Ethacrynic acid

Administration

  • Type: Loop diuretic
  • Dosage Forms:
  • Routes of Administration: PO, IV (ethacrynate sodium)
  • Common Trade Names: Edecrin

Adult Dosing

40mg furosemide = 20mg torsemide = 1mg bumetanide = 50 mg ethacrynic acid

  • Ethacrynic acid: 50 to 200 PO daily, adjust dose in 25mg increments
  • Ethacrynate sodium: 0.5 to 1 mg/kg IV, max 100mg per dose; average dose 50 mg.

Pediatric Dosing

  • Contraindicated in infants, safety/efficacy not well established in children
  • Ethacrynic acid: 25 mg PO daily initially, titrate in 25mg increments. Max dose 3 mg/kg/day
  • Ethacrynate sodium: dose not well established, titrate carefully

Special Populations

  • Pregnancy Rating: B
  • Lactation risk: Infant risk cannot be ruled out
  • Renal dosing: avoid use if GFR <10
  • Hepatic dosing: use smallest dose necessary to achieve adequate diuresis

Contraindications

  • Allergy to class/drug
  • Anuria
  • Severe renal disease: if worsening electrolyte imbalance, azotemia, or oliguria develops discontinue and do not reinitiate
  • If severe, watery diarrhea occurs, discontinue and do not reinitiate
  • Infants

Adverse Reactions

Serious

  • Electrolyte imbalances, hypocalcemia, hypokalemia, hyponatremia
  • GI bleed, GI perforation, diarrhea, pancreatitis
  • Agranulocytosis/neutropenia, thrombocytopenia
  • Thromboembolic disorder
  • Hepatic coma, jaundice
  • Ototoxicity, hearing loss

Common

Pharmacology

  • Half-life: 1-4h
  • Metabolism: Liver
  • Excretion: Mostly renal

Mechanism of Action

  • Loop diuretic: inhibits Na+/K+/2Cl symporter in ascending limb of loop of Henle, preventing reabsorption and thereby increasing urinary excretion of sodium, chloride, and potassium

Comments

See Also

References

Authors:

Claire