Two medicines, side by side
Bumetanide vs spironolactone
Bumetanide and spironolactone are both labeled for heart failure. Drugs@FDA records approvals of bumetanide since 1983 and of spironolactone since 1960. Pharmacies paid $0.108 per bumetanide 1 mg tablet and $0.0426 per spironolactone 25 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, bumetanide is a loop diuretic and spironolactone an aldosterone antagonist.
Check it at the source: the bumetanide FDA label on DailyMed (effective September 8, 2025); the spironolactone FDA label on DailyMed (effective November 28, 2025).
Highlights of the bumetanide record
Bumetanide (Bumex) · label of September 8, 2025
Bumex ® (bumetanide) is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required, and dose and dosage schedule have to be adjusted to the individual patient's needs (see DOSAGE AND ADMINISTRATION ).
Used for
From the label: indicationsBumex tablets are indicated for the treatment of edema associated with congestive heart failure, hepatic and renal disease, including the nephrotic syndrome. Almost equal diuretic response occurs after oral and parenteral administration of bumetanide. […]
On the market
- Earliest approval on file
- February 28, 1983
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.108 per tablet
Supply and safety
- Shortage
- Resolved
- Recalls
- 4
Highlights of the spironolactone record
Spironolactone (Aldactone) · label of November 28, 2025
Used for
From the label: indicationsALDACTONE is an aldosterone antagonist indicated for: • The treatment of NYHA Class III–IV heart failure and reduced ejection fraction to increase survival, manage edema, and to reduce the need for hospitalization for heart failure ( 1.1 ). • Use as an add-on therapy for the treatment of hypertension, to lower blood pressure. […]
On the market
- Earliest approval on file
- January 21, 1960
- Generic labelers
- 38 labelers
- Pharmacy cost
- $0.0426 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 6
Source: FDA drug labels via openFDA (Bumetanide label of September 8, 2025, Spironolactone label of November 28, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do bumetanide and spironolactone differ on the record?
In FDA's classes, bumetanide is a loop diuretic and spironolactone an aldosterone antagonist.
Half-life, in each label's words: Bumetanide, “Small pharmacokinetic studies of intravenous bumetanide in preterm and full-term neonates with respiratory disorders …”; Spironolactone, “The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and …”
Only the bumetanide label carries a boxed warning.
Generics: bumetanide since 1994; spironolactone since 1980 (Drugs@FDA).
| Bumetanide | Spironolactone | |
|---|---|---|
| Labeled for | Heart failure | Heart failure, Edema (fluid retention), High blood pressure |
| Pharmacologic class | Loop Diuretic | Aldosterone Antagonist |
| How it works (label) | n/a | Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted … |
| Half-life (label) | Small pharmacokinetic studies of intravenous bumetanide in preterm and full-term neonates with respiratory disorders have reported an apparent half-life of approximately 6 hours, with a range up to 15 hours and a serum … | The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and 6-β-hydroxy-7-α-(thiomethyl) spirolactone (HTMS) are 16.5, 13.8, and 15 hours, respectively. |
| Earliest approval on file (Drugs@FDA) | February 28, 1983 | January 21, 1960 |
| First generic approved | October 31, 1994 | May 7, 1980 |
| Generic labelers (NDC) | 36 labelers | 38 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.108 per tablet (Bumetanide 1 mg tablet) | $0.0426 per tablet (Spironolactone 25 mg tablet) |
| 12-month price change | -25% | -14% |
| Boxed warning | Yes | No |
| Shortage now | Resolved | A presentation being discontinued |
| Recalls recorded | 4 | 6 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 26,259 | 139,757 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Bumetanide label, warningsSupplemental potassium and/or spironolactone may prevent hypokalemia and metabolic alkalosis in these patients.
Source: FDA drug labels via openFDA
What next?
- Alternatives to bumetanide
- every medicine labeled for the same conditions