Ethacrynic acid
When ATH:
C03CC01
Pharmacological action.
Diuretic.
Application.
Edematous syndrome of various genesis (congestive heart failure, Portal cirrhosis, nephrotic syndrome), arterial hypertension (in a combination therapy), pulmonary edema, cephaledema.
Contraindications.
Hypersensitivity, anurija, expressed disturbances of water and electrolyte and acid-base balance, pechenochnaya coma, severe diabetes and gout, pregnancy, lactation, natural infancy (to 2 years).
Pregnancy and breast-feeding.
Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.
Side effects.
Anorexia, nausea, vomiting, abdominal pain, diarrhea, acute pancreatitis; orthostatic hypotension, tachycardia, arrhythmia, ototoxic violation, dizziness, headache, muscular weakness, degidratatsiya, metabolic acidosis, kaliopenia, chloropenia, giponatriemiya, gipomagniemiya, hypocalcemia.
Cooperation.
Potassium-sparing diuretics enhance the effect and reduce the hypokalemia and alkalosis. Deepens hypotension, caused by beta-blockers, gidralazinom, verapamil, nifedipine, captopril, clonidine, methyldopa, guanethidine, prazosin, reserpine, ganglioblokatorami (possible orthostatic collapse). Combined with indirect anticoagulants and glucocorticoids increases the more important and hypokalemia salurez. Increases GRT- and nephrotoxicity of other drugs, and the degree of dehydration on the background of laxatives.
Overdose.
Symptoms: expressed disturbances of water-electrolyte metabolism (kaliopenia, chloropenia, gipovolemiя), metabolic alkalosis, hypotension, Arrhythmia.
Treatment: gastric lavage, administration of drugs, correcting the acid-base balance (potassium supplements); if necessary, resuscitation measures to restore the function of breathing and the cardiovascular system.
Dosing and Administration.
Inside, morning, after meal, beginning with 0,05 g / day, if necessary, resuscitation measures to restore the function of breathing and the cardiovascular system.
Precautions.
In cirrhosis application requires careful medical supervision. Treatment should be carried out against the background of diet, rich in potassium, and, if necessary, to prescribe his drugs.
Cooperation
Active substance | Description of interaction |
Amikacin | FMR: synergism. Strengthens (mutually) the probability of ototoxicity; In sharing caution. |
Vancomycin | FMR: synergism. Against the background of ethacrynic acid may increase the risk of symptoms of general relativity- and / or nephrotoxicity; simultaneously or sequentially using audiometry and the need for periodic determination of creatinine clearance. |
Warfarin | FKV. FMR: synergism. Against the background of ethacrynic acid increases the concentration of the free fraction of blood (It is displaced from its association with proteins) and enhanced effect; with a joint appointment may require dose reduction. |
Verapamil | FMR: synergism. Strengthens (mutually) hypotensive effect. |
Gentamicin | FMR. Increases (mutually) the probability of ototoxicity; combined use is not recommended. |
Glipizide | FMR: antagonizm. Against the background of ethacrynic acid weakens effect. |
Digoxin | FMR. Against the background of ethacrynic acid (It causes a loss of potassium) It increases the risk of cardiac manifestations. |
Diclofenac | FMR: antagonizm. Reduces the diuretic, natriuretic and hypotensive effects. |
Diclofenac potassium | FMR: antagonizm. Reduces the diuretic, natriuretic and hypotensive effects. |
Indomethacin | FMR: antagonizm. Reduces the diuretic, natriuretic and hypotensive effects. |
Kanamycin | FMR: synergism. Strengthens (mutually) the probability of ototoxicity; combined use is not recommended. |
Captopril | FMR: synergism. Strengthens (mutually) hypotensive effect. |
Lithium carbonate | FMR. Against the background of ethacrynic acid increases the risk of intoxication. |
Methyldopa | FMR: synergism. Strengthens (mutually) hypotensive effect. |
Nifedipine | FMR: synergism. Strengthens (mutually) hypotensive effect. |
Perindopril | FKV. FMR. Strengthens (mutually) hypotensive effect. Against the background of ethacrynic acid decreases bioavailability. |
Prazosin | FMR: synergism. Strengthens (mutually) hypotensive effect. |
Ramipril | FMR: synergism. Strengthens (mutually) hypotensive effect. |
Repaglinide | FMR: antagonizm. Against the background of ethacrynic acid weakens effect. |
Streptomycin | FMR. Strengthens (mutually) the probability of ototoxicity; co-administration is not recommended. |
Tobramycin | FMR. Strengthens (mutually) the probability of ototoxicity; combined use is not recommended. |
Phenylbutazone | FMR: antagonizm. Reduces the diuretic, natriuretic and hypotensive effects. |
Fosinopril | FMR: synergism. Strengthens (mutually) hypotensive effect. |
Celecoxib | FMR: antagonizm. Reduces the diuretic, natriuretic and hypotensive effects. |
Tsefazolyn | FMR: synergism. Strengthens (mutually) The risk of developing ototoxicity. |
Cefaclor | FMR. Increases (mutually) The risk of developing ototoxicity. |
Cephalexin | FMR: synergism. Increases (mutually) the risk of kidney damage. |
Tsefalotin | FMR. Increases (mutually) The risk of developing ototoxicity. |
Tsefoksytyn | FMR. Increases (mutually) The risk of developing ototoxicity. |
Cefoperazone | FMR. Increases (mutually) The risk of developing ototoxicity. |