Drug interactions
Bumetanide + Tolvaptan
Severity: Moderate
Bumetanide and Tolvaptan: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs increase urinary water loss, so together they can cause excessive volume depletion, hypotension and renal impairment. Tolvaptan may also cause rapid serum sodium rise, and electrolyte shifts can be unpredictable.
What this interaction means in plain words
Bumetanide and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Bumetanide belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive diuresis from loop diuretic natriuresis and vasopressin V2 receptor antagonist aquaresis.
What to do
Monitor volume status, serum sodium, potassium and renal function closely, especially in the first days of tolvaptan. Reduce the diuretic dose if hypovolemia or overly rapid sodium correction develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Bumetanide
Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Bumetanide with Tolvaptan?
MediHelp rates the interaction as moderate. Bumetanide and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs increase urinary water loss, so together they can cause excessive volume depletion, hypotension and renal impairment. Tolvaptan may also cause rapid serum sodium rise, and electrolyte shifts can be unpredictable.
How serious is the interaction between Bumetanide and Tolvaptan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor volume status, serum sodium, potassium and renal function closely, especially in the first days of tolvaptan. Reduce the diuretic dose if hypovolemia or overly rapid sodium correction develops.
What other medicines interact with Bumetanide?
MediHelp also lists interactions of Bumetanide with, for example, Amifostine, Amikacin, Captopril-hydrochlorothiazide. The full list is on the Bumetanide page.
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