II. Indications

  1. See Loop Diuretic
  2. Ethacrynic Acid is the only Loop Diuretic that is not a Sulfonamide

III. Mechanism

IV. Dosing: Adult

  1. Oral
    1. Start: 25 mg orally daily
    2. Increase to 50 mg orally twice daily after first day
    3. Increase to 100 mg orally in the AM and 50 to 100 mg orally in PM
    4. Maximum: 200-400 mg divided twice daily
    5. Onset: 30 minutes
    6. Duration: 6 to 8 hours
  2. Intravenous
    1. Infusion concentration: 50 mg/ml
    2. Start: 0.5 to 1 mg/kg IV slowly over 20 to 30 minutes
    3. Maximum: 100 mg/dose
    4. IV Dose in 2023 costs $2500 in U.S.
    5. Onset: 5 minutes
    6. Duration: 2 hours

V. Dosing: Child

  1. Not FDA approved for use in children, and avoid in infants
  2. IV: 1 mg/kg IV

VI. Adverse Effects

  1. See Loop Diuretic
  2. Ototoxicity
    1. Most potentially ototoxic of the Loop Diuretics

VII. Safety

  1. Pregnancy Category B
  2. Unknown Safety in Lactation

VIII. Drug Interactions

  1. Increases Lithium levels

X. References

  1. (2021) Presc Lett, Resource #370507, Commonly Used Diuretics
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 62-3
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

ethacrynic acid (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ETHACRYNIC ACID 25 MG TABLET Generic $2.53 each

Ontology: Ethacrynic Acid (C0014963)

Definition (NCI) An unsaturated ketone derivative of aryloxyacetic acid without a sulfonamide substituent belonging to the class of loop diuretics. Ethacrynic acid is extensively bound to plasma proteins; both ethacrynic acid in its unchanged form as well as its metabolites are excreted in bile and urine.
Definition (MSH) A compound that inhibits symport of sodium, potassium, and chloride primarily in the ascending limb of Henle, but also in the proximal and distal tubules. This pharmacological action results in excretion of these ions, increased urinary output, and reduction in extracellular fluid. This compound has been classified as a loop or high ceiling diuretic.
Definition (PDQ) An aryloxy-acetic acid derivative belonging to the class of loop diuretics. Ethacrynic acid interferes with the chloride binding site of the Na+, K+, Cl- cotransporter system in the thick ascending loop of Henle, thereby inhibiting the reabsorption of sodium, potassium, and chloride ions. This leads to an increase in the excretion of sodium, potassium, chloride, calcium, and water. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41163&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41163&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C485" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D004976
SnomedCT 373536004, 81947000
English Acid, Etacrynic, Acid, Ethacrynic, Etacrynic Acid, Acetic acid, (2,3-dichloro-4-(2-methylene-1-oxobutyl)phenoxy)-, Acid, Ethacrinic, Ethacrinic Acid, [2,3-Dichloro-4-(2-methylene-1-oxobutyl)phenoxy]acetic Acid, ethacrynic acid, EA, ethacrynic acid (medication), Ethacrynic Acid, Ethacrynic Acid [Chemical/Ingredient], ethacrinic acid, etacrynic acid, Ethacrynic acid, Ethacrynic acid product, Etacrynic acid, Ethacrynic acid (product), Ethacrynic acid (substance), Etacrynic acid product, ETHACRYNIC ACID
Swedish Etakrynsyra
Czech kyselina ethakrynová
Finnish Etakryynihappo
Russian ETAKRINOVAIA KISLOTA, ЭТАКРИНОВАЯ КИСЛОТА
Japanese エタクリン酸
Croatian ETAKRINSKA KISELINA
Polish Kwas etakrynowy
Spanish ácido etacrínico (producto), ácido etacrínico (sustancia), ácido etacrínico, Ácido Etacrínico
French Acide étacrynique
German Etacrynsäure
Italian Acido etacrinico
Portuguese Ácido Etacrínico

Ontology: Edecrin (C0591434)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D004976
English edecrin, Edecrin