Bumetanide is nearly totally absorbed from the gastro-intestinal tract. After peroral administration, a bioavailability of between 80-95% is observed. Diuresis begins within ½-1 hour with a peak effect between 1 and 2 hours. The diuretic effect lasts up to about 4 hours. Bumetanide is eliminated with half-life ranging from between 1 to 2 hours after oral administration of a dose of -2 mg. It is strongly bound to plasma proteins and renal excretion of unchanged drug accounts for about half of the total clearance. The hepatic metabolism and biliary excretion accounts for the other half. The primary metabolites are conjugated alcohols of bumetanide. No active metabolites have been found. Bumetanide has a steep dose response curve.
low amounts of white cells in the blood (may cause fever or frequent infections), runny nose, lowered female fertility (see section 2), sensing things that are not there, high blood creatinine levels seen in blood tests, kidney failure, kidney disease (may cause changes in the need to or amount of urine), thirst, fever, inflammation in the eye (causing eye pain or changes in vision), tingling or “pins and needles”, a spinning sensation, abnormal liver function seen in tests, worsening of Parkinson’s disease, general feeling of discomfort and illness, swelling of the hands and feet, swelling in the eye (causing headaches or blurred vision).
In mild cases of toxicity (atrial fibrillation with a slow ventricular response or occasional ectopic beats), temporary withdrawal of the drug and electrocardiogram monitoring is sufficient. 6 Gastric lavage or emesis together with supportive measures, such as electrolyte replacements, antiarrhythmics (eg, lidocaine, phenytoin), and atropine, have been used to manage acute poisonings. Digoxin-specific Fab antibody fragments may be used in managing acute intoxications caused by digitalis and related cardioactive glycosides; however, their efficacy remains unproven by controlled clinical trials. 13 , 25 , 28 , 29