Biegus Jan, Ponikowska Beata, Canonico Mario Enrico, Damman Kevin, Palazzuoli Alberto, Ambrosy Andrew P
Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
Department of Pathophysiology, Wroclaw Medical University, Wrocław, Poland.
Heart Fail Rev. 2025 May 13. doi: 10.1007/s10741-025-10517-y.
Loop diuretics are the cornerstone of managing congestion in heart failure (HF). It is hypothesized that in heavily congested patients, gut edema may lead to lower bioavailability of oral drugs, including diuretics, which, in turn, may lead to insufficient diuresis. Intravenous (IV) loop diuretics are often required to achieve rapid diuresis due to their high plasma concentrations. However, reliance on IV administration limits options in ambulatory settings, where effective rescue therapies are needed. Bumetanide Nasal Spray (BNS) is a novel formulation designed to overcome absorption challenges and provide rapid, high bioavailability through intranasal administration. This mini-review summarizes the results of the recently presented bioavailability study of BNS conducted in healthy individuals, showing its bioequivalence to oral formulations. Lastly, the paper discusses the potential caveats and limitations of the trial and further perspectives.
袢利尿剂是治疗心力衰竭（HF）充血的基石。据推测，在严重充血的患者中，肠道水肿可能导致口服药物（包括利尿剂）的生物利用度降低，进而可能导致利尿不足。由于静脉注射（IV）袢利尿剂的血浆浓度高，常常需要使用它们来实现快速利尿。然而，在需要有效急救治疗的门诊环境中，依赖静脉给药限制了选择。布美他尼鼻喷雾剂（BNS）是一种新型制剂，旨在克服吸收难题，并通过鼻内给药提供快速、高生物利用度。本综述总结了最近在健康个体中进行的BNS生物利用度研究结果，表明其与口服制剂具有生物等效性。最后，本文讨论了该试验的潜在注意事项和局限性以及进一步的前景。
