Bumecard 2 Injection

What is Bumecard Injection?

Bumecard Injection contains Bumetanide, a potent loop diuretic given by injection for rapid relief of fluid overload when oral therapy is not practical or a fast onset of action is required. It is used to treat fluid retention (edema) associated with congestive heart failure, liver disease, and kidney disease, including nephrotic syndrome. 1 mg of Bumetanide has a diuretic potency roughly equivalent to 40 mg of furosemide.

Indications

Bumecard Injection is indicated for the treatment of edema associated with congestive heart failure, hepatic disease, and renal disease, including the nephrotic syndrome, particularly where a rapid diuretic effect is needed or oral administration is not feasible.

Pharmacology

Bumetanide is a loop diuretic that acts primarily at the ascending limb of the loop of Henle, inhibiting sodium and chloride reabsorption. It may also have an additional action in the proximal tubule, evidenced by phosphaturia during diuresis, though this is not related to carbonic anhydrase inhibition. Bumetanide does not appear to have a noticeable effect on the distal tubule.

Dosage & Administration

By IV Injection: 1-2 mg, repeated after 20 minutes if necessary.
By IV Infusion: 2-5 mg over 30-60 minutes.
By IM Injection: 1 mg initially, then adjusted according to response.
Injection is generally reserved for situations where oral therapy is impractical, such as in patients with severe edema, gastrointestinal malabsorption, or in emergency settings. Safety and effectiveness in paediatric patients below 18 years have not been established.

Interaction

Should generally not be combined with lithium (reduces renal clearance, raising toxicity risk). Should not be administered with probenecid. Concurrent therapy with indomethacin is not recommended. May potentiate the effect of antihypertensive drugs, requiring dose adjustment. No significant interaction observed with digoxin or warfarin in human studies.

Contraindications

Loop diuretics should be avoided in severe hypokalaemia, severe hyponatraemia, anuria, and comatose or precomatose states associated with liver cirrhosis, as well as in renal failure.

Side Effects

Muscle cramps, dizziness, hypotension, headache, nausea. Less commonly: ECG changes, musculoskeletal pain, abdominal pain, renal failure, and thrombocytopenia. Rapid IV administration may increase the risk of transient hypotension.

Pregnancy & Lactation

Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. It is not known whether this drug is excreted in human milk.

Precautions & Warnings

Serum potassium should be measured periodically, with potassium supplements or potassium-sparing diuretics added if necessary. Overdosage can lead to acute profound water loss, electrolyte depletion, dehydration, and circulatory collapse with possible vascular thrombosis and embolism; treatment involves careful fluid and electrolyte replacement with monitoring. Use with caution in elderly and hepatically impaired patients.

Therapeutic Class

Loop diuretics.

Storage Conditions

Store below 30°C temperature, protected from light. Do not freeze. Keep out of the reach of children.