Experiences with

Bumetanide

Bumetanide is a type of medicine called a diuretic. It's used to treat heart failure and the build up of fluid in your body (oedema).

Diuretics are sometimes called "water tablets" because they make you pee more. This helps get rid of extra fluid in your body.

Bumetanide is only available on prescription. It comes as tablets and as a liquid that you swallow.

Bumetanide also comes mixed with another diuretic called amiloride to treat oedema.

Who can take bumetanide

Most adults and children, including babies, can take bumetanide.

Who may not be able to take bumetanide

Bumetanide is not suitable for everyone. To make sure that it's safe for you, tell your doctor if you have:

• ever had an allergic reaction to bumetanide or any other medicines
• low blood pressure (hypotension)
• symptoms of dehydration, such as being thirsty, having a dry mouth and dark pee
• liver disease
• diabetes
• difficulty peeing
• gout

If you're going to have a glucose test, tell your doctor you are taking bumetanide.

Dosage and strength

Bumetanide is available as 1mg and 5mg tablets and a liquid containing 1mg in 5ml.

The usual dose for adults to treat heart failure or a build up of fluid in the body (oedema) is 1mg to 10mg a day.

If you are over 65 your doctor may give you a lower dose.

For babies and children, your doctor will use your child's weight or age to work out the right dose.

How to take it

You'll usually take bumetanide once a day in the morning or afternoon. If your doctor prescribes it twice a day, take it once in the morning and again in the afternoon.

You do not need to take bumetanide at the same time every day. You can occasionally take it at a different time if it's more convenient for you. For example, you could take it later if you need to go out for a few hours in the morning and will not be near a toilet.

Do not take bumetanide too late in the day (after 4pm) or at night, otherwise you may have to wake up to go to the toilet. Your pharmacist or doctor will advise the best times for you to take your medicine.

You can take bumetanide with or without food. Swallow the tablets whole with a drink of water.

If you're taking bumetanide as a liquid, it will come with a plastic spoon or syringe to help you measure the correct amount. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

How long to take it for

Depending on the reason why you're taking bumetanide, you may have to take it for a long time, even for the rest of your life.

If you get ill while taking it

Contact your doctor if:

• you're ill with a a high temperature
• you're sweating and shaking
• you're being sick (vomiting) or have severe diarrhoea

Your doctor may recommend you stop taking bumetanide for 1 to 2 days until you are better. You can start taking it again when you're eating and drinking normally.

If you take bumetanide when you have an illness that makes you dehydrated, it can make the dehydration worse.

If you forget to take it

Take your forgotten dose as soon as you remember, unless it is after 4pm. If this happens, leave out the missed dose and take your next dose at the usual time.

Do not take 2 doses to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.

Stopping bumetanide

Talk to your doctor if you want to stop taking bumetanide. Stopping it may cause fluid to build up in your body.

If you're bothered by side effects, your doctor may be able to prescribe you a different medicine.

If you take too much

Taking too much bumetanide can cause headaches, make you feel dizzy, give you a pounding or irregular heartbeat, make you faint, and make you feel thirsty.

The amount of bumetanide that can lead to an overdose varies from person to person.

you take more than your prescribed dose of bumetanide. This is very important if you:

• feel unwell
• are over 65 (even if you feel well)
• have liver, kidney or heart problems (even if you feel well)

Go to 111.nhs.uk or call 111 .

If you need advice for a child under the age of 5, call 111 .

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the bumetanide packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of bumetanide happen in more than 1 in 100 people. There are things you can do to help cope with them:

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or lasts more than a few days.

Serious side effects

Serious side effects are rare.

Call your doctor or call 111 now if you have:

• unexplained bruising or bleeding, a high temperature, sore throat and mouth ulcers – these could be signs of a blood disorder
• ringing in your ears (tinnitus) or loss of hearing

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to bumetanide.

Bumetanide is safe to take for a long time, but you will have to see your doctor or nurse every so often for blood and urine tests. These are done to check that the chemicals in your blood are properly balanced.

How often you need these tests will depend on the reason why you're taking bumetanide, if your dose has changed recently, or if you have any other health problems.

Other side effects

These are not all the side effects of bumetanide. For a full list, see the leaflet inside your medicine packet.

Bumetanide and pregnancy

Bumetanide is not usually taken in pregnancy, but you can take it if your doctor thinks it is OK.

If you're trying to get pregnant or are already pregnant, talk to your doctor about whether taking bumetanide is right for you. Continue taking bumetanide until you have been reviewed.

Bumetanide and breastfeeding

Bumetanide is not usually recommended while you're breastfeeding. It would not be expected to cause any side effects in your baby but bumetanide may reduce the amount of breast milk you produce.

It is not known if bumetanide passes into breast milk.

If you're breastfeeding or planning to breastfeed, talk to your doctor or pharmacist as other medicines might be better while breastfeeding.

If you do need to take bumetanide while you're breastfeeding, your doctor and midwife will monitor your baby's weight.

If you notice that your baby is not feeding as well as usual or if you have any other concerns about your baby, then talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

Bumetanide and fertility

There's no evidence that bumetanide reduces fertility in men or women.

However, if you're trying to get pregnant, talk to your doctor first as this medicine is usually not recommended in pregnancy.

It is strongly recommended that you discuss pregnancy with your doctor if you are on treatment for heart failure. They will need to review your medical condition and medicine before you try for a baby.

Cautions with other medicines

Some medicines can affect the way bumetanide works.

Tell your doctor if you're taking any of these medicines before starting bumetanide:

• medicines which treat or might give you an irregular heartbeat, including amiodarone, digoxin, disopyramide, flecainide or sotalol
• medicines that change the level of potassium in your blood, such as steroids or other diuretics
• medicines to treat mental health problems, such as amisulpride, lithium, pimozide or risperidone
• non-steroidal anti-inflammatory drugs (NSAIDs), including diclofenac, ibuprofen or naproxen
• medicines to treat high blood pressure, or those that have a side effect of low blood pressure

Taking bumetanide with everyday painkillers

Some painkillers contain a lot of sodium, which is found in salt. Too much salt can stop bumetanide working properly.

Medicines that contain a lot of salt include:

• soluble paracetamol
• soluble co-codamol

Speak to a pharmacist or doctor to see if these medicines are safe for you to take alongside bumetanide.

Mixing bumetanide with herbal remedies and supplements

Tell your doctor if you are taking any:

• potassium supplements – these change the levels of potassium in your blood and can affect the way bumetanide works
• remedies for heartburn and indigestion – some of these contain a lot of sodium, which is found in salt – too much salt can stop bumetanide working properly

There's not enough information to say that other herbal remedies and complementary medicines are safe to take with bumetanide. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

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