Bumetanide 1mg tablets are currently out of stock and will remain unavailable until at least mid-August 2025, according to a national patient safety alert issued by the Department of Health and Social Care (DHSC).

The supply disruption is due to a combination of manufacturing issues and a resulting increase in demand to other suppliers, the alert said.

Bumetanide is a loop diuretic licensed for the treatment of oedema associated with conditions such as congestive heart failure, renal dysfunction including nephrotic syndrome, and cirrhosis of the liver in adults.

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There is a risk of decompensation and unintentional fluid retention if patients stop taking bumetanide 1mg tablets. Patients affected by the shortage will require a switch to an alternative loop diuretic to avoid treatment interruption.

Bumetanide 1mg/5ml oral solution and 5mg tablets remain available, but cannot support additional prescribing. However, furosemide 20mg and 40mg tablets are available and can support increased demand during the shortage.

Pharmacy teams are advised not to initiate new patients on bumetanide 1mg tablets until the supply issue has resolved.

In addition, patients currently prescribed bumetanide 1mg tablets should be identified and assessed as to whether it is still the most suitable therapy and if they have sufficient stock to last until the resupply date.

Where required, patients may be switched to furosemide, provided they are not allergic, and counselled appropriately on dose, side effects, and the need for daily weight monitoring. Those already established on higher doses of bumetanide may need follow-up to ensure fluid balance remains stable after switching.

Remaining supplies of bumetanide 1mg tablets should be prioritised for patients who are allergic to furosemide, those with severe left ventricular systolic dysfunction, or those who have not been adequately managed on furosemide previously.

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Prescribers should immediately refer patients to a specialist for advice on alternative treatments if none of these options are suitable.

The shortage of bumetanide 1mg tablets is the latest in a long line of pharmaceutical supply issues.

Community Pharmacy England’s 2025 annual pressures survey recently revealed that almost three-quarters (74%) of pharmacy owners in England are spending ‘longer than ever before’ to procure medicines amid worsening shortages.

In addition, a recent Healthwatch England survey uncovered persistent problems experienced by pharmacy patients in accessing medication due to supply-side issues.

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Despite the ongoing problems, the government has effectively ruled out a review on the impact of medicine shortages on pharmacies.