Ethacrynate sodium

Ethacrynate sodium for injection, USP is a potent diuretic which, if given in excessive amounts, may lead to profound diuresis with water and electrolyte depletion. Ethacrynic acid is an unsaturated ketone derivative of an aryloxyacetic acid. It is designated chemically as [2,3-dichloro-4-(2- methylene-1-oxobutyl)phenoxy] acetic acid.

Pharmacokinetics and Metabolism

Ethacrynate sodium acts on the ascending limb of the loop of Henle and on the proximal and distal tubules. Urinary output is usually dose dependent and related to the magnitude of fluid accumulation. Water and electrolyte excretion may be increased several times over that observed with thiazide diuretics, since ethacrynate sodium inhibits reabsorption of a much greater proportion of filtered sodium than most other diuretic agents. Therefore, ethacrynate sodium is effective in many patients who have significant degrees of renal insufficiency

Indications

Ethacrynate sodium is indicated for treatment of edema when an agent with greater diuretic potential than those commonly employed is required.

• 1.Treatment of the edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome.
• 2.Short-term management of ascites due to malignancy, idiopathic edema, and lymphedema.
• 3.Short-term management of hospitalized pediatric patients, other than infants, with congenital heart disease or the nephrotic syndrome. 4.Intravenous ethacrynate sodium is indicated when a rapid onset of diuresis is desired, e.g., in acute pulmonary edema, or when gastrointestinal absorption is impaired or oral medication is not practicable.

Contraindications

All diuretics, including ethacrynic acid, are contraindicated in anuria. If increasing electrolyte imbalance, azotemia, and/or oliguria occur during treatment of severe, progressive renal disease, the diuretic should be discontinued. In a few patients this diuretic has produced severe, watery diarrhea. If this occurs, it should be discontinued and not used again. Until further experience in infants is accumulated, therapy with parenteral ethacrynate sodium is contraindicated. Hypersensitivity to any component of this product.