Storage Condition
Store in a cool & dry place. Protect from light.
Innovators Monograph
You find simplified version here Budema
Budema contains Bumetanide see full prescribing information from innovator Budema Monograph, Budema MSDS, Budema FDA label