What are the precautions for Bumetanide Nasal Spray (Bumetanide)-Enbumyst

In clinical studies of Bumetanide Nasal Spray (Bumetanide) - Enbumyst for the treatment of edema associated with congestive heart failure and hepatic and renal disease (including adult nephrotic syndrome), warnings and precautions emerged regarding fluid, electrolyte and metabolic abnormalities, worsening renal function, ototoxicity, and potential altered absorption in patients with nasal mucosal or structural abnormalities. Discontinue and resume at reduced dose upon recovery, or permanently discontinue based on severity.

1. Fluid, electrolytes and metabolic abnormalities

Bumetanide may cause fluid, electrolyte, and metabolic abnormalities such as hypovolemia, hypokalemia, azotemia, hyponatremia, hypochloremic alkalosis, hypomagnesemia, hypocalcemia, hyperglycemia, or hyperuricemia, particularly in patients receiving higher doses, patients with insufficient oral electrolyte intake, and elderly patients. Excessive diuresis may lead to dehydration and volume depletion with circulatory collapse and may lead to vascular thrombosis and embolism, especially in elderly patients. Serum electrolytes, CO2, BUN, creatinine, glucose, and uric acid should be monitored frequently during bumetanide treatment.

2. Deterioration of kidney function

Bumetanide can cause dehydration and azotemia. Bumetanide should be discontinued if azotemia and increased oliguria develop during treatment of severe progressive renal disease.

3. Ototoxicity

Tinnitus and hearing loss (usually reversible) have been reported with loop diuretics includingBumetanide. Reports indicate that ototoxicity is associated with rapid injection, severe renal impairment, use of higher than recommended doses of the drug, hypoalbuminemia, or concomitant use of aminoglycoside antibiotics, etanin, or other ototoxic drugs.

4. Potential altered absorption in patients with nasal mucosal or structural abnormalities

ENBUMYST has not been evaluated in individuals with nasal mucosal or structural abnormalities. Avoid use in patients with significant nasal mucosal or structural abnormalities, such as acute exacerbations of rhinitis or congestion from any cause. Consider alternative products or therapies for these patients.

Reference materials:https://www.drugs.com/enbumyst.html