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Overview: Enbumyst is a type of medicine called a diuretic that is used short-term to reduce fluid build-up from certain conditions. Headache is a common side effect. Enbumyst is a nasal spray and will likely be replaced by a diuretic that you take by mouth. As this medicine lowers the amount of fluid in your body, you can be at risk for certain problems. Keep all appointments to have your blood checked.

Uses

What is Enbumyst used for?

Enbumyst (bumetanide nasal) is a diuretic that is commonly used short-term to reduce an episode of edema (fluid retention) caused by the following conditions.

  • Congestive heart failure, which is a condition where the heart is not pumping as well as it should
  • Liver disease, such as cirrhosis, which can lead to a buildup of fluid in the abdomen (ascites)
  • Kidney disease, including nephrotic syndrome

Enbumyst may also be used for other conditions as determined by your health care provider.

Bumetanide is also available as a tablet that you swallow or an injection that is given to you. See Bumetanide for more information.

How does Enbumyst work (mechanism of action)?

Enbumyst works by increasing how much you pee. It does this by helping the kidneys remove electrolytes, such as sodium (salt), and water from the body.

How is Enbumyst supplied (dosage forms)?

Enbumyst is available as a single-dose 0.5 mg nasal spray.

How should I store Enbumyst?

Enbumyst should be stored between 59 F and 77 F (15 C and 25 C). It can be exposed to temperatures between 39 F and 104 F (4 C and 40 C) for short periods of time. Store in a cool, dry place. Do not freeze.

Side Effects

What are the most common side effects of Enbumyst?

The most common side effects of Enbumyst are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Low fluid levels in your body
  • Headache
  • Muscle cramps
  • Dizziness
  • Low blood pressure
  • Nausea

There may be other side effects of Enbumyst that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Enbumyst?

While less common, the most serious side effects of Enbumyst are described below, along with what to do if they happen.

Severe Allergic Reactions. Enbumyst may cause allergic reactions, which can be serious. Stop using Enbumyst and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Electrolyte Changes and Increased Blood Sugar or Uric Acid. Enbumyst may increase your blood sugar (hyperglycemia) or uric acid levels (hyperuricemia) and cause changes to the levels of certain minerals in your body, called electrolytes. For example, it may cause low potassium levels (hypokalemia), low sodium levels (hyponatremia), low magnesium levels (hypomagnesemia), low chloride levels (hypochloremia), or low calcium levels (hypocalcemia). These changes can be serious. Your health care provider will do bloodwork to check your glucose, uric acid, and electrolyte levels, especially if you take certain other medicines. Keep your appointments to have your blood checked. Call your health care provider if you have any of the following symptoms. 

  • Weakness
  • Unusual tiredness or thirst
  • Muscle cramps or twitching
  • Constipation
  • Nausea, vomiting, or loss of appetite
  • Dizziness or lightheadedness
  • Restlessness or irritability
  • Difficulty breathing
  • Confusion or decreased alertness
  • Abnormal heart rhythm or fast heartbeat
  • Seizures
  • Pain, redness, or swelling in a joint like your big toe
  • Numbness, tingling, or burning sensation in your arms, feet, or face (paresthesia)

Hearing Loss. Enbumyst may be associated with hearing loss, which is also called ototoxicity. Tell your health care provider right away if you have hearing loss or if you hear a ringing or roaring sound in your ears while using Enbumyst.

Worsening Kidney Function. Enbumyst can cause low fluid levels in your body. Poor blood flow to important organs such as your kidneys can occur, especially if you are elderly. A build-up of waste products that your kidneys normally help to get rid of may happen, which is called azotemia. Tell your health care provider right away if you have any of the following symptoms.

  • Peeing less than normal
  • Swelling in your legs, ankles, and feet
  • Loss of appetite or nausea
  • A hard time catching your breath or chest pain or pressure
  • Weakness or unusual tiredness
  • Seizures

Dehydration. Enbumyst may cause dehydration. Dehydration may lead to low blood pressure, especially when you stand up (orthostatic hypotension) or blood clots. Get out of bed or from a seated position slowly. Drink enough water to stay hydrated, especially if you have excess sweating, vomiting, or diarrhea. Call your health care provider right away if you have any of the following symptoms.

  • Dizziness or lightheadedness
  • Weakness or unusual tiredness
  • Confusion
  • Unsteadiness
  • Peeing less than normal
  • Extreme thirst
  • Pain, redness, warmth, or swelling in your leg
  • Dry mouth or tongue
  • Dark pee (urine)
  • Pale, tight, cool, or clammy skin

Warnings & Precautions

Who should not use Enbumyst?

Allergies to Ingredients. People who are allergic to any of the following should not use Enbumyst.

  • Bumetanide
  • Enbumyst
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Enbumyst.

No Urine Production. Do not use Enbumyst if you are making very little to no pee. This condition is also called anuria.

What should I know about Enbumyst before using it?

Do not use Enbumyst unless it has been prescribed to you by a health care provider. Use it as prescribed. Read the “Instructions for Use” that comes with your medicine. 

Do not share Enbumyst with other people, even if they have the same condition as you. It may harm them.

Keep Enbumyst out of the reach of children.

Enbumyst is for short-term use. A diuretic that you take by mouth will likely replace Enbumyst. Do not use Enbumyst if you take a diuretic or get one by an injection into your vein (see Interactions section for more information). Talk with your health care provider if you do not know if you take or got a diuretic.

The nasal spray only provides 0.5 mg of this medicine. You may need to use more than one nasal spray to get the dose your health care provider prescribes for you. If you need more than one nasal spray, use one in your left nostril and one in the right nostril. If you need three or four nasal sprays, keep alternating which side of the nose you use for each spray.

Do not test or prime the device. Once you use it, throw it away. 

Keep all appointments to have your blood checked. This medicine can cause serious side effects. Your lab results will help your health care provider help you to use this medicine safely.

Talk with your health care provider if you use other nasal sprays.

Enbumyst can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Enbumyst affects you.

People who are 65 years of age or older can be at greater risk of some side effects from Enbumyst. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using Enbumyst?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Enbumyst is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Nose problems like a runny nose, stuffy nose, nasal polyps
  • Any surgery on your nose or sinuses
  • Broken nose
  • Diarrhea
  • Diabetes
  • Gout

Lab Results. Enbumyst may cause serious problems if you already have an electrolyte imbalance.

Tell your health care provider if you have had any low electrolyte levels. Your health care provider needs to know about any lab results.

Other Medicines and Supplements. Enbumyst may interact with other medicines and supplements. Before using Enbumyst, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how Enbumyst could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use Enbumyst while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if Enbumyst passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Enbumyst while breastfeeding. If you do use Enbumyst while breastfeeding, tell your health care provider right away if you notice changes in how many wet diapers you need to change or if your baby seems more tired or weak.

 How can I get more information about Enbumyst?

For more information about Enbumyst, you can call the drugmaker at 877-300-5339.

Interactions

Does Enbumyst interact with foods or drinks?

Tell your health care provider if you are on a low salt diet. Enbumyst affects electrolytes like sodium, so it is important to discuss your intake of electrolytes.

It is unknown if drinking alcohol will affect Enbumyst. Both Enbumyst and alcohol can cause dehydration. It is best to limit the amount of alcohol that you drink. 

Does Enbumyst interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Enbumyst.

  • Lithium, which is a medicine for certain mental health conditions
  • Probenecid, which is a medicine commonly used for gout
  • Indomethacin, which is a medicine commonly used for many types of arthritis and certain other painful conditions
  • An aminoglycoside antibiotic, such as amikacin or gentamicin, which is a medicine given by injection to treat infections
  • A medicine for high blood pressure
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure

This may not be a complete list of medicines that can interact with Enbumyst. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Enbumyst?

If you or someone else has used too much Enbumyst, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Enbumyst?

Enbumyst is meant to be used only when needed (short-term). Use it as your health care provider recommends. If you miss a dose, contact your health care provider. Do not use double or extra doses.