| drug name | Ethacrynic Acid |
| classification | Loop diuretic |
| pharmacokinetics | | absorption | Rapidly absorbed from the gastrointestinal tract, peak plasma levels reached within 1-2 hours. | | distribution | Distributes widely throughout the body, including the kidneys and other organs. | | metabolism | Primarily metabolized in the liver, with a small amount excreted unchanged in the urine. | | excretion | Elimination primarily through the kidneys, with a half-life of approximately 2-3 hours. |
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| suggested dosage | | adults | | oral | Initial dosage is typically 25-50 mg twice daily, adjusted based on response and tolerability. Higher doses (up to 200 mg/day) may be needed in severe cases. | | IV | Administered intravenously, starting dose varies based on the specific patient and clinical context, typically 25-50 mg, and then titrated according to renal response. |
| | note | Dosage must be individualized. It is crucial to follow the prescribing physician's instructions carefully and not adjust dosage without medical advice. Frequency of administration depends on the specific case and clinical requirements. |
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| indications | | 1 | Edema associated with congestive heart failure | | 2 | Edema associated with renal failure | | 3 | Hypertension | | 4 | Acute pulmonary edema | | 5 | Other fluid retention conditions |
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| safety in pregnancy | Ethacrynic acid should be used during pregnancy only if the potential benefits outweigh the potential risks to the fetus. It is not recommended for use during the first trimester and should be used with caution in the later stages. Consult with a physician regarding the specific use in pregnancy and the potential risks. |
| safety in breastfeeding | Ethacrynic acid may be excreted in breast milk. It's not recommended for use in breastfeeding mothers due to the potential for adverse effects in the infant. Consult with a healthcare professional before using this medication if breastfeeding. |
| side effects | | 1 | Gastrointestinal disturbances (nausea, vomiting, diarrhea) | | 2 | Hypokalemia | | 3 | Hypotension | | 4 | Ototoxicity (hearing loss, tinnitus) | | 5 | Metabolic abnormalities (e.g., hyperglycemia, hypomagnesemia) | | 6 | Skin rashes | | 7 | Dehydration | | 8 | Electrolyte imbalances | | 9 | Fatigue | | 10 | Weakness |
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| alternatives | |
| contraindications | | 1 | Known hypersensitivity to ethacrynic acid or other sulfonamide-derived drugs | | 2 | Severe dehydration | | 3 | Severe electrolyte disturbances | | 4 | Renal impairment with severe oliguria | | 5 | Anuria | | 6 | Preexisting hearing loss | | 7 | Known predisposition to ototoxicity | | 8 | Pregnancy in the first trimester |
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| interactions | | 1 | Digoxin: Increased risk of digoxin toxicity | | 2 | Lithium: Increased lithium levels | | 3 | Nonsteroidal anti-inflammatory drugs (NSAIDs): May reduce the effectiveness of ethacrynic acid | | 4 | Other ototoxic drugs: Increased risk of ototoxicity | | 5 | Other diuretics: Potential for additive or synergistic effects | | 6 | Corticosteroids: May increase risk of hypokalemia |
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| warnings and precautions | | 1 | Monitor blood electrolytes (sodium, potassium, chloride, magnesium) closely during treatment and adjust dosage as needed. | | 2 | Monitor renal function routinely to adjust dosage based on renal response. | | 3 | Avoid concomitant use of other ototoxic drugs. | | 4 | Regular monitoring of hearing acuity should be conducted to assess for ototoxicity, especially in patients at risk (e.g., elderly, those with pre-existing renal dysfunction, and those receiving multiple nephrotoxic agents). | | 5 | In patients with severe renal insufficiency, the dosage of ethacrynic acid should be carefully titrated. | | 6 | Monitor for signs of hypovolemia and dehydration. Ensure adequate hydration. |
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| additional information | Ethacrynic acid is effective in treating fluid retention, but it can cause severe side effects, including hearing loss. It should only be used under strict medical supervision and monitoring. Patients should be instructed to report any unusual symptoms or signs immediately to their physician. |
| patient specific information | |
