- Dosages
- Side effects in children
- Warnings & precautions in children
- Contra-indications in children
-
Interactions - PK
- Renal impairment
- References
Pharmacokinetics in children
Bumetanide is eliminated both renally and non-renally; on average, 34% of the dose is found unchanged in the urine (Marshall et al.).
The clearance increases with increasing postnatal age, from 0.2-1.0 ml/min/kg in premature neonates to 2.7±1.9 ml/min/kg in infants [Lopez et al., Sullivan et al.].
Average elimination half-life in premature infants: 6-7 hours (range 4-19 hours).
The study by Sullivan et al. shows that the elimination half-life decreases exponentially in the first month of life, principally because of the increased clearance. Average elimination half-life in infants: 2.3 ± 1.4 hours
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
dose recommendation of formulary compared to licensed use (on-label versus off-label)
No information is present at this moment.
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
Available formulations
No information is present at this moment.
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
Dosages
| Diuretics for oedema |
|---|
|
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
Renal impaiment in children > 3 months
Adjustment in renal impairment as specified:
GFR 50-80 ml/min/1.73 m2
Adjustment not necessary.GFR 30-50 ml/min/1.73 m2
Adjustment not necessary.GFR 10-30 ml/min/1.73 m2
Adjustment not necessary.GFR < 10 ml/min/1.73 m2
No generalized dose recommendations are givenClinical consequences
In reduced renal function, bumetanide often has to be given at a higher dosage in order to achieve sufficient diuretic effect.
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects in children
At higher dosages and in long-term use, there can be hearing damage and electrolyte imbalances, particularly hypokalaemia and hypomagnesaemia. Extra caution is needed when other ototoxic drugs are being used concomitantly (including aminoglycosides, indomethacin, amphotericin B). In children in particular, dehydration can result in thromboembolic processes or collapse. In premature infants, elevations of the serum creatinine concentration, total bilirubin and direct bilirubin have also been observed.
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here
Contra-indications
No information available on specific contra indications in children.
The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here
Warnings & precautions in children
Caution is needed in neonates with hyperbilirubinaemia. Because of the longer half-life in premature infants, the dosage given each time must not be exceeded. Also given the lack of any dose-effect relationship for dosages of above 0.2 mg/kg, higher dosages are not recommended: At dosages of higher than 0.2 mg/kg, only a very slight increase in diuresis is seen, but the risk of electrolyte problems and ototoxicity increases.
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
| Sulfonamides, plain | ||
|---|---|---|
| C03CA01 | ||
| C03CA04 | ||
| Aryloxyacetic acid derivatives | ||
|---|---|---|
| C03CC01 | ||
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
References
- Oliveros M, et al, The use of bumetanide for oliguric acute renal failure in preterm infants, Pediatr Crit Care Med, 2010, Jul 9
- Marshall JD, et al, Pharmacokinetics and pharmacodynamics of bumetanide in critically ill pediatric patients, J Clin Pharmacol, 1998, Nov;38(11), 994-1002
- Lopez-Samblas AM, et al, The pharmacokinetics of bumetanide in the newborn infant., Biol Neonate, 1997, 72(5), 265-72
- Sullivan JE, et al, Dose-ranging evaluation of bumetanide pharmacodynamics in critically ill infants, Clin Pharmacol Ther, 1996, Oct;60(4), 424-34
- Sullivan JE, et al, Analysis of the variability in the pharmacokinetics and pharmacodynamics of bumetanide in critically ill infants, Clin Pharmacol Ther, 1996, Oct;60(4), 414-23
- Sullivan JE, et al, Pharmacokinetics of bumetanide in critically ill infants, Clin Pharmacol Ther, 1996, Oct;60(4), 405-13
- Walker PC, et al, The bilirubin-displacing capacity of bumetanide in critically ill neonates, Dev Pharmacol Ther, 1988, 11(5), 265-72
- Ward OC, et al, Bumetanide in heart failure in infancy, Arch Dis Child, 1977, Nov;52(11), 877-82
A second drug has not been selected yet.
Press ‘drugs’ followed with and select second drug from list to add the second drug to the comparison.
Changes
Changes
