Nurphex. Bumex

Urinary and biliary metabolites identified in this study were formed by oxidation of the N-butyl side chain	Mean serum half-life of bumetanide was 2
Biliary excretion of Bumex amounted to only 2% of the administered dose	Probenecid Pretreatment with probenecid reduces both the natriuresis and hyperreninemia produced by Bumex

Therefore, careful medical supervision is required, and dose and dosage schedule have to be adjusted to the individual patient's needs see.

Bumex: Laboratory Tests Studies in normal subjects receiving Bumex revealed no adverse effects on glucose tolerance, plasma insulin, glucagon and growth hormone levels, but the possibility of an effect on glucose metabolism exists
Bumex: Bumetanide was not teratogenic when given intravenously to mice and rats at doses up to 140 times the maximum human therapeutic dose
Bumex: Following oral administration of Bumex the onset of diuresis occurs in 30 to 60 minutes

Treatment consists of replacement of fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels	Urine flow rate peaked during the first hour after drug administration in 80% of patients and by 3 hours in all patients
Other reported clinical experience has not identified differences in responses between the elderly and younger patients	Concurrent therapy with Bumex is thus not recommended

Nonrenal clearance, bioavailability, and volume of distribution were not significantly different between the two groups.

Bumex: If the diuretic response to an initial dose of Bumex tablets is not adequate, in view of its rapid onset and short duration of action, a second or third dose may be given at 4- to 5-hour intervals up to a maximum daily dose of 10 mg
Bumex: Hypokalemia Hypokalemia can occur as a consequence of Bumex administration
Bumex: This antagonistic effect of probenecid on Bumex natriuresis is not due to a direct action on sodium excretion but is probably secondary to its inhibitory effect on renal tubular secretion of bumetanide

Patients under treatment should be observed regularly for possible occurrence of blood dyscrasias, liver damage or idiosyncratic reactions, which have been reported occasionally in foreign marketing experience	Bumex may increase urinary calcium excretion with resultant hypocalcemia
Pregnancy Teratogenic Effects Bumex is neither teratogenic nor embryocidal in mice when given in doses up to 3400 times the maximum human therapeutic dose	There are no adequate and well-controlled studies in pregnant women

In patients with hepatic failure, keep the dosage to a minimum.

Bumex: Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function
Bumex: Bumex was not teratogenic in the hamster at an oral dose of 0
Bumex: A study using pooled sera from critically ill neonates found that bumetanide at concentrations of 0