Ethacrynic Acid

Ethacrynic Acid Brand Name– Edecrin

What is Ethacrynic Acid

Ethacrynic acid is a potent loop diuretic used in the management of edema associated with various causes including congestive heart failure, cirrhosis, and renal disease.

Ethacrynic acid can be particularly useful in patients who are unresponsive to other diuretics or who have severe renal impairment.

Despite this, ethacrynic acid is seldom used due to its greater risk of ototoxicity when compared to the other loop diuretics bumetanide and furosemide. It has also been used in the treatment of mild to moderate hypertension, although it is not FDA approved for this indication.

Ethacrynic acid was approved by the FDA in 1967.

An ophthalmic formulation was undergoing investigation for the treatment of glaucoma but was found to lack efficacy.

Indications

1. ascites
2. edema
3. heart failure
4. hypercalcemia
5. hypertension
6. lymphedema
7. nephrotic syndrome
8. pulmonary edema

For the treatment of peripheral edema, including idiopathic edema, lymphedema, or edema secondary to ascites, heart failure, or nephrotic syndrome

Side Effects

1. agranulocytosis
2. anorexia
3. anxiety
4. azotemia
5. blurred vision
6. chills
7. confusion
8. diarrhea
9. dysphagia
10. elevated hepatic enzymes
11. fatigue
12. fever
13. GI bleeding
14. headache
15. hearing loss
16. hematuria
17. hyperglycemia
18. hyperuricemia
19. hypocalcemia
20. hypochloremia
21. hypokalemia
22. hypomagnesemia
23. hyponatremia
24. hypovolemia
25. injection site reaction
26. jaundice
27. malaise
28. metabolic alkalosis
29. muscle cramps
30. nausea
31. neutropenia
32. oliguria
33. orthostatic hypotension
34. pancreatitis
35. paresthesias
36. polyuria
37. rash
38. syncope
39. thrombocytopenia
40. tinnitus
41. vertigo
42. vomiting

Monitoring Parameters

• audiometry
• blood glucose
• serum creatinine/BUN
• serum electrolytes
• serum uric acid
• weight

Contraindications

• acid/base imbalance
• acute myocardial infarction
• anuria
• breast-feeding
• children
• dehydration
• diabetes mellitus
• diarrhea
• electrolyte imbalance
• geriatric
• gout
• hearing impairment
• heart failure
• hepatic disease
• hepatic encephalopathy
• hyperaldosteronism
• hyperglycemia
• hyperuricemia
• hypocalcemia
• hypochloremia
• hypokalemia
• hypomagnesemia
• hypotension
• hypovolemia
• infants
• metabolic alkalosis
• neonates
• orthostatic hypotension
• pancreatitis
• pregnancy
• renal disease
• renal failure
• renal impairment
• sympathectomy
• syncope
• systemic lupus erythematosus (SLE)
• ventricular arrhythmias

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