PO: 0.5-2 mg once; may be repeated in 4-5 hours for up to 2 doses; not to exceed 10 mg/day IM: 0.5-1 mg once; may be repeated in 2-3 hours for up to 2 doses; not to exceed 10 mg/day IV: 1 mg initially, then 0.5-2 mg/hr In general, dosage selection for elderly should be cautious, usually starting at low end of dosing range, in view of higher incidence of decreased hepatic, renal, or cardiac function and greater frequency of concomitant disease or other drug therapy Hyponatremia (9%) Hyperglycemia (7%) Increased serum creatinine (7%) Variations in phosphorus (5%) Variations in CO2 content (4%) Variations in bicarbonate (3%) Variations in calcium (2%) Dizziness (1%) Muscle cramps (1%) Ototoxicity (1%) Agent is potent diuretic that, if given in excessive amounts, may lead to profound diuresis with water and electrolyte depletion Careful medical supervision is required; dosing must be adjusted to patient's needs Risk of electrolyte imbalance, alterations in glucose metabolism, blood dyscrasias, development of oliguria or increased blood urea nitrogen (BUN) or creatinine, hepatic disease, hyperuricemia, hypomagnesemia, hypovolemia, neonates at risk for kernicterus Hypokalemia may occur; close medical supervision and dose evaluation required; may need potassium supplementation and/or use of potassium-sparing diuretics to prevent hypokalemia; loop diuretics can also decrease serum calcium levels; electrolyte disturbances can predispose a patient to serious cardiac arrhythmias Risk of ototoxicity with rapid IV administration Fluid status and renal function should be monitored to prevent oliguria, increased creatinine and BUN, and azotemia Avoid use in neonates at risk for kernicterus; drug is a potent displacer of bilirubin in neonates If given the morning of surgery, drug may render patient volume depleted and blood pressure may be labile during general anesthesia Use with caution in patients with cirrhosis Coadministration with antihypertensive agent may increase risk of hypotension The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Hospital admission for congestive heart failure is extremely common and quite expensive, although it is frequently preventable. New drugs and therapies have been reported to reduce admissions, decrease morbidity and mortality, and improve the quality of life for these patients. Patients with an ejection fraction less than 40 percent (decreased systolic function) should be treated with medication to improve symptoms and prevent progression of heart failure. Angiotensin-converting enzyme (ACE) inhibitors are a mainstay of treatment in patients who can tolerate them; in patients who cannot take these drugs, angiotensin II receptor blocking agents offer an alternative. Patients with New York Heart Association class II or III heart failure should also receive a beta blocker (metoprolol, carvedilol or bisoprolol). Recent research has shown that treatment with spironolactone improves mortality and hospital readmission rates. An exercise program should also be recommended for all patients with heart failure unless their condition is unstable.
Bumex is a loop diuretic with a rapid onset and short duration of action. Pharmacological and clinical studies have shown that 1 mg Bumex has a diuretic potency equivalent to approximately 40 mg furosemide. The major site of Bumex action is the ascending limb of the loop of Henle. Bumex and Lasix are brand name diuretics used to treat edema. Edema is the swelling of certain areas, usually the hands and legs, that can occur from congestive heart failure, liver cirrhosis, and renal disease.