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.