Brand and Other Names:Edecrin
- Classes: Diuretics, Loop
Dosing & Uses
Dosage Forms & Strengths
powder for injection
Not necessary to supplement dose; not removed by hemo- or peritoneal dialysis
CrCl <10 mL/minute: Not recommended
May use normal saline for volume replacement
May use dopamine or norepinephrine to treat hypotension
If dysrhythmia due to decreased K+ or Mg+ suspected replace aggressively
Discontinue treatment if no symptoms after 6hr
Other Indications & Uses
Edema-associated with CHF, hepatic cirrhosis, renal dysfunction, malignancy, & pulmonary edema
Short-term use in children (other than infants) with congenital heart disease or nephrotic syndrome
Use when fluid retention refractory to thiazides, or with impaired renal function
Dosage Forms & Strengths
powder for injection
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Injection site reaction
Hypersensitivity to ethacrynic acid
Anuria, severe, watery diarrhea
Use in infants
Avoid concurrent use with lithium or furosemide
Diabetes mellitus, geriatrics, liver disease, renal impairment
Risk of fluid or electrolyte imbalance, hyperglycemia, hyperuricemia, hypotension, metabolic alkalosis
Risk of ototoxicity (tinnitus, reversible/irreversible hearing impairment)
Discontinue use if severe, watery diarrhea occurs
Pregnancy & Lactation
Pregnancy Category: B
Lactation: excretion in milk unknown/not recommended
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Loop diuretic acting at Na/2Cl reabsorptive pump at ascending loop of Henle and distal renal tubule. Intereference with the chloride-binding cotransport system, causes increased excretion of water, sodium, chlorine, magnesium, and calcium.
Half-Life: 2-4 hr
- Initial effect: IV: 5-15 min, PO: 30-60 min
- Max effect: IV: 15 min-3 hr, PO: 2 hr
Duration: IV: 2-7 hr, PO: 4-8 hr
Protein Bound: 90%
Metabolism: conjugation w/ compounds containing sulfhydryl groups, such as cysteine & N-acetylcysteine in liver
Excretion: urine 66%
Whole blood or its derivatives
Additive: hydralazine, procainamide, ranitidine, tolazoline, triflupromazine
Additive: chlorpromazine, cimetidine, prochlorperazine, promazine
Y-site: heparin & hydrocortisone Na-succinate, KCl, vit B/C
Do not give SC or IM due to local pain & irritation
Single doses should not exceed 100 mg
Administer IVP at 10 mg/min
If second dose needed, a new injection site is recommended to avoid possible thrombophlebitis
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