What are the equivalent dosages of bumetanide, furosemide & torsemide?
The equivalent doses of bumetanide, furosemide, and torsemide are as follows:
- Bumetanide 1mg is equivalent to furosemide 40mg (oral), furosemide 20mg (IV), and torsemide 10-20mg (equivalent dosage varies depending on reference source).
Note that the bioavailability of oral furosemide is only about 50% which means the IV dose is generally half the oral dose (for example, if you are giving 40mg of furosemide orally only give 20mg IV).
Trials have also reported a massive range in intra- and inter-patient variability in the bioavailability of oral furosemide (range is from 10 to 100%).
Torsemide has a longer half-life than furosemide (3.5 hours versus 1-2 hours respectively) and increased bioavailability (> 80%). References differ in what they cite as an equivalent dose but generally, the range of 10mg to 20mg of oral/IV torsemide is considered equivalent to 40mg of oral furosemide (20mg IV furosemide). Use clinical judgment when deciding on equivalent dosages.
Conversions Bumetanide to Furosemide to Torsemide simplified
- Bumetanide to furosemide conversion: 1mg bumetanide (oral/IV) is equivalent to 40mg furosemide oral or 20mg furosemide IV
- Furosemide to bumetanide conversion: 40mg furosemide oral or 20mg furosemide IV is equivalent to 1mg bumetanide (oral/IV)
- Furosemide to torsemide conversion: 40mg furosemide oral or 20mg furosemide IV is equivalent to 10-20mg of torsemide (oral/IV)
- Furosemide to Bumex conversion: 40mg furosemide oral or 20mg furosemide IV is equivalent to 1mg Bumex (oral/IV)
- Bumex to furosemide conversion: 1mg Bumex(oral/IV) is equivalent to 40mg furosemide oral or 20mg furosemide IV
- Torsemide to furosemide conversion: 10-20mg of torsemide (oral/IV) is equivalent to 40mg furosemide oral or 20mg furosemide IV
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Loop Diuretic Quick Conversion Chart
Loop diuretics | Oral | IV |
---|---|---|
Furosemide (Lasix) | 40mg | 20mg |
Bumetanide (Bumex) | 1mg | 1mg |
Torsemide | 10-20mg | 10-20mg |
References
- How to prescribe loop diuretics in oedema. BMJ 2019;364:l359: https://www.bmj.com/content/364/bmj.l359
- Loop diuretic doses for adult patients with common causes of edema (2023). UpToDate https://www.uptodate.com/contents/image?imageKey=NEPH%2F120718
- Furosemide Versus Torsemide. Meded101. https://www.meded101.com/furosemide-versus-torsemide-difference/#:~:text=Furosemide%20Versus%20Torsemide%3A%20Half%2Dlife&text=For%20torsemide%2C%20the%20half%2Dlife,is%20about%201%2D2%20hours
- Mentz RJ, Anstrom KJ, Eisenstein EL, et al. Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure: The TRANSFORM-HF Randomized Clinical Trial. JAMA. 2023;329(3):214–223. doi:10.1001/jama.2022.23924
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