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Etacrynic acid (INN) or ethacrynic acid (USAN), trade name Edecrin, is a loop diuretic used to treat high blood pressure and the swelling caused by diseases like congestive heart failure, liver failure, and kidney failure.
Ethacrynic acid is sold in 25 mg and 50 mg tablets for oral use. The sodium salt (ethacrynate sodium) can also be given intravenously. The IV solution must be prepared and maintained with a pH above 5.
Ethacrynic acid can also cause low potassium levels, which may manifest as muscle cramps or muscle weakness. It has also been known to cause reversible or permanent hearing loss (ototoxicity) and liver damage. On oral administration, it produces diarrhea; intestinal bleeding may occur at higher doses.
Mechanism of actionEdit
Ethacrynic acid acts by inhibiting sodium-potassium-chloride cotransport in the ascending loop of Henle. Loss of potassium ions is less marked but chances of hypochloremic alkalosis are greater. The dose response curve of ethacrynic acid is steeper than that of furosemide and, in general, it is less manageable; dose range is 50-150mg.
Ethacrynic acid and its glutathione-adduct are potent inhibitors of glutathione S-transferase family members, which are enzymes involved in xenobiotic metabolism. This family of enzymes has recently been shown to have a high rate of genetic variability.
- ↑ Somberg JC, Molnar J (January 2009). The Pleiotropic Effects of Ethacrynic Acid. Am J Ther 16: 102.
- ↑ Bosher SK (1980). The nature of the ototoxic actions of ethacrynic acid upon the mammalian endolymph system. I. Functional aspects. Acta Otolaryngol. 89 (5–6): 407–18.
- ↑ Datey et al. (1967). Hepatocellular damage with ethacrynic acid. Br. Med. J. 3 (5558): 152–153.
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