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MagazineAugust 2001 (Vol. 12 Issue 5)Bumetanide

Our health officials luxuriate in the idea that we have freedom of information about medicine

Our health officials luxuriate in the idea that we have freedom of information about medicine. Patients are now properly informed, and every door is open.

Unfortunately, the reality remains rather different, as one of our readers can testify. She is taking 1 mg of bumetanide daily to treat her heart condition. She has heard that it can attack the bone marrow in 1 in 50,000 people taking the drug.

But is this so and, if it is, what is the level of risk? As she points out, when the bone marrow is weakened, even a simple cold can kill.

Finding the answer is not as simple as our administrators claim. "Freedom of information to us is non existent; the manufacturers will tell the doctors, but not us, and our GPs are run off their feet," she states. Doctors and consultants have a couple of minutes to spare on each patient before going on to the next.

Bumetanide is a powerful diuretic, and is usually given to treat congestive heart failure, or kidney or liver disease. This means that a patient needs to be carefully monitored to ensure that he or she does not dehydrate, and that water and electrolyte depletion does not endanger the life of the patient.

Common adverse reactions include muscle cramps, dizziness, hypotension, headache and nausea. Other reactions have included vertigo, chest pain, ear discomfort, fatigue, sweating, hyper ventilation, dry mouth, upset stomach, renal failure and diarrhoea most of which could be signs of dehydration.

Turning to our reader's concerns, tests have shown that calcium levels have been affected in 2.4 per cent of cases (or 1200 people per 50,000, to use her measure). Not all of these would necessarily lead to bone marrow depletion, but it is cause for concern.

Concern that warrants more than two minutes per patient.

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