Ethacrynic acid

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Generic Name: Ethacrynic acid Brand Name(s): Ethacrynic acid.

Uses

What is Ethacrynic acid used for?

Ethacrynic acid is a “water pill” (diuretic) that works in your kidneys to increase the amount of urine you make. This helps your body get rid of extra water. This medication is used to decrease swelling (edema) caused by conditions such as cancer, congestive heart failure, liver disease, and kidney disease. This effect can help your kidneys work better and lessen symptoms such as trouble breathing and swelling in your ankles, feet, hands, or belly.

This medication should not be used for infants.

How should I take Ethacrynic acid?

Take this medication by mouth as directed by your doctor, usually once or twice a day after a meal. If you take this drug too close to bedtime, you may need to wake up to urinate. It is best to take this medication at least 4 hours before your bedtime. Consult your doctor or pharmacist if you have questions about your dosing schedule.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Your doctor will adjust your dose based on your medical condition, response to treatment, and lab tests (such as sodium, potassium, chloride levels). Some people may be directed to take this medication every other day or only when needed. Follow your doctor’s directions carefully.

If your doctor has directed you to take this medication on a regular schedule, take it regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Tell your doctor if you do not get better or if you get worse.

How do I store Ethacrynic acid?

Ethacrynic acid is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Ethacrynic acid in the bathroom or the freezer. There may be different brands of Ethacrynic acid that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Ethacrynic acid down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Ethacrynic acid?

Before using this medication, tell your doctor or pharmacist your medical history, especially of: gout, kidney disease, liver disease.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.

This drug can lower certain salt/mineral levels (such as sodium, potassium) in your blood. Your doctor may tell you to use more salt, eat potassium-rich foods (such as bananas, orange juice), or take a potassium supplement. Ask your doctor for more details.

This medication may affect your blood sugar. If you have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially dizziness and water/mineral loss.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Ethacrynic acid during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Ethacrynic acid. Ethacrynic acid is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Ethacrynic acid?

Dizziness, lightheadedness, weakness, muscle cramps, upset stomach, or diarrhea may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This drug is a strong “water pill” (diuretic) which can cause a serious loss of body water (dehydration) and salt/minerals. Tell your doctor right away if you notice any symptoms of dehydration, such as confusion, unusual decreased urination, unusual dry mouth/thirst, fast/irregular heartbeat, or severe dizziness/lightheadedness.

Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, feeling of spinning (vertigo), hearing changes (such as ringing or fullness in the ears, decreased hearing/deafness), black/bloody stools, stomach/abdominal pain, vomit that looks like coffee grounds, signs of liver problems (such as nausea/vomiting that doesn’t stop, loss of appetite, yellowing eyes/skin, dark urine).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ethacrynic acid?

Some products that may interact with this drug include: furosemide, lithium.

Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Ethacrynic acid may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Ethacrynic acid?

Ethacrynic acid may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ethacrynic acid?

Ethacrynic acid may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Ethacrynic acid.

What is the dose of Ethacrynic acid for an adult?

Usual Adult Dose for Ascites

Oral:

50 to 200 mg orally per day in 1 to 2 divided doses; once effective diuresis has been achieved, adjust dose as needed in 25 to 50 mg increments to the minimum effective dose and give on a continuous or intermittent schedule.

Add-on dose: When adding this drug to an existing diuretic regimen, initial dose and dose changes should be in 25 mg increments.

Comments:

-Initial and maintenance doses as high as 200 mg twice a day may be required, mostly in patients with severe, refractory edema.

-Dose and frequency can usually be reduced once dry weight has been achieved.

-Intermittent dosing may consist of alternate daily dosing or more prolonged periods of diuretic therapy interspersed with rest periods.

Use: Management of edema when an agent with greater diuretic potential than those commonly employed is required for treatment of edema associated with congestive heart failure, liver cirrhosis, or renal disease, including nephrotic syndrome, or short-term management of ascites due to malignancy, idiopathic edema, or lymphedema.

IV:

50 mg (or 0.5 to 1 mg/kg) IV once; occasionally, a second dose at a new injection site may be required.

Comments: A single dose not exceeding 100 mg has been used in critical situations.

Use: When rapid onset of diuresis is desired (e.g., acute pulmonary edema) or when gastrointestinal absorption is impaired or oral medication is not practicable.

Usual Adult Dose for Edema

Oral:

50 to 200 mg orally per day in 1 to 2 divided doses; once effective diuresis has been achieved, adjust dose as needed in 25 to 50 mg increments to the minimum effective dose and give on a continuous or intermittent schedule.

Add-on dose: When adding this drug to an existing diuretic regimen, initial dose and dose changes should be in 25 mg increments.

Comments:

-Initial and maintenance doses as high as 200 mg twice a day may be required, mostly in patients with severe, refractory edema.

-Dose and frequency can usually be reduced once dry weight has been achieved.

-Intermittent dosing may consist of alternate daily dosing or more prolonged periods of diuretic therapy interspersed with rest periods.

Use: Management of edema when an agent with greater diuretic potential than those commonly employed is required for treatment of edema associated with congestive heart failure, liver cirrhosis, or renal disease, including nephrotic syndrome, or short-term management of ascites due to malignancy, idiopathic edema, or lymphedema.

IV:

50 mg (or 0.5 to 1 mg/kg) IV once; occasionally, a second dose at a new injection site may be required.

Comments: A single dose not exceeding 100 mg has been used in critical situations.

Use: When rapid onset of diuresis is desired (e.g., acute pulmonary edema) or when gastrointestinal absorption is impaired or oral medication is not practicable.

Renal Dose Adjustments

Contraindicated in patients with anuria.

If increasing electrolyte imbalance, azotemia, and/or oliguria occur during treatment of severe, progressive renal disease: Discontinue this drug.

Liver Dose Adjustments

Use with caution

Dose Adjustments

Oral doses can be increased by 25 to 50 mg/day.

Most patients respond to 50 to 100 mg/day.

A second IV dose can be administered in 6 to 8 hours.

Other Comments

IV Administration advice: Administer slowly through the tubing of a running infusion or by direct IV injection over a period of several minutes; do not give subcutaneously or intramuscularly.

IV Reconstitution/preparation techniques: To reconstitute the dry material, add 50 mL of sodium chloride injection or 5% dextrose injection to the vial; 5% dextrose injection solutions with a pH less than 5 are not recommended.

IV compatibility: Do not mix the solution of this drug with whole blood or its derivatives.

Monitoring:

-Metabolic: Serum electrolytes, carbon dioxide, and BUN frequently during early therapy and periodically thereafter; patient weight should be measured before and during treatment with this drug.

What is the dose of Ethacrynic acid for a child?

Usual Pediatric Dose for Edema

Less than 1 year: Contraindicated

1 year or older:

-Initial dose: 25 mg orally

-Maintenance dose: May adjust dose as needed in 25 mg increments.

-Use: Management of edema when an agent with greater diuretic potential than those commonly employed is required for short-term management of edema associated with congenital heart disease or nephrotic syndrome in hospitalized patients.

Precautions

Safety and efficacy of oral and parenteral use have not been established in infants.

Safety and efficacy of IV use has not been established in patients younger than 18 years.

How is Ethacrynic acid available?

Ethacrynic acid is available in the following dosage forms and strengths:

  • Oral Tablet
  • Intravenous Powder for Injection

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Ethacrynic acid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 26, 2018 | Last Modified: January 29, 2018

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