Conart^®

Conart ® is a preparation of Bumetanide which is a derivative of metanilamide and is chemically distinct from other available diuretics. It is a potent, high ceiling loop diuretic with a rapid onset and a short duration of action. The primary site of action is the ascending limb of the Loop of Henlé where it exerts inhibiting effects on electrolyte reabsorption causingthe diuretic and natriuretic action. After oral administration of Conart ® , diuresis begins within 30 minutes with a peak effect between one and two hours. The diuretic effect is virtually complete in three hours after oral administration.

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Conart ® is indicated for the treatment of edema associated with -

• Congestive heart failure
• Hepatic ascites and
• Renal disease including the nephrotic syndrome

The recommended dose of Conart ® is 1 mg once daily which can be given as a single morning or early evening dose. Depending on the patient's response, a second dose can be given 6 to 8 hours later. In refractory cases, the dose can be increased until a satisfactory diuretic response is obtained.
Dosage in the elderly:
In elderly patients, dosage adjustment should be according to response. A dose of 0.5 mg Bumetanide once daily may be sufficient in some elderly patients.
Children:
Bumetanide is not recommended for children under 18 years of age.

Bumetanide is in pregnancy category C. There are no adequate and well-controlled studies in pregnant women. Bumetanide should be given to a pregnant woman only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk, so nursing should not be undertaken while the patient is on Bumetanide.

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Serum potassium should be measured periodically and potassium supplements or potassium-sparing diuretics added if necessary. Periodic determinations of other electrolytes are advised in patients treated with high doses or for prolonged periods, particularly in those on low-salt diets. Electrolyte disturbances may occur, particularly in those patients taking a low salt diet. Bumetanide should be used with caution in patients already receiving nephrotoxic or ototoxic drugs.

The side effects of Bumetanide include: headache, dizziness, fatigue, postural hypotension and gastrointestinal symptoms. Various skin reactions, photosensitivity reactions and metabolic disturbances, including reduced glucose tolerance are less frequent. Electrolyte disturbances can occur especially during long term treatment.

Bumetanide is contraindicated in patients who have hypersensitivity to any of it’s components / ingredients. It is also contraindicated in patients with renal insufficiency, hepatic coma and care should be taken in states of severe electrolyte depletion. Bumetanide should not be administered concurrently with lithium salts. Diuretics can reduce lithium clearance resulting in high serum levels of lithium.

Concomitant use of Bumetanide may potentiate the effects of antihypertensive drugs. It shows a tendency to increase the excretion of potassium which can lead to an increase in the sensitivity of the myocardium to the toxic effects of digitalis. As with other diuretics, Bumetanide may cause an increase in blood uric acid.

Symptoms would be those caused by excessive diuresis. Empty stomach by gastric lavage or emesis.

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Store in a cool & dry place. Protect from light.