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Sodium Edecrin (ethacrynic acid) Disease Interactions

There are 7 disease interactions with Sodium Edecrin (ethacrynic acid):

Major

Loop Diuretics (Includes Sodium Edecrin) ↔ Anuria

Severe Potential Hazard, High plausibility

Applies to: Anuria

The use of loop diuretics is contraindicated in patients with anuria.

References

  1. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  4. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
View all 4 references
Major

Loop Diuretics (Includes Sodium Edecrin) ↔ Cirrhosis

Severe Potential Hazard, High plausibility

Applies to: Hepatic Coma, Cirrhosis

Loop diuretic therapy should be initiated in the hospital under strict observation in patients with liver cirrhosis and ascites. Sudden alteration of fluid and electrolyte balance may precipitate hepatic encephalopathy and coma in such patients, who are also at increased risk for the development of hypokalemia. Supplemental potassium and/or concomitant use of an aldosterone antagonist or potassium-sparing agent may help prevent hypokalemia and metabolic alkalosis. Loop diuretics should be withheld in patients with hepatic coma until the condition improves.

References

  1. Lieberman FL, Reynolds TB "The use of ethacrynic acid in patients with cirrhosis and ascites." Gastroenterology 49 (1965): 531-8
  2. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  3. Schwartz FD, Pillay VK, Kark RM "Ethacrynic acid: its usefulness and untoward effects." Am Heart J 79 (1970): 427-8
  4. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  5. Ring-Larsen H "Bumetanide in the treatment of hepatic ascites. A short and long-term study." Acta Med Scand 195 (1974): 411-4
  6. Knauf H, Mutschler E "Liver cirrhosis with ascites: pathogenesis of resistance to diuretics and long-term efficacy and safety of torasemide." Cardiology 84 (1994): 87-98
  7. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  8. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
View all 8 references
Major

Loop Diuretics (Includes Sodium Edecrin) ↔ Electrolyte Losses

Severe Potential Hazard, High plausibility

Applies to: Hypocalcemia, Hypokalemia, Hyponatremia, Magnesium Imbalance, Diarrhea, Electrolyte Abnormalities, Hyperaldosteronism, Malnourished, Ventricular Arrhythmia, Vomiting, Dehydration

The use of loop diuretics, particularly at high dosages or during chronic therapy, is commonly associated with loss of electrolytes, including potassium, sodium, chloride, magnesium, and calcium. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Excessive diuresis, as indicated by rapid weight loss, may induce dehydration and hypovolemia, which can result in acute hypotension, orthostasis, circulatory collapse, vascular thrombosis and embolism, and abrupt reduction in glomerular filtration and renal blood flow. Severe dehydration is most likely to occur in the elderly and patients under prolonged sodium restriction. Therapy with loop diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected before initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since the development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower diuretic dosage, potassium supplementation, or combined use with a potassium-sparing diuretic. Similarly, to prevent excessive dehydration and hyponatremia, sodium intake should be liberalized if clinically feasible.

References

  1. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  3. Cooperman LB, Rubin IL "Toxicity of ethacrynic acid and furosemide." Am Heart J 85 (1973): 831-4
  4. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
  5. DeRubertis FR, Michelis MF, Beck N, Davis BB "Complications of diuretic therapy: severe alkalosis and syndrome resembling inappropriate secretion of antidiuretic hormone." Metabolism 19 (1970): 709-19
  6. Sullivan RC, Freemon FR, Caranasos GJ "Complications from diuretic therapy with ethacrynic acid and furosemide." South Med J 64 (1971): 869-72
  7. Ponto LL, Schoenwald RD "Furosemide (frusemide): a pharmacokinetic/pharmacodynamic review." Clin Pharmacokinet 18 (1990): 381-408
  8. Menday AP, Adnitt PI, Underwood PN "Effect of long-term treatment with bumetanide/amiloride on electrolytes and renal function in elderly patients with heart failure." Curr Ther Res Clin Exp 50 (1991): 57-64
  9. White SJ, Williamson K "What to watch for when you give loop diuretics." RN 42 (1979): 25-7
  10. Fowler SF, Murray KM "Torsemide: a new loop diuretic." Am J Health Syst Pharm 52 (1995): 1771-80
  11. Schwartz AB "Diuretic-induced hypokalemia." Am Fam Physician 11 (1975): 101-4
  12. Schmidt P, Friedman IS "Adverse effects of ethacrynic acid." N Y State J Med 67 (1967): 1438-42
  13. Martinez-Maldonado M "Electrolyte disturbances resulting from diuretic therapy." Tex Med 69 (1973): 83-7
  14. Fowler SF, Murray KM "Torsemide: a new loop diuretic." Am J Health Syst Pharm 52 (1995): 1771-80
  15. Patterson JH, Adams KF, Applefeld MM, Corder CN, Masse BR "Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion." Pharmacotherapy 14 (1994): 514-21
  16. Roesner M "The loop diuretics: focus on furosemide and ethacrynic acid." N C Med J 47 (1986): 93-6
  17. Ward A, Heel RC "Bumetanide: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use." Drugs 28 (1984): 426-64
  18. Blose JS, Adams KF, Patterson JH "Torsemide: a pyridine-sulfonylurea loop diuretic." Ann Pharmacother 29 (1995): 396-402
  19. Kubik MM, Bowers E, Underwood PN "Longterm experience of the routine use of bumetanide." Br J Clin Pract 30 (1976): 11-4
  20. Tambyah JA, Lim MK "Effect of furesomide on calcium excretion." Br Med J 03/22/69 (1969): 751-2
  21. Schwartz FD, Pillay VK, Kark RM "Ethacrynic acid: its usefulness and untoward effects." Am Heart J 79 (1970): 427-8
  22. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  23. Oberbauer R, Krivanek P, Turnheim K "Pharmacokinetics and pharmacodynamics of the diuretic bumetanide in the elderly." Clin Pharmacol Ther 57 (1995): 42-51
  24. Plumb VJ, James TN "Clinical hazards of powerful diuretics. Furosemide and ethacrynic acid." Mod Concepts Cardiovasc Dis 47 (1978): 91-4
  25. Gaillard R, Vallotton B, Muller F "Letter: Hypotension after angiotensin-II infusion and hypovolaemia induced by diuretic." Lancet 1 (1974): 1349
  26. Dunn CJ, Fitton A, Brogden RN "Torasemide: an update of its pharmacological properties and therapeutic efficacy." Drugs 49 (1995): 121-42
View all 26 references
Major

Loop Diuretics (Includes Sodium Edecrin) ↔ Ototoxicity

Severe Potential Hazard, High plausibility

Applies to: Hearing Loss

Tinnitus and hearing loss, both reversible and permanent, have been reported with the use of loop diuretics. Ototoxic effects have generally been associated with rapid intravenous or intramuscular injection, severe renal impairment, unusually high dosages (i.e. several times the usual recommended dosages), and/or concomitant use of other ototoxic agents. Therapy with loop diuretics should be administered cautiously in patients with preexisting vestibular and/or auditory impairment, since it may delay the recognition or confound the diagnosis of a drug-induced ototoxic effect. High-dose parenteral therapy should be administered as controlled infusion.

References

  1. Hybels RL "Drug toxicity of the inner ear." Med Clin North Am 63 (1979): 309-19
  2. Schwartz FD, Pillay VK, Kark RM "Ethacrynic acid: its usefulness and untoward effects." Am Heart J 79 (1970): 427-8
  3. Ballantyne J "Ototoxicity: a clinical review." Audiology 12 (1973): 325-36
  4. Beauchamp GD, Crouch TC "Deafness. Review of intravenous ethacrynic acid." J Kans Med Soc 76 (1975): 166-8,180
  5. Pillay VK, Schwartz FD, Aimi K, Kark RM "Transient and permanent deafness following treatment with ethacrynic acid in renal failure." Lancet 1 (1969): 77-9
  6. Schneider WJ, Becker EL "Acute transient hearing loss after ethacrynic acid therapy." Arch Intern Med 117 (1966): 715-7
  7. Lloyd-Mostyn R, Lord I "Ototoxicity of intravenous furosemide." Lancet 2 (1971): 1156
  8. Rybak LP "Ototoxicity of ethacrynic acid (a persistent clinical problem)." J Laryngol Otol 102 (1988): 518-20
  9. Chaffee WG Jr "Hazards of ethacrynic acid." JAMA 212 (1970): 159
  10. David D, Hitzig P "Diuretics and ototoxicity." N Engl J Med 284 (1971): 1328
  11. Fowler SF, Murray KM "Torsemide: a new loop diuretic." Am J Health Syst Pharm 52 (1995): 1771-80
  12. Marlowe FI "Ototoxic agents." Otolaryngol Clin North Am 11 (1978): 791-800
  13. Matz GJ, Beal DD, Krames L "Ototoxicity of ethacrynic acid. Demonstrated in a human temporal bone." Arch Otolaryngol 90 (1969): 152-5
  14. Schwartz G "Ototoxicity induced by furosemide." N Engl J Med 282 (1970): 1413
  15. Gomolin IH, Garschick E "Ethacrynic acid-induced deafness accompanied by nystagmus." N Engl J Med 303 (1980): 702
  16. Homer MJ "Deafness after ethacrynic acid." N Engl J Med 285 (1971): 1152
  17. Arnold W, Nadol JB Jr, Weidauer H "Ultrastructural histopathology in a case of human ototoxicity due to loop diuretics." Acta Otolaryngol (Stockh) 91 (1981): 399-414
  18. Rybak LP "Ototoxicity of loop diuretics." Otolaryngol Clin North Am 26 (1993): 829-44
  19. Boston Collaborative Drug Surveillance Program "Drug-induced deafness." JAMA 224 (1973): 515-6
  20. Sheffield PA, Turner JS Jr "Ototoxic drugs: a review of clinical aspects, histopathologic changes and mechanisms of action." South Med J 64 (1971): 359-63
  21. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  22. Quick CA, Hoppe W "Permanent deafness associated with furosemide administration." Ann Otol Rhinol Laryngol 84 (1975): 94-101
  23. Ng PS, Conley CE, Ing TS "Deafness after ethacrynic acid." Lancet 1 (1969): 673-4
  24. Vargish T, Benjamin R, Shenkman L "Deafness from furosemide." Ann Intern Med 72 (1970): 761
  25. Cooperman LB, Rubin IL "Toxicity of ethacrynic acid and furosemide." Am Heart J 85 (1973): 831-4
  26. Matz GJ "The ototoxic effects of ethacrynic acid in man and animals." Laryngoscope 86 (1976): 1065-86
  27. David DS, Hitzig P "Diuretics and ototoxicity." N Engl J Med 284 (1971): 1328-9
  28. Quick CA, Duvall AJ 3d "Early changes in the cochlear duct from ethacrynic acid: an electronmicroscopie evaluation." Laryngoscope 80 (1970): 954-65
  29. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
  30. Dunn CJ, Fitton A, Brogden RN "Torasemide: an update of its pharmacological properties and therapeutic efficacy." Drugs 49 (1995): 121-42
  31. Ajodhia JM, Dix MR "Drug-induced deafness and its treatment." Practitioner 216 (1976): 561-70
  32. Matz GJ, Naunton RF "Ototoxic drugs and poor renal function." JAMA 206 (1968): 2119
  33. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  34. Blose JS, Adams KF, Patterson JH "Torsemide: a pyridine-sulfonylurea loop diuretic." Ann Pharmacother 29 (1995): 396-402
  35. Meriwether WD, Mangi RJ, Serpick AA "Deafness following standard intravenous dose of ethacrynic acid." JAMA 216 (1971): 795-8
  36. Heidland A, Wigand N "Influence of high doses of furosemide on hearing of uremic patients." Klin Wochenschr 48 (1970): 1052
  37. Venkateswaran P "Transient deafness from high doses of furosemide." Br Med J 4 (1971): 113
  38. Fowler SF, Murray KM "Torsemide: a new loop diuretic." Am J Health Syst Pharm 52 (1995): 1771-80
  39. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  40. Merrill JP "Hazards of ethacrynic acid." JAMA 212 (1970): 159
View all 40 references
Major

Loop Diuretics (Includes Sodium Edecrin) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Impaired effectiveness and possible delayed excretion of loop diuretics may occur in patients with severe renal dysfunction. These individuals may require high dosages that are associated with an increased risk of electrolyte abnormalities (hyponatremia, hypochloremic alkalosis, hypokalemia, hypomagnesemia, hypocalcemia) and ototoxicity (tinnitus, hearing loss). Therapy with loop diuretics should be administered cautiously in patients with significantly impaired renal function. Prolongation of the dosing intervals may be appropriate to prevent drug accumulation. The patient should be monitored closely for the signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Excessive diuresis should be avoided as it may induce dehydration and hypovolemia, which can result in an abrupt reduction in glomerular filtration and renal blood flow. If increasing azotemia and oliguria occur during treatment of severe progressive renal disease, or if renal function becomes progressively worse as indicated by rising BUN or serum creatinine levels, an interruption or discontinuation of therapy should be considered.

References

  1. Tilstone WJ, Fine A "Furosemide kinetics in renal failure." Clin Pharmacol Ther 23 (1978): 644-50
  2. Marcantonio LA, Auld WH, Murdoch WR, Purohit R, Skellern GG, Howes CA "The pharmacokinetics and pharmacodynamics of the diuretic bumetanide in hepatic and renal disease." Br J Clin Pharmacol 15 (1983): 245-52
  3. Rane A, Villeneuve JP, Stone WJ, et al "Plasma binding and disposition of furosemide in the nephrotic syndrome and in uremia." Clin Pharmacol Ther 24 (1978): 199-207
  4. Risler T, Schwab A, Kramer B, Braun N, Erley C "Comparative pharmacokinetics and pharmacodynamics of loop diuretics in renal failure." Cardiology 84 (1994): 155-61
  5. Rose HJ, O'Malley K, Pruitt AW "Depression of renal clearance of furosemide in man by azotemia." Clin Pharmacol Ther 21 (1976): 141-6
  6. Pentikainen PJ, Pasternack A, Lampainen E, Neuvonen PJ, Penttila A "Bumetanide kinetics in renal failure." Clin Pharmacol Ther 37 (1985): 582-8
  7. Keller E, Hoppe-Seyler G, Mumm R, Schollmeyer P "Influence of hepatic cirrhosis and end-stage renal disease on pharmacokinetics and pharmacodynamics of furosemide." Eur J Clin Pharmacol 20 (1981): 27-33
  8. Huang CM, Atkinson AJ, Levin M, et al "Pharmacokinetics of furosemide in advanced renal failure." Clin Pharmacol Ther 16 (1974): 659-66
  9. Berg KJ, Tromsdal A, Wideroe TE "Diuretic action of bumetanide in advanced chronic renal insufficiency." Eur J Clin Pharmacol 9 (1976): 265-75
  10. Menday AP, Adnitt PI, Underwood PN "Effect of long-term treatment with bumetanide/amiloride on electrolytes and renal function in elderly patients with heart failure." Curr Ther Res Clin Exp 50 (1991): 57-64
  11. Cutler RE, Forrey AW, Christopher TG, Kimpel BM "Pharmacokinetics of furosemide in normal subjects and functionally anephric patients." Clin Pharmacol Ther 15 (1974): 588-96
  12. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  13. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  14. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
  15. Donatucci CF, Deshon GE, Wade CE, Hunt M "Furosemide-induced disturbances of renal function in patients undergoing TURP." Urology 35 (1990): 295-300
  16. Sullivan RC, Freemon FR, Caranasos GJ "Complications from diuretic therapy with ethacrynic acid and furosemide." South Med J 64 (1971): 869-72
  17. Andreasen F, Hansen HE, Mikkelsen E "Pharmacokinetics of furosemide in anephric patients and in normal subjects." Eur J Clin Pharmacol 13 (1978): 41-8
  18. Lowenthal DT, Dickerman D "The use of diuretics in varying degrees of renal impairment: an overview." Clin Exp Hypertens A 5 (1983): 297-307
  19. Kaye M, Dufresne L, McDade D "Ethacrynic acid in acute renal failure." Lancet 1 (1968): 1255
  20. White SJ, Williamson K "What to watch for when you give loop diuretics." RN 42 (1979): 25-7
  21. Ward A, Heel RC "Bumetanide: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use." Drugs 28 (1984): 426-64
  22. Pillay VK, Schwartz FD, Aimi K, Kark RM "Transient and permanent deafness following treatment with ethacrynic acid in renal failure." Lancet 1 (1969): 77-9
  23. Keller E, Hoppe-Seyler G, Schollmeyer P "Disposition and diuretic effect of furosemide in the nephrotic syndrome." Clin Pharmacol Ther 32 (1982): 442-9
  24. Matz GJ, Naunton RF "Ototoxic drugs and poor renal function." JAMA 206 (1968): 2119
  25. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  26. Beermann B, Dalen E, Lindstrom B "Elimination of furosemide in healthy subjects and in those with renal failure." Clin Pharmacol Ther 22 (1977): 70-8
  27. Plumb VJ, James TN "Clinical hazards of powerful diuretics. Furosemide and ethacrynic acid." Mod Concepts Cardiovasc Dis 47 (1978): 91-4
  28. Russo D, Minutolo R, Andreucci VE "Role of loop diuretics in chronic renal failure." Cardiology 84 (1994): 162-70
View all 28 references
Moderate

Loop Diuretics (Includes Sodium Edecrin) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus, Abnormal Glucose Tolerance

Loop diuretics may cause hyperglycemia, glycosuria, and alterations in glucose tolerance tests. Rarely, precipitation of diabetes mellitus has been reported. Therapy with loop diuretics should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during therapy, and their antidiabetic regimen adjusted accordingly.

References

  1. Domenet JG "Diabetogenic effect of oral diuretics." Br Med J 3 (1968): 188
  2. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  4. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
  5. Dimitriadis G, Tegos C, Golfinopoulou L, Roboti C, Raptis S "Furosemide-induced hyperglycaemia - the implication of glycolytic kinases." Horm Metab Res 25 (1993): 557-9
  6. Andersen OO, Persson I "Carbohydrate metabolism during treatment with chlorthalidone and ethacrynic acid." Br Med J 2 (1968): 798-801
  7. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  8. Coni NK, Gordon PW, Mukherjee AP, Read PR "The effect of frusemide and ethacrynic acid on carbohydrate metabolism." Age Ageing 3 (1974): 85-90
  9. Gray GM "Drugs, malnutrition, and carbohydrate absorption." Am J Clin Nutr 26 (1973): 121-4
  10. Chaudhuri ML, Catania J "A comparison of the effects of bumetanide (Burinex) and frusemide on carbohydrate metabolism in the elderly." Br J Clin Pract 42 (1988): 427-9
View all 10 references
Moderate

Loop Diuretics (Includes Sodium Edecrin) ↔ Hyperuricemia

Moderate Potential Hazard, High plausibility

Applies to: Gout

Loop diuretics may decrease the rate of uric acid excretion. Hyperuricemia can occur but is usually asymptomatic and rarely leads to clinical gout except in patients with a history of gout or chronic renal failure. Therapy with loop diuretics should be administered cautiously in such patients.

References

  1. "Product Information. Bumex (bumetanide)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Edecrin (ethacrynic acid)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Lasix (furosemide)." sanofi-aventis , Bridgewater, NJ.
  4. "Product Information. Demedex (torsemide)." Boehringer Mannheim, Gaithersburg, MD.
View all 4 references

Sodium Edecrin (ethacrynic acid) drug Interactions

There are 683 drug interactions with Sodium Edecrin (ethacrynic acid)

Sodium Edecrin (ethacrynic acid) alcohol/food Interactions

There is 1 alcohol/food interaction with Sodium Edecrin (ethacrynic acid)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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