Ethacrynic acid

{{Infobox drug | Watchedfields = changed | verifiedrevid = 464388631 | IUPAC_name = 2-[[(2,3-Dichlorophenyl)acetyl]oxy]-4-(ethenyloxy)butanoic acid | image = Ethacrynic acid.svg | width = 250 | image2 = Ethacrynic-acid-3D-balls.png | width2 = 250 | tradename = Edecrin, others | Drugs.com = Monograph | MedlinePlus = a682857 | pregnancy_category = | legal_status = Rx-only | routes_of_administration = By mouth, intravenous | bioavailability = Variable | protein_bound = 91% | metabolism = Liver | elimination_half-life = 2 to 3 hours | excretion = Kidney | CAS_number = 58-54-8 | ATC_prefix = C03 | ATC_suffix = CA01 | PubChem = 3199 | DrugBank = DB00903 | ChemSpider = 3088 | UNII = 0J48LPH2TH | KEGG = D00313 | ChEBI = CHEBI:4876 | ChEMBL = CHEMBL1464 | synonyms = Ethacrynic acid, Ethacrynate sodium }}

Ethacrynic acid, sold under the brand name Edecrin among others, is a diuretic medication used to treat edema often associated with heart failure, cirrhosis, and renal disease. It is also used for the management of hypertension (high blood pressure). Unlike many other diuretics, ethacrynic acid is not a sulfonamide and can be used in patients who are allergic to sulfonamides.

Medical uses

Ethacrynic acid is primarily used to treat fluid build-up due to heart failure, kidney disease, or liver disease. It can also be used for the treatment of high blood pressure. The drug works by inhibiting the reabsorption of sodium in the kidneys, increasing the release of water.

Mechanism of action

Ethacrynic acid works as a loop diuretic, similar to furosemide. It acts on the ascending limb of the loop of Henle in the kidney. It does this by blocking the chloride pump, which leads to an increase in the excretion of sodium, chloride, and water.

Side effects

Common side effects include dehydration, increased blood urea nitrogen (BUN), and electrolyte imbalances. Serious side effects may include ototoxicity (hearing loss), severe hypokalemia (low blood potassium), and severe dehydration. Ethacrynic acid is also associated with a higher risk of gastrointestinal disturbances compared to other diuretics.

Pharmacology

Ethacrynic acid is absorbed from the gastrointestinal tract and undergoes extensive metabolism in the liver. Its action is dose-dependent and its effects are seen within minutes when administered intravenously and within an hour when taken by mouth. The drug is primarily excreted by the kidneys.

History

Ethacrynic acid was approved for medical use in the United States in 1967. It was developed as a powerful diuretic with a distinct chemical structure, not based on the sulfonamide framework, which is common in other diuretics.

Society and culture

Generic versions of ethacrynic acid are available, but the drug is not as commonly prescribed as other diuretics such as furosemide or hydrochlorothiazide due to its side effects and risk profile.