Bedside Snapshot

Use It For
Acute decompensated heart failure with congestion; edema from heart failure, cirrhosis or renal disease; diuretic resistance; furosemide allergy or poor oral absorption
Adult Dose
  • Edema: 0.5–1 mg IV/IM over 1–2 min, repeat every 2–3 hr; 0.5–2 mg PO daily; max 10 mg/day
  • ADHF: loop-naive 1–2 mg IV; home loop: IV total/day ≥ home oral dose in furosemide equivalents (ESC 2026: ×2), every 12 hr or drip
Pediatric Dose
Not established in children: specialist use only. Published dosing 0.015–0.1 mg/kg/dose IV/IM or PO every 6–24 hr (max initial 1 mg IV, 2 mg PO); neonates every 24–48 hr
Onset / Duration
IV: within minutes, peak 15–30 min, short-acting (no labeled IV duration); PO: 30–60 min, peak 1–2 hr / about 4 hr at 1–2 mg (4–6 hr at higher doses); IM: onset about 40 min (not in the label)
Do Not Give / Hold If
Anuria; hepatic coma; severe electrolyte depletion; bumetanide allergy. Hold for symptomatic hypotension or hypovolemia. Replete K⁺ and Mg²⁺ alongside dosing; mild hypokalemia should not delay urgent decongestion
Watch For
Volume depletion (orthostasis, rising creatinine); low K⁺ and Mg²⁺ (ectopy, cramps); ototoxicity (tinnitus, hearing loss); encephalopathy in cirrhosis (confusion, asterixis)
Reversal / Rescue
No antidote: stop the drug; replace fluid and electrolytes guided by urine output and serum K⁺, Mg²⁺ and Na⁺; support BP
Must Remember
Not mg-for-mg with furosemide: labels state 1 mg bumetanide ≈ 40 mg furosemide (≈ 20 mg IV furosemide per the Enbumyst label). PO and IV bumetanide are about equal, so the dose does not change with the route

Indications

ED / ICU / Transport

  • Acute decompensated heart failure (ADHF) with congestion: pulmonary or systemic fluid overload, the fluid backing up. Prompt IV loop diuretic therapy is a Class 1 recommendation. Bumetanide can stand in for furosemide
  • Diuretic resistance: escalating IV bolus doses, continuous infusion (off-label) or a second diuretic. AHA 2022 rates this a Class 2a option. Patients already on a loop diuretic: ESC 2026 names short-term IV acetazolamide or oral hydrochlorothiazide (Class IIa)
  • Impaired gut absorption or no oral route: bowel-wall edema, vomiting or NPO status. The gut can't be trusted, so give IV or IM
  • Furosemide allergy or intolerance: bumetanide working after a furosemide reaction suggests there is no cross-sensitivity
  • Interfacility transfer: after IV doses or on a running infusion

Other Uses

  • Edema from heart failure, cirrhosis or renal disease, including nephrotic syndrome: the labeled use, given PO, IV, IM and intranasal
  • Cirrhotic ascites: it is an add-on only. The mainstay is an aldosterone antagonist (spironolactone), alone or with a loop diuretic. That loop is usually furosemide, with bumetanide as the alternative. A loop diuretic is not used alone
  • Short-term outpatient decongestion: the adult nasal spray, used when oral absorption is unreliable. Swap it for an oral diuretic as soon as practical
  • Hypertension with chronic kidney disease or volume overload: (off-label)

Dosing & Administration

Doses vary by protocol; follow local protocols and medical direction.

Available Forms

  • Injection: 0.25 mg/mL in amber vials: 4 mL single-dose (1 mg) and 10 mL multiple-dose (2.5 mg); contains benzyl alcohol 10 mg/mL; the form used in the ED, ICU and transport
  • Tablets: 0.5 mg, 1 mg and 2 mg (Bumex and generics)
  • Nasal spray: 0.5 mg per 0.1 mL single-use unit-dose device (Enbumyst), adults only

Adult Dosing

IndicationDose & RouteRepeat / MaxNotes
Edema: parenteral
0.5–1 mg IV/IM; IV push over 1–2 min
If response is inadequate, a 2nd or 3rd dose every 2–3 hr; max 10 mg/day
Labeled edema starting dose; switch to PO as soon as possible. ADHF dosing: next rows
ADHF, loop-naive
About 40 mg IV furosemide equivalent per ESC 2026: bumetanide 1 mg IV at 1:40 or 2 mg IV at the Enbumyst 1:20 IV ratio, per institutional practice
Response targets and escalation as in the next row; label max 10 mg/day
Higher than the labeled 0.5–1 mg edema start; protocol-dependent
ADHF, already on a loop diuretic
IV dose at least equal to the home daily oral loop dose per AHA 2022; DOSE trial: 1 or 2.5 times the home daily dose per day, as boluses every 12 hr or an infusion; ESC 2026: start at twice the home daily oral dose. Home bumetanide: 1–2.5 times the home daily dose IV. Home furosemide: convert per institutional practice. Example, home furosemide 80 mg/day PO: the 1-times target is 80 mg/day IV furosemide, which is bumetanide 4 mg/day IV at the Enbumyst 1:20 IV ratio. 2 mg/day IV (1:40 used IV to IV) only matches the home oral dose under that label; if the lower dose is given, check the response at 2–6 hr and double early
Adequate response per ESC 2026: spot urine Na ≥70 mEq/L at 2 hr or urine output ≥100 mL/hr over 6 hr; repeat every 12 hr until decongested. If not met: double the IV dose, or add IV acetazolamide or hydrochlorothiazide; if still insufficient, escalate further or add another diuretic. Label max 10 mg/day; higher totals or large single boluses are an ICU or specialist protocol decision, with slow pushes
IV conversion is uncertain: the injection and tablet labels state 1 mg ≈ 40 mg furosemide; the Enbumyst label and HF equivalence tables use 1 mg ≈ 20 mg IV furosemide. DOSE enrolled home furosemide 80–240 mg/day only. Response monitoring in Monitoring
Edema: oral
0.5–2 mg PO once daily
If inadequate, a 2nd or 3rd dose every 4–5 hr; max 10 mg/day
Maintenance: label favors intermittent dosing (alternate days, or 3–4 days on, 1–2 off)
Edema: intranasal
0.5–2 mg IN once daily (0.5 mg per spray)
Max 2 mg/day
Adults; short-term use only. Avoid with rhinitis or nasal congestion
Diuretic resistance: continuous infusion (off-label)
1 mg IV bolus, then 0.5–2 mg/hr IV infusion
Always exceeds the labeled 10 mg/day (0.5 mg/hr = 12 mg/day; 2 mg/hr = 48 mg/day): ICU or specialist protocol only
Not superior to boluses in the DOSE trial (furosemide); always load first

Pediatric Dosing

Not established in children: The FDA label says safety and effectiveness below 18 years have not been established. Every dose below is specialist use, pulled from a pediatric dosing reference. See weight-based dosing.
IndicationDose (per kg) & RouteMax Single / Max TotalNotes
Edema: infants, children, adolescents (specialist use)
0.015–0.1 mg/kg/dose IV/IM or PO every 6–24 hr
Max initial dose 1 mg IV/IM or 2 mg PO; do not exceed the adult 10 mg/day
Infants up to 6 months: maximal diuresis at about 0.035–0.04 mg/kg
Neonates (specialist use)
0.01–0.05 mg/kg/dose IV/IM or PO every 24–48 hr
Same caps; long intervals because clearance is slow
Half-life about 6 hr at birth (up to 15 hr); displaces bilirubin; the injection contains benzyl alcohol
Continuous infusion
Specialist use: PICU or cardiac ICU protocol only (reference range 1–10 mcg/kg/hr)
Per unit protocol
Higher rates appear in retrospective pediatric cardiac ICU series, which are not a dosing source; in one series, maximum rates of 100 mcg/kg/hr or more were associated with more deaths (association only)

Continuous Infusion

SettingExample ConcentrationStartTitrateUsual Range / Max
Adult ADHF or diuretic resistance (off-label)
0.25 mg/mL undiluted (ASHP adult standard, per PDR 2024), example (institution-specific)
1 mg IV bolus, then 0.5 mg/hr
Within range by urine output and natriuresis per protocol
0.5–2 mg/hr; exceeds the labeled 10 mg/day
Pediatric (specialist use)
0.04 mg/mL or 0.25 mg/mL (ASHP pediatric standards, per PDR 2024), example (institution-specific)
1–10 mcg/kg/hr
Per PICU or cardiac ICU protocol
Per unit protocol

Preparation & Administration

  • Measure in mL carefully: at 0.25 mg/mL, 0.5 mg = 2 mL and 1 mg = 4 mL
  • Push rate: undiluted, IV over 1–2 min. Push it fast and the ototoxicity risk goes up
  • IM: undiluted, deep into a large muscle (gluteal or lateral thigh)
  • Dilution: compatible with D5W, 0.9% sodium chloride and lactated Ringer's in glass or PVC containers; use within 24 hr
  • Pump: infusions on a smart pump programmed in mg/hr (mcg/kg/hr in children)
  • Nasal spray: single use, do not prime; spray into the nostril, not against the nasal wall; alternate nostrils when more than one spray is needed
Dosing Notes:
  • per the injection and tablet labels, 1 mg bumetanide ≈ 40 mg furosemide. Enbumyst's label puts it at 40 mg oral or 20 mg IV furosemide, and every institution sets its own conversion
  • switch the route and the dose stays put. Oral, IV and IM bumetanide give almost the same diuresis
  • Renal and hepatic notes: Special Populations

Contraindications & Precautions

Contraindications

  • Anuria
  • Hepatic coma
  • Severe electrolyte depletion, until corrected
  • Hypersensitivity to bumetanide (anaphylactic and anaphylactoid reactions reported)

Precautions

  • Older adults and excess dosing: circulatory collapse with thrombosis and embolism
  • Hypokalemia risk: digoxin therapy, cirrhosis with ascites, aldosterone excess, potassium-losing nephropathy, diarrhea, prior ventricular arrhythmias
  • Cirrhosis with ascites: a sudden electrolyte shift can tip the patient into hepatic encephalopathy and coma. Start in hospital, with small doses
  • Ototoxicity: rapid injection, severe renal impairment, high doses, hypoproteinemia, aminoglycosides or other ototoxic drugs
  • Sulfonamide allergy: hypersensitivity is possible. It is a warning, not a labeled contraindication
  • Neonates: bilirubin displacement (kernicterus risk) and benzyl alcohol in the injection

Hold / Reassess If

  • Symptomatic hypotension or signs of hypovolemia: hold and reassess volume status
  • Oliguria or a marked BUN or creatinine rise in progressive renal disease: stop
  • K⁺ <3.5 mEq/L or low Mg²⁺: replete before or alongside further doses; do not delay decongestion in respiratory distress for mild hypokalemia
  • New tinnitus, hearing loss, confusion or asterixis: stop and notify
FDA Boxed Warning: Bumetanide, injection or tablets, is a potent diuretic. Too much means profound diuresis with water and electrolyte depletion. Give it under careful medical supervision, with the dose and schedule adjusted to the patient.

Adverse Effects & Toxicity

Common

  • Hyperuricemia (18% of patients tested), usually asymptomatic
  • Hypochloremia (15%) and hypokalemia (15%)
  • Azotemia (11%) and creatinine rise (7%)
  • Hyponatremia (9%) and hyperglycemia (7%)
  • Hypocalcemia from urinary Ca²⁺ loss (serum calcium changes in about 2%) and hypomagnesemia from urinary Mg²⁺ loss
  • Muscle cramps and dizziness (about 1% each), hypotension (0.8%), headache and nausea (0.6%)

Serious / Life-Threatening

EffectRecognitionManagement
Volume depletion and circulatory collapse
Hypotension, orthostasis, tachycardia, rising BUN and creatinine; thrombosis or embolism, mainly in older adults
Stop; replace fluid as indicated; recheck labs
Hypokalemia and hypomagnesemia
Low K⁺ or Mg²⁺, ectopy or U waves, weakness, cramps; raises digoxin toxicity risk
Replete K⁺ and Mg²⁺ (magnesium sulfate); consider a potassium-sparing diuretic
Ototoxicity
Tinnitus, hearing loss, vertigo; usually reversible
Stop; review dose, push rate, renal function and aminoglycosides
Hepatic encephalopathy
Confusion or asterixis in pre-existing liver disease (0.6%)
Stop; correct K⁺ and volume; treat encephalopathy per protocol
Severe hypersensitivity or skin reaction
Anaphylaxis; Stevens-Johnson syndrome or toxic epidermal necrolysis
Stop permanently; treat anaphylaxis with IM epinephrine; specialist care for skin reactions
Thrombocytopenia (rare)
Falling platelets, bruising or bleeding
Check platelets; stop if drug-related

Overdose & Toxicity Management

  • Signs: profound water and electrolyte loss, circulatory collapse, thrombosis; weakness, dizziness, confusion, lethargy, vomiting, cramps
  • Immediate management: stop bumetanide; cardiac monitoring for hypokalemia-related arrhythmias; replace fluid and electrolytes guided by urine output and serum electrolytes
  • Antidote: none; care is supportive

Monitoring
ParameterWhen / How OftenTarget / Act If
Clinical: urine output
Hourly for the first 6 hr after an IV dose in ADHF, then per protocol
Below 100 mL/hr over the first 6 hr: insufficient response per the ESC 2026 guideline; double the IV loop dose, or add IV acetazolamide or hydrochlorothiazide (chronic loop users); recheck at 2–6 hr
Clinical: spot urine sodium
2 hr after the first IV dose, and 2–6 hr after each escalation; urine sodium–guided therapy may be considered (ESC 2026, Class IIb; not in the AHA 2022 guideline)
Below 70 mEq/L: insufficient response; double the IV loop dose or add a second diuretic. Thresholds apply to decompensated (acute) heart failure
Clinical: weight, intake and output, congestion
Daily weight (same scale); intake and output every shift
Weight falling faster than planned or new orthostasis: reduce or hold
Clinical: BP and perfusion
Before each dose and after IV doses
Symptomatic hypotension: hold and reassess volume
Clinical: hearing and mental status
Every assessment
Tinnitus or hearing loss: stop. Confusion or asterixis in cirrhosis: stop, check electrolytes
Laboratory: K⁺, Mg²⁺ and Ca²⁺
Baseline, then regularly during IV diuresis (daily or per protocol); periodically on oral therapy
K⁺ <3.5 mEq/L or low Mg²⁺: replete; low Ca²⁺: check ionized calcium and replete if symptomatic; tighter K⁺ targets with digoxin or arrhythmias per protocol
Laboratory: Na⁺, Cl⁻ and HCO₃⁻
With K⁺
Falling Na⁺ or rising HCO₃⁻ (contraction alkalosis): reassess the dose
Laboratory: BUN and creatinine
Baseline and with electrolytes
Marked creatinine rise with oliguria in progressive renal disease: stop
Laboratory: glucose, uric acid, platelets
Periodically; glucose more often in diabetes
Hyperglycemia: adjust therapy; platelet fall: evaluate
Drug Levels: lithium, digoxin
When co-prescribed
Rising lithium level: notify; digoxin with low K⁺: correct K⁺ first

Interactions & Compatibility

Clinically Significant Interactions

Drug / ClassEffectWhat To Do
Aminoglycosides, other ototoxic or nephrotoxic drugs
Additive ototoxicity and nephrotoxicity
Avoid IV/IM bumetanide with aminoglycosides, especially in renal impairment, unless life-threatening; if unavoidable, slow pushes and monitor hearing and renal function
Lithium
Reduced lithium clearance; high toxicity risk
Generally avoid; if combined, check lithium levels
NSAIDs, including indomethacin and ketorolac
Blunted natriuresis; higher risk of renal insufficiency
Indomethacin co-therapy is not recommended; avoid NSAIDs and monitor renal function and diuretic response
Probenecid
Blocks tubular secretion of bumetanide; less natriuresis
Do not give together
Antihypertensives and vasodilators (nitroglycerin, ACE inhibitors, ARBs)
Additive hypotension
Reduce antihypertensive doses as needed; watch BP after IV doses
Digoxin
Levels unchanged, but low K⁺ and Mg²⁺ promote digoxin toxicity
Keep K⁺ and Mg²⁺ normal
Diuretics acting at another nephron site (thiazide-type such as hydrochlorothiazide, metolazone or chlorothiazide; acetazolamide)
Synergistic natriuresis; marked K⁺, Na⁺ and Mg²⁺ loss (thiazide-type); acetazolamide adds bicarbonate loss
Add per protocol when the response is inadequate; ESC 2026 (Class IIa) names short-term IV acetazolamide or oral hydrochlorothiazide in patients already on a loop diuretic, as an alternative to doubling the loop dose. Monitor electrolytes and volume closely

IV Compatibility

  • Diluents: D5W, 0.9% sodium chloride or lactated Ringer's; prepare fresh and use within 24 hr
  • Y-site: check before co-infusing with other drugs
  • Verify with an institutional compatibility resource.

Special Populations
  • Pediatrics: not established below 18 years, so this is specialist use only. See the Pediatric Dosing table. Edema is the only labeled use. Neonatal seizures are not an indication. The NEMO trial was a phase 1/2 dose-finding and feasibility study.
  • Neonates: the half-life is about 6 hr at birth (up to 15 hr) and about 2.4 hr by 1 month. Bumetanide displaces bilirubin, so go carefully with jaundiced or critically ill neonates (kernicterus). The injection carries benzyl alcohol, which is linked to neonatal gasping syndrome.
  • Pregnancy: human data are limited. The Enbumyst label, in its newer pregnancy and lactation format, says available data have not identified a drug-associated risk of major birth defects or miscarriage. The injection and Bumex tablet labels say there are no adequate studies in pregnant women. In animals it was not teratogenic. Slight embryocidal effects were seen in rats at very high doses, and in rabbits at about 3.4 times the maximum human dose. Those labels advise use only if the benefit justifies the fetal risk. Untreated heart failure, cirrhosis or kidney disease carries its own risks.
  • Lactation: the Enbumyst label reports no milk data and no reported infant harm. It advises watching the infant for excess urine output, dehydration and lethargy. The current injection and Bumex tablet labels say nursing generally should not be undertaken. Decide case by case.
  • Older Adults: clearance is lower, peaks are higher, and volume depletion, thrombosis and embolism come more easily. Start low and monitor renal function.
  • Renal Impairment: there is no set adjustment. In end-stage renal disease, higher doses at extended intervals may be needed, and ototoxicity risk rises. Anuria is a contraindication. Stop for oliguria or a marked BUN or creatinine rise in progressive renal disease.
  • Hepatic Impairment: hepatic coma is a contraindication. With cirrhosis and ascites, start in hospital at the lowest dose, because encephalopathy is the risk. Potassium or spironolactone helps prevent hypokalemia and alkalosis. In cirrhotic ascites, the aldosterone antagonist spironolactone is the mainstay, alone or with a loop diuretic. A loop diuretic is not used alone.
  • Obesity / Dosing Weight: adult doses are fixed, not weight-based. No specific adjustment is established.
  • Nasal Disease: skip the nasal spray with significant mucosal or structural abnormalities, rhinitis or congestion.

Field & Transport Considerations
  • Scope: you will usually meet this at interfacility transfer, on RN and critical-care transport, not on an EMS truck. IV doses and infusion management (Paramedic/RN/CCT) vary by state and agency protocol.
  • Storage & Stability: keep it at 20–25°C (68–77°F), with excursions to 15–30°C (59–86°F) allowed. Protect it from light, and use diluted solutions within 24 hr. Avoid leaving vials in hot or freezing vehicles.
  • Carried Concentration: 0.25 mg/mL only. 1 mg is 4 mL. Do not mix up bumetanide milligrams with furosemide milligrams: the gap is about 40-fold per the labels, and about 20-fold against IV furosemide per the Enbumyst label.
  • Infusions in Transport: transport pump with drug library, mg/hr confirmed against the order, enough volume for the trip plus delays.
  • Diuresis on the Road: IV diuresis starts within minutes and peaks at 15–30 min. Plan for a urinal or catheter. Watch for orthostasis as you move the patient.
  • Handoff Essentials: each dose and time, 24-hr total (labeled max 10 mg/day), infusion rate, urine output since the first dose, spot urine sodium if drawn, last K⁺, Mg²⁺ and creatinine, weight trend.

Clinical Pearls
Loop Diuretic Equivalence: Roughly the same diuretic effect at these doses:
  • Furosemide 40 mg PO
  • Furosemide 20 mg IV
  • Bumetanide 1 mg PO or IV
  • Torsemide 20 mg PO
Milliliters Are Not Milligrams: A 1 mg dose fills a 4 mL vial at 0.25 mg/mL. Units get crossed when an order is written in furosemide-sized numbers, or when mL is entered as mg. Either one is a large overdose.
Same Dose Any Route: Oral bumetanide is absorbed far more reliably than furosemide, which is why PO and IV doses come out about equal. Gut edema that blunts oral furosemide? That is a classic reason to switch.
Check Response Early: Spot urine sodium below 70 mEq/L at 2 hr, or urine output below 100 mL/hr over 6 hr, per ESC 2026, means the dose is too small. Double it. Do not repeat an ineffective dose. Converting from home furosemide? Use the institutional ratio: 1:40 per the injection and tablet labels, 1:20 to IV furosemide per the Enbumyst label. At 1:40, the IV dose only matches the failing home oral dose. Recheck early.
Ototoxicity Stack: Put a rapid push, high doses, renal failure and an aminoglycoside together and the hearing-loss risk is at its highest. Push over 1–2 min, and ask about tinnitus.
Exam Discriminator, Sulfa vs Furosemide Allergy: For bumetanide, a sulfonamide allergy is a labeled warning, not a contraindication. A prior furosemide reaction does not rule it out either. Successful use after a furosemide allergy suggests no cross-sensitivity. If a true severe sulfonamide or loop-diuretic hypersensitivity makes bumetanide unsuitable, the non-sulfonamide loop diuretic is ethacrynic acid.
Bolus or Drip: The DOSE trial found bolus and infusion strategies gave similar results. Infusion regimens begin with a 1 mg IV bolus. Do not start a drip alone.

Pharmacology

Mechanism of Action

  • It blocks the Na⁺-K⁺-2Cl⁻ cotransporter (NKCC2) in the thick ascending limb of the loop of Henle. The result is large sodium, chloride and water loss, slightly more chloruretic than natriuretic, and rapid decongestion.
  • More sodium reaches the distal nephron. That costs K⁺ and H⁺. Ca²⁺ and Mg²⁺ go out too, leaving hypokalemia, contraction alkalosis and hypomagnesemia.
  • Probably a second action in the proximal tubule, causing phosphaturia. It does not work through carbonic anhydrase inhibition.
  • It has to be secreted into the tubular lumen to work. Probenecid and poor renal function blunt the effect, and uric acid excretion falls.

Pharmacokinetics

RouteOnsetPeakDuration
IV
Within minutes
15–30 min
Short; not stated in the label
IM
About 40 min (drug reference; not stated in the label)
—
Not stated in the label
PO
30–60 min
1–2 hr
About 4 hr at 1–2 mg; 4–6 hr at higher doses
IN
Under 60 min
0.75–1.5 hr
Largely complete within 4 hr at 2 mg
  • Half-life: 1–1.5 hr in adults (about 3 hr after the nasal spray); about 6 hr at birth, falling over the first month
  • Bioavailability: oral absorption is reliable, unlike furosemide. The labels state an almost equal diuretic response after oral and parenteral dosing. Nasal exposure looks like oral exposure, with an AUC of about two-thirds of IV
  • Metabolism: oxidation of the N-butyl side chain
  • Elimination: 81% in urine (45% unchanged); biliary about 2%
  • Protein binding: 94–96%

Names & Classification
Generic Name
Bumetanide
Brand Names
Bumex (tablets, US); Enbumyst (nasal spray, US); Burinex (international); injection is generic
Pharmacologic Class
Loop diuretic (sulfamoylbenzoic acid derivative)
Therapeutic Class
Diuretic for edema and volume overload
Controlled Substance
Not controlled
ISMP High-Alert
No
Look-Alike / Sound-Alike
None on the current ISMP confused drug names list; confusion with furosemide doses is the practical error

Related

References
  1. Hikma Pharmaceuticals USA. (2026). Bumetanide Injection, USP [package insert; label text revised December 2019]. DailyMed SPL updated July 8, 2026, accessed October 2026. U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=681b5e9d-e2c7-4f29-aaad-e06d4a528c11
  2. Corstasis USA. (2026). Enbumyst (bumetanide nasal spray): Prescribing information [label revised November 2025]. DailyMed SPL updated August 27, 2026, accessed October 2026. U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d6f752c5-d2bd-4f77-9611-ca2110066d1f
  3. Validus Pharmaceuticals. (2024). Bumex (bumetanide) tablets: Prescribing information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/018225Orig1s029lbl.pdf
  4. Heidenreich, P. A., Bozkurt, B., Aguilar, D., et al. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation, 145(18), e895–e1032. https://doi.org/10.1161/CIR.0000000000001063
  5. Køber, L., Adamo, M., Ruwald, A.-C., et al. (2026). 2026 ESC guidelines for the management of heart failure. European Heart Journal, 47(38), 5346–5457. https://doi.org/10.1093/eurheartj/ehag100
  6. Biggins, S. W., Angeli, P., Garcia-Tsao, G., Ginès, P., Ling, S. C., Nadim, M. K., Wong, F., & Kim, W. R. (2021). Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology, 74(2), 1014–1048. https://doi.org/10.1002/hep.31884
  7. Sidhu, G., & Puckett, Y. (2023). Bumetanide. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559181/
  8. PDR. (2024). Bumetanide: Drug summary (adult, pediatric and neonatal dosing). Prescribers' Digital Reference. https://www.pdr.net/drug-summary/Bumetanide-Tablets-bumetanide-3034
  9. Felker, G. M., Lee, K. L., Bull, D. A., et al. (2011). Diuretic strategies in patients with acute decompensated heart failure. New England Journal of Medicine, 364(9), 797–805. https://doi.org/10.1056/NEJMoa1005419
  10. Ellison, D. H., & Felker, G. M. (2017). Diuretic treatment in heart failure. New England Journal of Medicine, 377(20), 1964–1975. https://doi.org/10.1056/NEJMra1703100
  11. Pressler, R. M., Boylan, G. B., Marlow, N., et al. (2015). Bumetanide for the treatment of seizures in newborn babies with hypoxic ischaemic encephalopathy (NEMO): an open-label, dose finding, and feasibility phase 1/2 trial. The Lancet Neurology, 14(5), 469–477. https://doi.org/10.1016/S1474-4422(14)70303-5
  12. Narasimhulu, S. S., Williams, B., Kelly, B., et al. (2025). Retrospective evaluation of dosing effects of bumetanide continuous infusions in the Pediatric Cardiac Intensive Care Unit. The Journal of Pediatric Pharmacology and Therapeutics, 30(5), 617–622. https://doi.org/10.5863/jppt-24-00050

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