Can You Take Bumex And Lasix Together?
In our latest question and answer, our pharmacist discusses the problem of combining Lasix and Bumex.
I’m taking bumetanide 1mg and furosemide 20 mg from 2 different doctors. Should I be taking both since they are both basically Lasix?
Jun 20, 2023- Bumex and Lasix are both loop diuretics that work the same way in the body, so they are not typically combined together.
- If you have prescriptions for both medications from different doctors, you should speak with your pharmacist or doctors to clarify what you are supposed to be taking.
- While doctors sometimes combine different types of diuretics to overcome diuretic resistance, using two diuretics from the same class is considered therapeutic duplication and should be addressed.
Quick Answer
Bumex (bumetanide) and Lasix (furosemide) are generally not combined as they are both loop diuretics. If you received prescriptions for these from two different doctors, be sure to speak with them to clarify or at the very least speak to your pharmacist so they can help clear up what your medication regimen is supposed to be.
Detailed Answer
As mentioned in the 'quick answer', Bumex and Lasix are both loop diuretics. In fact, Bumex is structurally related to Lasix but Bumex is about 40 times more potent on a milligram-to-milligram basis.
Loop diuretics, overall, have a similar effect on the body when given at equivalent doses. For instance, if a person with normal kidney function takes 40 mg of furosemide, it would be roughly the same as taking 1 mg of bumetanide.
Dosing does need adjusting in certain situations, however. For example, if someone has impaired kidney function, the ratio changes to around 20:1 for furosemide and bumetanide due to increased clearance of bumetanide outside the kidneys in these individuals.
Now, it would be very unlikely that two loop diuretics are used together but it's certainly not uncommon that diuretics from different classes are used together due to what is known as diuretic resistance.
Diuretic Resistance
Diuretic resistance is a common problem, especially in the treatment of severe congestive heart failure (CHF) when excess fluid builds up in the body.
Loop diuretics, like Bumex and Lasix, may become less effective over time due to an adaptation of a specific part of the kidney called the distal tubule. Studies in animals have shown that when loop diuretics are given, the distal tubule adapts by becoming more efficient at reabsorbing sodium.
This means that even with the diuretic, the kidneys still hold on to more sodium and water, leading to the persistence of fluid retention.
To overcome diuretic resistance, doctors have found that combining different types of diuretics can be helpful.
One effective combination is using a loop diuretic along with a thiazide diuretic (such as hydrochlorothiazide), which works on a different part of the kidney called the distal tubule. By targeting multiple areas, these diuretics can work together to enhance the removal of excess fluid from the body.
Use Of Lasix And Bumex
So, circling back here, while it's relatively common practice to use two different diuretics from different classes in certain situations, it's not common to use two from the same class (like Lasix and Bumex) since they work the same way, and in the same part of the kidney.
Without more information or context, it seems like you have a situation where two different doctors are prescribing the same kind of drug for your condition without communication with one another.
On the surface, it looks like a therapeutic duplication that should be addressed before you start taking both meds.
Final Words
Thanks for contacting us and I hope this helped!
References & sources
Glossary — Terms in This Answer
- Loop diuretics
- Medications that increase urine production by working on a specific part of the kidney called the loop of Henle to help remove excess fluid from the body.
- Potent
- Having a strong or powerful effect, meaning a smaller dose is needed to produce results.
- Impaired kidney function
- A condition where the kidneys are not working properly and cannot filter waste and fluids from the blood as effectively as normal.
- Clearance
- The process by which the body eliminates a drug, either through the kidneys or other organs.
- Diuretic resistance
- A condition where diuretic medications become less effective over time at removing excess fluid from the body.
- Distal tubule
- A part of the kidney's filtering system that reabsorbs sodium and water back into the bloodstream.
- Congestive heart failure
- A medical condition where the heart cannot pump blood effectively, causing fluid to build up in the body.
- Thiazide diuretic
- A type of water pill that works on a different part of the kidney than loop diuretics to help remove excess fluid and salt.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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