bumetanide / Generic mfg. - LARVOL DELTA

Hydroelectrolytic syndromes in neuroanesthesia and neurocritical care. (PubMed, World J Crit Care Med) - "Chloride dysregulation, driven by cation-chloride cotransporter imbalances, exacerbates cytotoxic edema and seizures, warranting trials of bumetanide and balanced crystalloids...Innovations such as point-of-care testing and targeted therapies (e.g., acetate-buffered hypertonic saline) show promise, yet reliance on observational data and preclinical models highlights the urgency for randomized controlled trials. This review advocated for protocolized monitoring, dynamic assessments, and research to define optimal correction thresholds and validate emerging interventions in this high-risk population."

Journal • Review • Cardiovascular • CNS Disorders • Critical care • Endocrine Disorders • Epilepsy • Heart Failure • Hematological Disorders • Subarachnoid Hemorrhage • Vascular Neurology

Predicting Pharmacokinetics of Drugs in Patients with Heart Failure and Optimizing Their Dosing Strategies Using a Physiologically Based Pharmacokinetic Model. (PubMed, Pharmaceutics) - "Eight commonly used drugs (digoxin, furosemide, bumetanide, torasemide, captopril, valsartan, felodipine and midazolam) for treating HF and its comorbidities were selected. A PBPK model was successfully developed to predict the plasma concentration-time profiles of the eight tested drugs in both healthy subjects and HF patients. Furthermore, this model may also be applied to guide digoxin dose optimization for HF patients."

Journal • PK/PD data • Cardiovascular • Congestive Heart Failure • Heart Failure

Is KCC2 activation more effective than NKCC1 inhibition for the treatment of seizures? (AES 2025) - " We compared the net effects of the NKCC1 inhibitor bumetanide, the putative KCC2 activator CLP257 and the WNK-SPAK/OSR1 inhibitor WNK463 that reciprocally inhibits NKCC1 and activates KCC2 activity on [Cl-]i elevation and extrusion rates during spontaneous ictal-like discharges, and the correlation between ionic and electrographic effects... In the context of seizure treatment, neither NKCC1 antagonists nor putative KCC2 activators are more "effective" than the other, and the best approach depends on the severity of seizures and the rate of chloride elevation. Our findings also demonstrate that mutual NKCC1 inhibition and KCC2 activation via the regulatory WNK-SPAK/OSR1 pathway exerts powerful anti-ictal effects by facilitating [Cl-]i extrusion and provide a coherent understanding of the role of WNK-SPAK/OSR1 kinase and cation-chloride co-transport activity in neuronal chloride homeostasis, GABA signaling and ictogenesis."

Cardiovascular • CNS Disorders • Epilepsy • Vascular Neurology

The Proof is in the Pillbox: An Elusive Case of Cardiomyopathy (AHA 2025) - "A 63-year-old female with mixed connective tissue disease on long-term immunosuppression (prednisone, azathioprine, hydroxychloroquine (HCQ)) was referred to a tertiary care center for evaluation of progressive dyspnea and exertional chest discomfort...Catheterization revealed severe pulmonary hypertension and elevated filling pressures, without significant coronary disease.Medical treatment included empagliflozin (discontinued due to urosepsis), bumetanide, spironolactone, and metoprolol succinate...Multimodal imaging and biopsy are crucial for diagnosis. Early recognition is essential to prevent irreversible myocardial damage and improve long-term outcomes."

Clinical • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Fibrosis • Heart Failure • Immunology • Inflammation • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Rheumatology • Ventricular Tachycardia

Intranasal bumetanide in heart failure: Innovation ahead of evidence. (PubMed, Br J Clin Pharmacol) - No abstract available

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

A Case of Steven-Johnson Syndrome Secondary to Bumetanide. (PubMed, Cureus) - "Bumetanide, which is a loop diuretic often prescribed for edema associated with heart, liver, and kidney conditions, is a sulfonamide-containing drug that has been linked to severe cutaneous adverse reactions (SCARs). This case report details a confirmed instance of SJS secondary to bumetanide administration in a 64-year-old gentleman. Prompt identification, discontinuation of the offending agent, and supportive care led to gradual recovery."

Journal • Allergy • Immunology • Nephrology • Steven-Johnson Syndrome

Cardiac Cachexia: A Case of Esophageal Compression (AHA 2025) - "The patient was started on a milrinone infusion and treated with intravenous bumetanide.A nasogastric feeding tube was inserted for tube feeds. As the patient also suffers chronic heart failure, cardiac cachexia was likely a significant contributor to the patient's weight loss. Early recognition and intervention are crucial to improving quality of life and survival."

Clinical • Atrial Fibrillation • Cachexia • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Gastrointestinal Disorder • Heart Failure • Hypertrophic Cardiomyopathy • Obstructive Hypertrophic Cardiomyopathy • Pulmonary Disease

Administration of bumetanide after spinal cord injury mutes the effect of nociceptive stimulation, reducing plastic potential and pain-induced tissue loss (Neuroscience 2025) - "The latter appears to contribute to tissue loss after a contusion injury. Importantly, this adverse effect is blocked by a drug treatment known to restore GABA inhibition."

CNS Disorders • Neuralgia • Pain

Intergenerational neurocognitive disorder induced by the general anesthetic sevoflurane: underlying mechanisms and pharmacological prevention strategies (Neuroscience 2025) - "We hypothesized that (1) repeated exposure to the general anesthetic sevoflurane upregulates the hypothalamic-pituitary-adrenal (HPA) axis and inflammation via the excitatory NKCC1/GABA type A receptor (GABAAR) pathway in hypothalamic arginine vasopressin (AVP)-producing neurons, creating a perpetuating feedback loop that sustains HPA axis activation, inflammation, and neurocognitive deficits in both exposed rats and their offspring; (2) the NKCC1 inhibitor bumetanide or the glucocorticoid receptor (GR) antagonist RU486 disrupt this loop, providing therapeutic benefits...NKCC1 and GRs may serve as potential targets for the pharmacological prevention of PND. Considering the feasibility of non-invasive gut microbiome sampling, gut microbiota changes have the potential to serve as biomarkers of intergenerational PND in humans."

CNS Disorders • Cognitive Disorders • Psychiatry • FOS • SLC12A2

Periprocedural Volume Management After Ablation: A Missed Opportunity in Electrophysiology. (PubMed, JACC Adv) - No abstract available

Journal • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure

Terlipressin for Sinusoidal Obstruction Syndrome: Expanding Indications Beyond Cirrhotic Hepatorenal Syndrome (KIDNEY WEEK 2025) - "Case Description A 45-year-old woman with B-cell acute lymphoblastic leukemia underwent matched related donor allogeneic HCT following inotuzumab ozogamicin exposure, placing her at high risk for SOS. She received reduced-intensity conditioning and post-transplant cyclophosphamide...Prior to dialysis initiation, she received terlipressin (0.85 mg IV q6h) and continuous bumetanide infusion...Despite standard therapy with defibrotide and diuretics, she progressed to severe fluid overload and impending dialysis...As dialysis in HCT carries >80% mortality, early reversal is critical. This is the first reported case of successful terlipressin use in SOS-AKI."

Acute Kidney Injury • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Hepatology • Hypotension • Leukemia • Liver Failure • Nephrology • Portal Hypertension • Renal Disease

Shredding 35kg: The Dramatic Effect of Diuresis (KIDNEY WEEK 2025) - "Due to rising creatinine (peaked to 5.2), alkalosis requiring acetazolamide (HCO 3 39), and persistent congestion, therapy was escalated to continuous IV bumetanide at 1 mg/h, targeting 3-4 L/day urine output. This case shows early intensive diuresis can be both effective and safe when closely monitored, even with initial worsening renal function. UOP vs Weight"

Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Metabolic Disorders • Nephrology • Pulmonary Disease • Renal Disease

Effects of Sodium-Free Chloride Supplementation on Cardiorenal Function in Chronic Heart Failure (KIDNEY WEEK 2025) - "Methods Patients with stable, euvolemic HF and serum chloride 40mg of oral furosemide/day were randomized in a double-blind, placebo-controlled, crossover trial of 5 days of lysine chloride (165mmol/day in 3 divided doses) or matching placebo...Secondary outcomes were change in natriuresis to IV bumetanide and the ability to renally excrete a saline load...Conclusion Sodium-free chloride supplementation improved total blood volume, diuretic-induced natriuresis, and ability to excrete a sodium load without worsening kidney function. These proof-of-concept results indicate chloride supplementation may modulate renal salt sensing and improve volume status and sodium avidity in human HF."

Late-breaking abstract • Cardiovascular • Congestive Heart Failure • Heart Failure • CST3

Primary or Secondary? A Diagnostic Dilemma in Tip Lesion FSGS (KIDNEY WEEK 2025) - "Diclofenac tablets were discontinued, and she was managed conservatively with telmisartan, bumetanide, and dietary sodium restriction. Although the biopsy showed features typical of primary FSGS (tip lesion and diffuse podocyte effacement), the clinical context pointed to a secondary NSAID-induced cause. Moving forward, a more precise classification system is needed to better distinguish subtypes as this is crucial in guiding appropriate management."

Focal Segmental Glomerulosclerosis • Glomerulonephritis • Nephrology • Pulmonary Disease • Renal Disease

Bumetanide Nasal Spray: First Approval. (PubMed, Clin Drug Investig) - "Bumetanide nasal spray received its first approval on 12 September 2025 in the USA for the treatment of oedema associated with congestive heart failure (CHF), and hepatic and renal disease, including nephrotic syndrome in adults. This article summarizes the milestones in the development of bumetanide nasal spray leading to this first approval for the treatment of oedema."

Journal • Review • Cardiovascular • Congestive Heart Failure • Glomerulonephritis • Heart Failure • Nephrology • Renal Disease

Comparing Loop Diuretic Efficacy and Safety in Patients with Acute Myeloid Leukemia and Differentiation Syndrome (ASH 2024) - "Patients were treated with furosemide (n=2,431), bumetanide (n=466), or torsemide (n=206), alongside glucocorticoids and allopurinol. This may be due to bumetanide's higher potency, rapid absorption, and shorter half-life, potentially increasing the risk of electrolyte imbalances and acute kidney injury. Conversely, furosemide may facilitate greater cumulative sodium excretion in patients with chronic renal insufficiency."

Clinical • Acute Kidney Injury • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Heart Failure • Hematological Malignancies • Hypertension • Leukemia • Metabolic Disorders • Nephrology • Oncology • Renal Disease

Safety and Feasibility of Intra-Arterial Treatment of Pancreatic Cancer Using an Emulsion of Ethiodized Oil plus Bumetanide in an Oncopig Model. (PubMed, J Vasc Interv Radiol) - "Intra-arterial injection of BU/Lipiodol emulsion is safe and feasible in treating pancreatic tumor in a transgenic porcine model."

Journal • Oncology • Pancreatic Cancer • Pancreatitis • Solid Tumor • KRAS

A Case Of DRESS From Bumetanide (ACAAI 2025) - "She was incidentally found to have acute cystitis and was started on ceftriaxone empirically. It should be considered in patients with new drug exposure within 2 to 8 weeks of rash onset. While bumetanide is not commonly implicated, it should not be excluded as a causative agent."

Clinical • Chronic Kidney Disease • Eosinophilia • Immunology • Nephrology • Renal Disease

Cardiogenic Shock due to Flecainide Toxicity: No substitute for time. (AHA 2025) - "Treatment of flecainide toxicity included sodium bicarbonate boluses, anti-tachycardia pacing, synchronized cardioversion, and amiodarone infusion...Cardiogenic shock was managed with bumetanide infusion and placement of an intra-aortic balloon pump...The patient did not tolerate milrinone due to hypotension and tachycardia...None of the antiarrhythmic strategies were immediately successful at restoring sinus rhythm. Ultimately, the most successful strategy was tincture of time to allow for flecainide clearance and the patient recovered."

Acute Kidney Injury • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension • Nephrology • Pulmonary Disease • Renal Disease

BUFF: Bumetanide vs. Furosemide in Cirrhosis (clinicaltrials.gov) - P3 | N=500 | Not yet recruiting | Sponsor: Stacy Johnson | Trial completion date: Oct 2027 ➔ Mar 2029 | Initiation date: Oct 2025 ➔ Mar 2026 | Trial primary completion date: Oct 2027 ➔ Mar 2029

Trial completion date • Trial initiation date • Trial primary completion date • Fibrosis • Immunology

The Efficacy and Safety of Bumetanide in Children with Autism Spectrum Disorder: An Updated Meta-analysis. (PubMed, Eur Child Adolesc Psychiatry) - "The treatment of ASD is challenging since there are no approved drugs except for risperidone and aripiprazole, which have a limited effect on core symptoms and are associated with a wide range of adverse events. Common adverse events include polyurea, hypokalemia, and dehydration. Although statistically significant improvements were observed on some measures, we cannot conclude the superiority of bumetanide in alleviating ASD symptoms. Further large clinical trials should be conducted to determine the effect of bumetanide on different symptoms of ASD and the variation in treatment effect among different patient populations."

Journal • Retrospective data • Review • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Genetic Disorders • Psychiatry

Outpatient loop diuretic use and the effect of natriuresis-guided diuretic therapy: A prespecified sub-analysis of the PUSH-AHF study. (PubMed, Eur J Heart Fail) - "Outpatient LD use results in reduced natriuresis. However, the beneficial effects of natriuresis-guided diuretic therapy on 24-h natriuresis were consistent, regardless of previous LD use."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Extracellular vesicles-mediated delivery of bumetanide alleviates depressive-like behaviors of male mice via restoring chloride homeostasis. (PubMed, Mol Ther) - "Additionally, extracellular vesicles (EVs) derived from bumetanide-treated HEK-293T cells and engineered with acetylcholine receptor (AChR)-specific rabies virus glycoprotein (RVG) peptides, when injected via the tail vein, were found to alleviate depressive symptoms. These results suggest that KCC2-mediated chloride homeostasis plays a key role in depression pathology and bumetanide can be used to treat depression."

Journal • Preclinical • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry

RIGHT-SIDED PULMONARY EDEMA: A POSTOPERATIVE COMPLICATION FOLLOWING CABG AND AORTIC VALVE REPLACEMENT THROUGH MEDIAN STERNOTOMY (CHEST 2025) - "Epinephrine and vasopressin were added for further hemodynamic assistance, as well as doses of both IV furosemide and IV bumetanide...He continued to have good urine output and remained on milrinone... In this case, post-cardiac surgery through median sternotomy, UPE was successfully treated with rapid initiation of aggressive pulmonary hygiene in addition to pharmacological and ventilator management."

Acute Lung Injury • Anesthesia • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease • Diabetes • Dyslipidemia • Hypertension • Immunology • Inflammation • Metabolic Disorders • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Systemic Inflammatory Response Syndrome • Type 2 Diabetes Mellitus

FROM BRADYCARDIA TO SHOCK: NAVIGATING THE BRASH SYNDROME CASCADE (CHEST 2025) - "CASE PRESENTATION: A 79-year-old male with a history of hypertension (on metoprolol succinate, losartan, spironolactone), dilated cardiomyopathy, T2DM, and hypothyroidism presented to ED after being found unresponsive by family members...Initiated Levophed and epinephrine, 2 g IV calcium gluconate. Eventually started on IV bumetanide but ultimately had a temporary HD catheter placed secondary to volume overload not responsive to diuretics... Diagnosis of BRASH syndrome is not always clear and straightforward, and it requires a comprehensive integration and evaluation of a patient's medical history, medication regimen, and clinical presentation. In addition to treating individual components of BRASH, recognizing the synergistic pathophysiology involved is critical for proper management."

Cardiomyopathy • Cardiovascular • Endocrine Disorders • Hypertension • Hypoglycemia • Hypotension • Renal Disease • Type 2 Diabetes Mellitus