Medicinal preparation Bumex (Bumetanide) (the international non-proprietary name) is intended for the removal of puffiness in heart failure and hypertension, and is also used as an effective antiepileptic agent.
Lasix (Furosemide) is effectively used for the removal of excessive water from the body. What is the differenece between these diuretics from one group of drugs? Let's have a closer look at them in this article.
What is Bumex?
Bumex (Bumetanide) belongs to the class of organotropic drugs that regulate the function of the organs of the genitourinary system. This drug is a diuretic and is classified as an extrarenal acid-forming diuretic. It is a white microcrystalline powder, insoluble in water, and sparingly soluble in alcohol.
The active substance is almost completely absorbed into the bloodstream, since its bioavailability is up to 80%, and has a diuretic effect on the kidneys. The reaction occurs in the thick ascending part of the Henle loop, which connects the proximal and distal tubules of the nephron (the structural and functional unit of the kidney).
The action of the drug occurs in several directions:
• It blocks the transport of chlorine, reducing its concentration in cells, and also inhibits the reverse absorption (reabsorption) from the primary urine into the bloodstream of sodium, calcium, potassium and magnesium.
• The active substance is able to slightly slow down the formation of carbonic anhydrase, which increases the excretion of bicarbonate salts (HCO3) from the body.
• Promotes the expansion of peripheral veins, restores their blood filling.
• Reduces pressure in the pulmonary artery and normalizes blood filling in the left ventricle of the heart.
• A low concentration of chlorine hyperpolarizes gamma-a minobutyric acid, which helps suppress convulsive syndrome in infants, in the neonatal period.
It is taken orally, usually in the morning before eating, 0.001 1 time a day, for 3-5 days, then 0.001-0.002 g once every 2-3 days. Single dose increase to 0.002 g in the absence of the desired effect. The highest daily dose is 0.006 g. Intramuscular injection is of 2-4 ml of 0.25%.
Intravenously injected slowly for 2-3 minutes, the drug diluted with 20 ml of isotonic sodium chloride solution or 5% glucose solution. The highest daily dose for parenteral administration is 0.005 g.
In chronic renal failure, it is intravenously administered drip for 30-60 minutes at a dose of 0.002-0.005 g (dissolved in 500 ml of 0.9% sodium chloride solution). If necessary, repeat the infusion in the same dose after 6-8 hours.
Are Bumex and Lasix the Same medications?
The action of these diuretics after IV introduction usually starts after 15-30 minutes, and after oral administration - after 30-60 minutes. By the severity of the diuretic effect they are located as follows: bumetanide, furosemide. Both drugs are from the same category of diuretics. Let's check how they work.
This group of drugs, especially with IV injections, along with diuretic causes a number of hemodynamic changes: decrease in preload, reduction of end-diastolic pressure (CDA) and, of course, diastolic volume (BWW) in the LV, pressure drop in a small circle of blood circulation . In addition, there is a decrease in the volume of extracellular fluid and the work of the respiratory apparatus.
Bioavailability of loop diuretics in healthy people varies from 50 to 90% (bumetanide, piretanide) and 11-90% (furosemide). The maximum concentration of diuretics in the blood is established after about an hour. Half-life is about an hour. Bumex is metabolized in the liver. It is possible to stimulate metabolism with other drugs, as well as suppress it. Apparently, there are individual features of the diuretic effect. Metabolites of bumetanide do not have pharmacological activity.
Bumetanide does not accumulate with uremia. About 50% of furo-seven is excreted unchanged in urine, 20% in the form of glucuronides. Furosemide has only a renal elimination pathway and accumulates in the body with uremia.
It is applied with edema of various origins and arterial hypertension. Issue in ampoules of 0.25 mg and in tablets of 1 mg. It is recommended to take it inside 1-2 mg in the morning on an empty stomach. If the dose is ineffective, you can increase it gradually. A maintenance dose should be from 0.20 to 5 mg per day by intravenous injection of 0.5-1.0 mg.
What Are Possible Side Effects of Bumex?
Strictly not recommended simultaneous reception with cardiac glycosides, as increased intoxication. It is forbidden to use the drug in acute renal and hepatic insufficiency, type 1 and type 2 diabetes, hearing impairment, acute heart failure, acute pancreatitis, in the first trimester of pregnancy.
Note: In the elderly, taking medication can provoke acute heart failure. In some patients, there were side effects. Among unpredictable reactions, the following manifestations are observed:
• From the side of water-electrolyte metabolism: hyponatremia, hypokalemia, hypochloraemic alkalosis.
• From the cardiovascular system: arterial hypotension up to orthostatic collapse, arrhythmia.
• On the part of the digestive system: dry mouth, thirst, abdominal pain, nausea, vomiting, anorexia, diarrhea, impaired liver function (icterus sclera, skin), pancreatitis.
• From the side of metabolism: hyperuricemia, hyperglycemia, azotemia, increased concentration of creatinine.
• From the central and peripheral nervous system: dizziness, headache.
• From the musculoskeletal system: muscle spasms, myalgia, convulsions, pain in the joints (with exacerbation of gout).
• On the part of the hematopoiesis system: leukopenia or agranulocytosis, thrombocytopenia.
• From the sense organs: hearing impairment, visual impairment.
• Dermatological reactions: itchy skin.
• Allergic reactions: urticaria.
When taking Bumetanide in high doses, hearing loss and visual disturbances are possible (loss of vision clarity). In rare cases, there may be allergic reactions, in the form of pruritus and urticaria. In men, side effects can appear, in the form of accelerated ejaculation and erectile dysfunction.
Bumex or Lasix: what is best for me?
Such loop diuretics as furosemide and bumetanide are characterized by a rapid but short-lived diuretic effect, which increases with increasing doses. After oral administration, the diuretic effect occurs within 30-60 minutes and lasts 4-9 hours; after intravenous administration, the effect develops within 5-15 minutes and lasts 2-3 hours.
In this regard, loop diuretics are used in emergency cases, for example, with pulmonary edema or hypertensive crisis. After the cessation of the diuretic effect, the rate of excretion of sodium ions in the urine from the body decreases to a level below the initial "ricochet phenomenon".
In this regard, when taken once a day loop diuretics can not have a significant effect on the daily release of sodium ions and, accordingly, are not effective enough as antihypertensive drugs. To achieve removal of sodium ions from the body, short-acting loop diuretics are prescribed 2 times a day. The drugs are very similar as they belong to one category having the same possible side effects and contraindications.
You need to consult your doctor to make sure that you don't have individual intolerance to one of the main components of the drugs.