hard earned [5.:<5, which may result in a hazy or opalescent solution that should not be used. 129 Compatibility For information on systemic interactions resulting from concomitant use, see Interactions. Parenteral Solution Compatibility b Compatible Dextrose 5% in water Dextrose 5% in sodium chloride 0.9% Ringer s injection Ringer s injection, lactated Sodium chloride 0.9% Incompatible Normosol-M Drug Compatibility HID Admixture Compatibility Compatible Chlorpromazine HCl Prochlorperazine edisylate Incompatible Hydralazine HCl Procainamide HCl Ranitidine HCl Y-Site Compatibility Compatible Heparin sodium with hydrocortisone sodium succinate Potassium chloride Incompatible Nesiritide Actions Loop diuretic with rapid onset of action. 129 b In vitro, inhibits active transport of chloride in the lumen of the ascending limb of the loop of Henle and thereby, diminishes reabsorption of sodium and chloride at that site. b Increases potassium excretion in the distal renal tubule, and exerts a direct effect on electrolyte transport at the proximal tubule. b Does not inhibit carbonic anhydrase and is not an aldosterone antagonist. b Aldosterone secretion may increase during therapy and may contribute to hypokalemia. b Enhances excretion of sodium, chloride, potassium, hydrogen, calcium, and magnesium. b Initially, sodium and chloride excretion is substantial, and chloride loss exceeds that of sodium. 129 With prolonged administration, sodium and chloride excretion declines, and excretion of potassium and hydrogen may increase. 129 b Excessive losses of potassium, hydrogen, and chloride may result in metabolic alkalosis. Maximum diuresis and electrolyte loss are greater with ethacrynic acid than with the thiazides or most other diuretics except furosemide. b Has little or no direct effect on GFR or renal blood flow; however, a fall in GFR may accompany pronounced reductions in plasma volume associated with rapid or excessive diuresis. 129 A hypotensive effect may result from decreased plasma volume. b Advice to Patients Importance of reporting manifestations of fluid and electrolyte depletion (e.g., dryness of mouth, thirst, weakness, dizziness, faintness, mental confusion, lassitude, lethargy, drowsiness, restlessness, muscle pains or cramps, paresthesia, muscular fatigue, hypotension, headache, oliguria, tachycardia, arrhythmia, anorexia, nausea, vomiting). 129 b Importance of discussing dietary measures and supplementation to prevent or correct hypokalemia. b Importance of informing patients with diabetes mellitus that blood glucose and urine glucose concentrations may increase. b Importance of immediately reporting severe diarrhea. b Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses. 129 Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. 129 Importance of informing patients of other important precautionary information. 129 (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Ethacrynic Acid Routes Dosage Forms Strengths Brand Names Manufacturer Oral Tablets 25 mg Edecrin (scored) Aton Pharma Ethacrynate Sodium Routes Dosage Forms Strengths Brand Names Manufacturer Parenteral For injection, for IV use only equivalent to ethacrynic acid 50 mg Sodium Edecrin Aton Pharma AHFS DI Essentials. Copyright 2017, Selected Revisions February 1, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. † Use is not currently included in the labeling approved by the US Food and Drug Administration. References Only references cited for selected revisions after 1984 are available electronically. 100. Fischer AF, Parker BR, Stevenson DK. Nephrolithiasis following in utero diuretic exposure: an unusual case. Pediatrics . 1988; 81:712-4. [PubMed 3282218] 101. The Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The 1984 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med . 1984; 144:1045-57. [PubMed 6143542] 102. 1988 Joint National Committee. The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med . 1988; 148:1023-38. [PubMed 3365073] 103. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med . 1993; 153:154-83. [PubMed 8422206] 104. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Bethesda, MD: National Institutes of Health. (NIH publication No. 98-4080.) 105. Kaplan NM. Choice of initial therapy for hypertension. JAMA . 1996; 275:1577-80. [PubMed 8622249] 106. Psaty BM, Smith NL, Siscovich DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA . 1997; 277:739-45. [PubMed 9042847] 107. Whelton PK, Appel LJ, Espeland MA et al. for the TONE Collaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA . 1998; 279:839-46. [PubMed 9515998] 108. Anon. Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Part II. Management of heart failure: approaches to the prevention of heart failure. Am J Cardiol . 1999; 83:9A-38A. 109. Merck. Edecrin (ethacrynic acid) tablets and Intravenous Sodium Edecrin (ethacrynate sodium) prescribing information (dated 1997 Jun). In: Physicians desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:1790-1. 110. Leary WP, Reyes AJ. Drug interactions with diuretics. S Afr Med J . 1984; 65:455-61. [PubMed 6701709] 111. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA . 1988; 259:539-44. [PubMed 2447297] 112. Richardson A, Bayliss J, Scriven AJ et al. Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. Lancet . 1987; 2:709-11. [PubMed 2888942] 113. Sherman LG, Liang CS, Baumgardner S et al. Piretanide, a potent diuretic with potassium-sparing properties, for the treatment of congestive heart failure. Clin Pharmacol Ther . 1986; 40:587-94. [PubMed 3533372] 114. Patterson JH, Adams KF Jr, Applefeld MM et al. Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Pharmacotherapy . 1994; 14:514-21. [PubMed 7997385] 115. Wilson JR, Reichek N, Dunkman WB et al. Effect of diuresis on the performance of the failing left ventricle in man. Am J Med . 1981;70:234-9. 116. Parker JO. The effects of oral ibopamine in patients with mild heart failure a double blind placebo controlled comparison to furosemide. Int J Cardiol . 1993; 40:221-7. [PubMed 8225657] 117. Hansten PD, Horn JR. Diuretics and non-steroidal anti-inflammatory drugs. Drug Interact Newsl. 1986; 6:27-9. 118. O Brien WM. Pharmacology of nonsteroidal anti-inflammatory drugs: practical review for clinicians. Am . J Med. 1983; 10:32-9. 119. Brater DC. Drug-drug and drug-disease interactions with nonsteroidal anti-inflammatory drugs. Am J Med . 1986; 80(Suppl 1A):62-77. [PubMed 3511686] 120. Edecrin (ethacrynic acid and ethacrynate sodium) tablets and injection. In: MedWatch: summary of safety-related drug labeling changes approved by FDA. Rockville, MD: US Food and Drug Administration; 1999 Oct. 121. The United States pharmacopeia, 24th rev, and The national formulary, 19th ed. Rockville, MD: The United States Pharmacopeial Convention, Inc; 2000:689. 122. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension . 2000; 35:1021-4. [PubMed 10818056] 123. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension . 2000; 35:1019-20. [PubMed 10818055] 124. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis . 2000; 36:646-61. [PubMed 10977801] 125. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site. 128. The Guidelines Subcommittee of the WHO/ISH Mild Hypertension Liaison Committee. 1999 guidelines for the management of hypertension. J Hypertension . 1999; 17:392-403. 129. Aton Pharma, Inc. Edecrin and Sodium Edecrin (ethacrynic acid and ethacrynate sodium) tablets and injection prescribing information. Lawrenceville, NJ; 2007 Oct. Accessed 2/27/08. 130. Slim HB, Black HR, Thompson PD. Older blood pressure medications-do they still have a place?. Am J Cardiol . 2011; 108:308-16. [PubMed 21550576] 500. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Bethesda, MD: National Institutes of Health; 2004 Aug. (NIH publication No. 04-5230.) 501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA . 2014; 311:507-20. [PubMed 24352797] 502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens . 2013; 31:1281-357. [PubMed 23817082] 503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension . 2014; 63:878-85. [PubMed 24243703] 504. Weber MA, Schiffrin EL, White WB et al. 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Dietary sodium intake in heart failure. Circulation . 2012; 126:479-85. [PubMed 22825409] 714. Hospira. Dopamine hydrochloride prescribing information. Lake Forest, IL; 2014 Mar. 715. Hospira. Dopamine hydrochloride and 5% dextrose injection prescribing information. Lake Forest, IL; 2014 May. 716. Cicci JD, Reed BN, McNeely EB et al. Acute decompensated heart failure: evolving literature and implications for future practice. Pharmacotherapy . 2014; 34:373-88. [PubMed 24214219] 717. Triposkiadis FK, Butler J, Karayannis G et al. Efficacy and safety of high dose versus low dose furosemide with or without dopamine infusion: the Dopamine in Acute Decompensated Heart Failure II (DAD-HF II) trial. Int J Cardiol . 2014;172(1):115-21. 718. Torres-Courchoud I, Chen HH. Is there still a role for low-dose dopamine use in acute heart failure?. Curr Opin Crit Care . 2014; 20:467-71. [PubMed 25137402] 719. Houston BA, Kalathiya RJ, Kim DA et al. 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Next Interactions Print this page Add to My Med List More about ethacrynic acid Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Images Drug Interactions Support Group Pricing & Coupons En Español 1 Review Add your own review/rating Drug class: loop diuretics Consumer resources Ethacrynic acid ... +4 more Professional resources Ethacrynic Acid (AHFS Monograph) Ethacrynate Sodium Injection (FDA) Ethacrynic Sodium (FDA) Ethacrynic Sodium Injection (FDA) Ethacrynic Acid (Wolters Kluwer) Other brands: Edecrin , Sodium Edecrin Related treatment guides Ascites Edema Nonobstructive Oliguria Pulmonary Edema Renal Failure> ]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA WADA Class Anti-Doping Classification Manufacturers Par Pharmaceutical, Inc. Roxane Laboratories, Inc. West-Ward Pharmaceuticals Drug Class Loop diuretics Related Drugs Nonobstructive Oliguria furosemide , Lasix , torsemide , Demadex , dopamine , Edecrin , More... Renal Failure furosemide , Lasix , torsemide , Demadex , Edecrin , ethacrynic acid , More... Ascites furosemide , Lasix , triamterene , torsemide , bumetanide , Bumex , More... Pulmonary Edema furosemide , Lasix , bumetanide , Bumex , Edecrin , ethacrynic acid , More... 1 more conditions... Ethacrynic acid Rating 1 User Review 8.0 /10 1 User Review 8.0 Rate it! Ethacrynic acid Images Ethacrynic acid systemic 25 mg (EDECRIN VRX 205) View larger images} } diagnosed
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