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Ethacrynic Acid: Uses, Dosage, Side Effects & Interactions Guide
Summary of Key Points
Ethacrynic acid is a prescription medication used to treat fluid retention (edema) caused by conditions such as heart failure, liver cirrhosis, and kidney disease. It belongs to a class of medications known as loop diuretics, which help the body eliminate excess water and salt. Ethacrynic acid is often prescribed when other diuretics are either ineffective or unsuitable. Always consult your healthcare provider before starting or adjusting your dose.
Names of Medication
US Brand Name: Edecrin (Ethacrynic acid)
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Ethacrynic acid is the generic name.
Pharmacologic Category
Loop Diuretic
Other medications in this category include furosemide (Lasix), bumetanide (Bumex), and torsemide (Demadex). These drugs assist the kidneys in removing excess fluid from the body.
Ethacrynic Acid Dosage
Ethacrynic acid is used to treat various conditions related to fluid retention and high blood pressure. Dosages vary depending on the specific condition, so it’s essential to follow your doctor’s instructions carefully. Never adjust your dose without consulting your healthcare provider. If you need to speak with a healthcare provider, you can schedule a telemedicine appointment with us today.
Edema (Fluid Retention)
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Congestive Heart Failure
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Liver Cirrhosis
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Nephrotic Syndrome
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Hypertension (High Blood Pressure)
Initial Dose: 50 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Pulmonary Edema
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Kidney Disease
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Ascites (Fluid in the Abdomen)
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Heart Failure
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Hypercalcemia (High Calcium Levels)
Initial Dose: 50 to 100 mg orally once a day.
Maintenance Dose: Adjust based on response, typically 25 to 100 mg daily.
Dosage Forms and Strengths
Oral Tablets: 25 mg, 50 mg
Injectable Solution: 50 mg/mL
Administration Instructions
Ethacrynic acid can be taken by mouth, with or without food. It’s important to take it at the same time each day. If prescribed once daily, it’s best to take it in the morning to avoid frequent nighttime urination. Always follow your healthcare provider’s instructions, and do not stop taking the medication without consulting your doctor.
Contraindications for Ethacrynic Acid
A contraindication is a specific situation where a medication should not be used because it may cause harm. Ethacrynic acid has several contraindications, meaning it is not safe for everyone. Below are the main contraindications and why they may be harmful.
Allergy to Ethacrynic acid: If you are allergic to Ethacrynic acid, taking it can trigger a severe allergic reaction, which may include rash, itching, swelling, or difficulty breathing.
Severe kidney dysfunction: Ethacrynic acid is processed by the kidneys. If your kidneys are not functioning properly, the drug may accumulate in your body, leading to toxicity or further deterioration of kidney function.
Severe electrolyte imbalances: Ethacrynic acid can alter electrolyte levels, such as potassium, sodium, and magnesium. If you already have an imbalance, this medication may worsen it, potentially leading to serious complications like heart rhythm disturbances.
Dehydration: Ethacrynic acid increases urine output, which can worsen dehydration. If you are already dehydrated, taking this medication can lead to dangerously low fluid levels.
Pregnancy: Ethacrynic acid is not recommended during pregnancy due to potential risks to the developing fetus (see more details below).
Drug-to-Drug Interactions
Ethacrynic acid can interact with other medications, potentially causing harmful effects or reducing the effectiveness of either drug. It’s important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Ethacrynic acid:
Digoxin (Lanoxin): Ethacrynic acid can lower potassium levels, increasing the risk of digoxin toxicity.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve): These drugs can reduce the effectiveness of Ethacrynic acid and may increase the risk of kidney damage.
Aminoglycoside antibiotics (e.g., gentamicin): Taking these antibiotics with Ethacrynic acid can increase the risk of kidney damage and hearing loss.
Corticosteroids (e.g., prednisone): These drugs can increase the risk of electrolyte imbalances when taken with Ethacrynic acid.
Antihypertensive medications (e.g., lisinopril, metoprolol): Ethacrynic acid may enhance the blood pressure-lowering effects of these drugs, leading to low blood pressure (hypotension).
Ethacrynic Acid in Pregnancy
Is it safe to take Ethacrynic acid when pregnant?
Ethacrynic acid, a loop diuretic, is generally not recommended during pregnancy due to the potential risk it poses to the developing fetus, particularly during the first trimester. While human studies are limited, animal research has shown concerning effects, suggesting a significant possibility of harm. If you are pregnant or planning to become pregnant, it is important to consult your healthcare provider to discuss safer alternatives. If you are currently taking Ethacrynic acid and discover you are pregnant, contact one of our providers through telemedicine immediately to review your options.
Ethacrynic Acid While Breastfeeding
Is it safe to take Ethacrynic acid while breastfeeding?
It is unclear whether Ethacrynic acid passes into breast milk. However, due to the potential for serious side effects, such as electrolyte imbalances and dehydration, it is generally not recommended while breastfeeding. If you require treatment for conditions like edema or heart failure, consult one of our telemedicine providers to explore safer alternatives that are compatible with breastfeeding.
Estimated Cost of Ethacrynic Acid Medication
The cost of a 30-day supply of Ethacrynic acid without insurance can vary depending on the pharmacy and location. With a GoodRx coupon, the estimated price typically ranges from $100 to $150 for a 30-day supply of 25 mg tablets. Prices may fluctuate, so it’s a good idea to check with your pharmacy or use a discount service to find the most affordable option.
Possible Alternatives to Ethacrynic Acid
Depending on your specific condition, there may be alternative treatments or lifestyle changes that can help manage your symptoms. Always consult your healthcare provider before making any adjustments to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these options in more detail.
Edema Treatment Alternatives
For edema, alternatives to Ethacrynic acid include other diuretics such as furosemide (Lasix). Additionally, lifestyle modifications like reducing salt intake and elevating the legs can help alleviate swelling.
Congestive Heart Failure Alternatives
In managing congestive heart failure, medications such as ACE inhibitors (e.g., lisinopril) and beta-blockers (e.g., metoprolol) may be effective. Lifestyle changes, including a low-sodium diet and regular physical activity, can also play a crucial role in symptom management.
Liver Cirrhosis Alternatives
For liver cirrhosis, diuretics like spironolactone (Aldactone) may be considered as an alternative. Additionally, avoiding alcohol and following a liver-friendly diet can help manage symptoms and support liver health.
Nephrotic Syndrome Alternatives
Treatment for nephrotic syndrome may involve other diuretics or medications such as corticosteroids. Dietary adjustments, including reducing sodium and protein intake, may also be beneficial in managing the condition.
Hypertension Alternatives
For hypertension, alternatives to Ethacrynic acid include other antihypertensive medications such as ACE inhibitors or calcium channel blockers. Lifestyle changes, including weight loss, regular exercise, and a low-sodium diet, can also help control blood pressure.
Pulmonary Edema Alternatives
In cases of pulmonary edema, other diuretics like furosemide (Lasix) may be used. Oxygen therapy and addressing the underlying cause, such as heart failure, are also essential components of treatment.
Kidney Disease Alternatives
Depending on the stage of kidney disease, treatment may involve other diuretics or medications aimed at managing blood pressure and preserving kidney function. Dietary changes, such as reducing protein intake, may also be recommended to support kidney health.
Ascites Alternatives
For ascites, diuretics like spironolactone (Aldactone) or procedures such as paracentesis (fluid drainage) may be used. Reducing salt intake can also help manage fluid buildup and alleviate symptoms.
Heart Failure Alternatives
In addition to diuretics, medications like beta-blockers and ACE inhibitors, combined with lifestyle changes such as reducing salt intake and engaging in regular physical activity, can help manage heart failure effectively.
Hypercalcemia Alternatives
Treatment for hypercalcemia may involve other diuretics like furosemide (Lasix) or medications that help lower calcium levels. Staying well-hydrated and avoiding calcium-rich foods can also support treatment efforts.
Recent Updates on Ethacrynic Acid Research
Recent studies on Ethacrynic acid have focused on its use in patients with kidney disease and heart failure. Researchers are particularly interested in its potential safety for individuals with sulfa allergies, as Ethacrynic acid is one of the few loop diuretics that does not contain a sulfa group. Ongoing research is also examining its role in managing fluid retention in patients with advanced liver disease. While Ethacrynic acid remains a valuable option for certain patients, newer diuretics and combination therapies are being explored for their potential to provide better outcomes with fewer side effects.
If you would like to learn more about the latest research or have questions about your current treatment, schedule a telemedicine appointment with one of our providers today.
