“…The mechanism underlying bumetanide's adjunct antiepileptic activity has been elucidated to be due to the inhibition of intracellular chloride accumulation through NKCC1, thereby facilitating the excitatory to inhibitory switch in gamma‐aminobutyric acid signalling (Ben‐Ari, ). However, the permeability of bumetanide across the blood–brain barrier (BBB) has been predicted and been shown experimentally to be a limiting factor, as it is a highly plasma protein bound, diprotic acid with pKa values of 3.6 and 7.7 (Fiori et al, ), therefore is > 99% ionized at physiological pH. Bumetanide has been shown to be a substrate of human organic anion transporter 3 (OAT3), murine organic anion‐transporting polypeptide 1a4 (Oatp1a4) and human multidrug resistance protein 4 (MRP4), which all operate as efflux transporters at the BBB at physiological pH (Donovan, O'Brien, Boylan, Cryan, & Griffin, ; Donovan, Schellekens, Boylan, Cryan, & Griffin, ; Puskarjov, Kahle, Ruusuvuori, & Kaila, ; Römermann et al, ).…”