Conart 1

Indications

Conart is prescribed for managing edema related to conditions such as congestive heart failure, liver disease, kidney disorders, and nephrotic syndrome.
Always use as directed by a registered healthcare professional.

Pharmacological Profile

Bumetanide, the active ingredient in Conart, is a potent loop diuretic known for its quick onset and brief duration of action. Clinical research demonstrates that a 1 mg dose of Bumetanide has diuretic effects comparable to 40 mg of furosemide. The primary site of action is the ascending limb of the loop of Henle, where Bumetanide inhibits sodium and chloride reabsorption.

Additionally, Bumetanide may exert an effect in the proximal tubule, causing phosphate excretion during diuresis, suggesting an extra renal action. However, this effect is not linked to carbonic anhydrase inhibition, and Bumetanide does not significantly impact the distal tubule.

Dosage and Administration

• Oral: 1 mg in the morning. If necessary, repeat after 6-8 hours. For severe cases, start with 5 mg daily and adjust by 5 mg every 12-24 hours as needed. In elderly patients, 500 micrograms per day may suffice.
• Intravenous (IV) Injection: 1-2 mg, with a repeat dose after 20 minutes if required. Elderly patients may need only 500 micrograms (1 ml of Bumecard) daily.
• IV Infusion: 2-5 mg over 30-60 minutes. Elderly patients typically need 500 micrograms (1 ml of Bumecard) daily.
• Intramuscular (IM) Injection: Start with 1 mg, adjusting the dose according to response. Elderly patients may only require 500 micrograms (1 ml of Bumecard) daily.

Pediatric Use

The safety and effectiveness of Bumetanide in children under 18 have not been established.
Always consult with a registered healthcare provider for appropriate use.

Drug Interactions

• Lithium: Caution is advised, as Bumetanide may reduce lithium clearance, increasing the risk of toxicity.
• Probenecid: Do not use concurrently with Conart.
• Indomethacin: Concurrent use with Conart is not recommended.
• Antihypertensives: Bumetanide may enhance the effects of antihypertensive medications, potentially requiring dosage adjustments.
• Digoxin: Studies show no significant effect on digoxin blood levels.
• Anticoagulants: No interaction with warfarin metabolism has been observed.

Contraindications

Conart should not be used in patients with severe hypokalemia, hyponatremia, anuria, comatose or precomatose states due to liver cirrhosis, or renal failure.

Side Effects

Common side effects include:

• Muscle cramps (1.1%)
• Dizziness (1.1%)
• Low blood pressure (0.8%)
• Headache (0.6%)
• Nausea (0.6%)
  Less common side effects include changes in ECG (0.4%), musculoskeletal pain (0.2%), abdominal pain (0.2%), renal failure (0.1%), and thrombocytopenia (0.2%).

Pregnancy and Lactation

Pregnancy Category C. There are no adequate studies in pregnant women. It is unknown whether Bumetanide is excreted in human breast milk.

Precautions and Warnings

Periodic monitoring of serum potassium levels is recommended. Potassium supplements or potassium-sparing diuretics may be necessary in case of depletion.

Use in Special Populations

• Pediatric Use: The safety and effectiveness of Bumetanide in children under 18 have not been established.

Overdose Effects

Overdose may result in severe dehydration, electrolyte imbalances, blood volume reduction, circulatory collapse, and increased risk of thrombosis and embolism. Treatment involves fluid and electrolyte replacement, with close monitoring of urine output and serum electrolyte levels.

Therapeutic Class

Loop Diuretics

Storage Conditions

Store below 30°C, protected from light and moisture. Keep out of the reach of children.