Dose:  0.1 mg/kg/dose IV
            0.02 to 0.1 mg/kg/dose PO

Frequency: Q 12 hours IV
                     Q 6 to 12 hours PO

Comments: Bumetanide is a "loop" diuretic that is 40 times more potent than furosemide at an equivalent dose.  Though equally effective as a diuretic, greater amounts of calcium and magnesium are lost in the urine.   Bumetanide is more expensive than furosemide and does not appear to offer substantive advantages over furosemide.  However, in circumstances when furosemide is unsuccessful, bumetanide may be effective.  It also has a more prolonged diuretic effect. 

Preparation:
IV: Bumetanide (Bumex) is available in a 2 ml ampule with a concentration of 0.25 mg/ml. Dilute using D5W, NS, or LR. The solution is stable for 24 hours, with or without refrigeration.

PO: An extemporaneous solution will need to be formulated using a 0.5 mg tablet.

Compatibility: No information available on filter or TPN. Compatible with allopurinol, astreonam, doxapram, filgrastim, furosemide, lorazepam, morphine, piperacillin-tazobactam, and propofol.  Incompatible with dobutamine and midazolam.