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ethacrynic acid (Rx)Brand and Other Names:Edecrin

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

powder for injection

  • 50mg

tablet

  • 25mg
more...

Edema

0.5-1 mg/kg up to 100 mg/dose slow IVP, OR 

25-100 mg PO qDay or q12hr

May take with food

Renal Impairment

Not necessary to supplement dose; not removed by hemo- or peritoneal dialysis

CrCl <10 mL/minute: Not recommended

Overdose Management

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

  • 50mg

tablet

  • 25mg
more...

Congenital Heart Disease, Nephrotic Syndrome

PO: 1 mg/kg/dose qDay; may increase q2-3days to maximum of 3 mg/kg/day

IV: Data limited; 1 mg/kg IV 

May cause hypertension and fluid imblances in the elderly; use alternatives if available

Edema

0.5-1 mg/kg up to 100 mg/dose slow IVP, OR 

25-50 mg PO qDay or q12hr

May take with food

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Interactions

Interaction Checker

ethacrynic acid and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Injection site reaction

            Hyperuricemia

            Gout

            Hypotension

            Hypokalemia

            Electrolyte abnormalities

            Hyperglycemia/hypoglycemia

            Hyperlipidemia

            Ototoxicity

            Tinnitus

            Photosensitivity

            Muscle cramps

            Dizziness

            Confusion

            Headache

            Nausea/vomiting

            Anorexia

            Dysphagia

            Diarrhea

            Pancreatitis

            Agranulocytosis

            Neutropenia

            Thrombocytopenia

            Hematuria

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            Warnings

            Contraindications

            Hypersensitivity to ethacrynic acid

            Anuria, severe, watery diarrhea

            Use in infants

            Cautions

            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

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excretion in milk unknown/not recommended

            Pregnancy Categories

            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.

            more...
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            Pharmacology

            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.

            Pharmacokinetics

            Half-Life: 2-4 hr

            Onset

            • Initial effect: IV: 5-15 min, PO: 30-60 min
            • Max effect: IV: 15 min-3 hr, PO: 2 hr

            Other Information

            Duration: IV: 2-7 hr, PO: 4-8 hr

            Bioavailability: 100%

            Protein Bound: 90%

            Metabolism: conjugation w/ compounds containing sulfhydryl groups, such as cysteine & N-acetylcysteine in liver

            Excretion: urine 66%

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            Administration

            IV Incompatibilities

            Whole blood or its derivatives

            Additive: hydralazine, procainamide, ranitidine, tolazoline, triflupromazine

            IV Compatibilities

            Additive: chlorpromazine, cimetidine, prochlorperazine, promazine

            Y-site: heparin & hydrocortisone Na-succinate, KCl, vit B/C

            IV Administration

            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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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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