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ethacrynic acid (Edecrin)
Tradename: Edecrin.
Indications:
1) treatment of hypertension & edema
2) IV form has been used to increase Ca+2 excretion in patients with hypercalcemia
3) used in combination with mannitol in the management of ethylene glycol toxicity
4) nephrogenic diabetes insipidus unresponsive to vasopressin or chlorpropamide
5) the ONLY diuretic which can be used in severe sulfa allergic patients
Dosage:
1) 0.5-1.0 mg/kg up to 50 mg IV.
2) 25-100 mg PO QD/BID.
Tabs: 25, 50 mg.
Injection: 50 mg.
Pharmacokinetics:
1) absorbed rapidly from GI tract
2) diuretic effect occurs within:
a) 30 minutes following oral administration
b) 5 minutes following IV administration
3) peak effect: 2 hours after PO, 30 min after IV administration
4) metabolized by conjugation with cysteine
Adverse effects:
1) common (> 10%)
- diarrhea
2) less common (1-10%)
- dilutional hyponatremia, hypochloremic alkalosis, hypokalemia with total body K+ depletion, ototoxicity more common than with other loop diuretics, blurred vision, headache, loss of appetite, orthostatic hypotension
3) uncommon (< 1%)
- skin rash, hematuria, gastrointestinal bleeding, hyperuricemia, hepatic dysfunction, leukopenia, agranulocytosis, thrombocytopenia, pancreatitis, local irritation, nervousness, stomach cramps
4) other [2]
- hypocalcemia
- hyperglycemia
- glucosuria
- vasculitis
- hypercholesterolemia (mild, LDL & total cholesterol)
- photosensitivity
Drug interactions:
1) drugs that cause K+ depletion - beta 2 agonists
2) ethacyrnic acid decreases lithium clearance
3) ethacryic acid increases requirement for insulin or sulfonylureas
4) probenecid
5) ethacrynic acid increases risk of NSAID-induced renal failure
Mechanism of action:
1) loop diuretic
2) site of action: loop of Henle
Interactions
drug interactions
drug adverse effects (more general classes)
monitor with loop diuretics
General
loop diuretic
Properties
MISC-INFO: elimination route KIDNEY
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998