ethacrynic acid (Rx)

Brand and Other Names:Edecrin
  • Print

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

powder for injection

  • 50mg

tablet

  • 25mg

Edema

0.5-1 mg/kg up to 100 mg/dose slow IVP, OR  

25-100 mg PO qDay or q12hr

May take with food

Renal Impairment

Not necessary to supplement dose; not removed by hemo- or peritoneal dialysis

CrCl <10 mL/minute: Not recommended

Overdose Management

May use normal saline for volume replacement

May use dopamine or norepinephrine to treat hypotension

If dysrhythmia due to decreased K+ or Mg+ suspected replace aggressively

Discontinue treatment if no symptoms after 6hr

Other Indications & Uses

Edema-associated with CHF, hepatic cirrhosis, renal dysfunction, malignancy, & pulmonary edema

Short-term use in children (other than infants) with congenital heart disease or nephrotic syndrome

Use when fluid retention refractory to thiazides, or with impaired renal function

Dosage Forms & Strengths

powder for injection

  • 50mg

tablet

  • 25mg

Congenital Heart Disease, Nephrotic Syndrome

PO: 1 mg/kg/dose qDay; may increase q2-3days to maximum of 3 mg/kg/day

IV: Data limited; 1 mg/kg IV  

May cause hypertension and fluid imblances in the elderly; use alternatives if available

Edema

0.5-1 mg/kg up to 100 mg/dose slow IVP, OR  

25-50 mg PO qDay or q12hr

May take with food

Next:

Interactions

Interaction Checker

and ethacrynic acid

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (10)

              • amikacin

                ethacrynic acid, amikacin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • baricitinib

                ethacrynic acid will increase the level or effect of baricitinib by decreasing elimination. Avoid or Use Alternate Drug. Coadministration of baricitinib with strong organic anion transporter 3 (OAT3) inhibitors is not recommended.

              • furosemide

                furosemide, ethacrynic acid. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Increased risk of ototoxicity.

              • gentamicin

                ethacrynic acid, gentamicin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • lofexidine

                lofexidine, ethacrynic acid. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              • neomycin PO

                ethacrynic acid, neomycin PO. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • paromomycin

                ethacrynic acid, paromomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • squill

                ethacrynic acid increases toxicity of squill by Other (see comment). Avoid or Use Alternate Drug. Comment: Potassium depletion may enhance toxicity of squill.

              • streptomycin

                ethacrynic acid, streptomycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              • tobramycin

                ethacrynic acid, tobramycin. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of ototoxicity and nephrotoxicity.

              Monitor Closely (147)

              • acebutolol

                acebutolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • aceclofenac

                aceclofenac increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • acemetacin

                acemetacin increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • albuterol

                albuterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • aldesleukin

                aldesleukin increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • amifostine

                amifostine, ethacrynic acid. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

              • amiloride

                amiloride increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • arformoterol

                arformoterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • aspirin

                aspirin increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • aspirin rectal

                aspirin rectal increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • atenolol

                atenolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • avanafil

                avanafil increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • beclomethasone, inhaled

                beclomethasone, inhaled increases toxicity of ethacrynic acid by increasing elimination. Use Caution/Monitor. Corticosteroids may increase the hypkalemic effects of loop diuretics.

              • benazepril

                benazepril, ethacrynic acid. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • bendroflumethiazide

                ethacrynic acid and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.

              • betaxolol

                betaxolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • bisoprolol

                bisoprolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • bretylium

                ethacrynic acid, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.

              • bumetanide

                bumetanide and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • buprenorphine, long-acting injection

                buprenorphine, long-acting injection decreases effects of ethacrynic acid by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Opioids can reduce diuretic efficacy by inducing antidiuretic hormone release.

              • candesartan

                candesartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • captopril

                captopril, ethacrynic acid. Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • carbenoxolone

                ethacrynic acid and carbenoxolone both decrease serum potassium. Use Caution/Monitor.

              • carbidopa

                carbidopa increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.

              • carvedilol

                carvedilol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • celecoxib

                celecoxib increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • celiprolol

                celiprolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cephaloridine

                ethacrynic acid, cephaloridine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.

              • chlorothiazide

                ethacrynic acid and chlorothiazide both decrease serum potassium. Use Caution/Monitor.

              • chlorthalidone

                ethacrynic acid and chlorthalidone both decrease serum potassium. Use Caution/Monitor.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • citalopram

                ethacrynic acid, citalopram. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.

              • cornsilk

                cornsilk increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).

              • cyclopenthiazide

                ethacrynic acid and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.

              • deflazacort

                ethacrynic acid and deflazacort both decrease serum potassium. Use Caution/Monitor.

              • dichlorphenamide

                dichlorphenamide and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • diclofenac

                diclofenac increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • diflunisal

                diflunisal increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • digoxin

                digoxin increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                ethacrynic acid increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Hypokalemia increases digoxin effects.

              • dobutamine

                dobutamine and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • dopexamine

                dopexamine and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • drospirenone

                drospirenone increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • empagliflozin

                empagliflozin, ethacrynic acid. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of empagliflozin with diuretics results in increased urine volume and frequency of voids, which might enhance the potential for volume depletion.

              • enalapril

                enalapril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • ephedrine

                ephedrine and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • epinephrine

                epinephrine and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • epinephrine racemic

                epinephrine racemic and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • eprosartan

                eprosartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • esmolol

                esmolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • etodolac

                etodolac increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fenoprofen

                fenoprofen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fentanyl

                fentanyl decreases effects of ethacrynic acid by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • fentanyl intranasal

                fentanyl intranasal decreases effects of ethacrynic acid by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • fentanyl transdermal

                fentanyl transdermal decreases effects of ethacrynic acid by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • fentanyl transmucosal

                fentanyl transmucosal decreases effects of ethacrynic acid by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).

              • flurbiprofen

                flurbiprofen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • formoterol

                formoterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • fosinopril

                fosinopril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • furosemide

                ethacrynic acid and furosemide both decrease serum potassium. Use Caution/Monitor.

              • gentamicin

                ethacrynic acid and gentamicin both decrease serum potassium. Use Caution/Monitor.

              • hydrochlorothiazide

                ethacrynic acid and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.

              • ibuprofen

                ibuprofen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ibuprofen IV

                ibuprofen IV increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • imidapril

                imidapril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • indacaterol, inhaled

                ethacrynic acid, indacaterol, inhaled. serum potassium. Use Caution/Monitor. Combination may increase risk of hypokalemia.

                indacaterol, inhaled, ethacrynic acid. Other (see comment). Use Caution/Monitor. Comment: Caution is advised in the coadministration of indacaterol neohaler with non-potassium-sparing diuretics.

              • indapamide

                ethacrynic acid and indapamide both decrease serum potassium. Use Caution/Monitor.

              • indomethacin

                indomethacin increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • insulin degludec

                ethacrynic acid decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.

              • insulin degludec/insulin aspart

                ethacrynic acid decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.

              • insulin inhaled

                ethacrynic acid decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.

              • irbesartan

                irbesartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • isoproterenol

                isoproterenol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • juniper

                juniper, ethacrynic acid. Other (see comment). Use Caution/Monitor. Comment: Juniper may potentiate or interfere with diuretic therapy. Juniper has diuretic effects, but may cause kidney damage at large doses.

              • ketoprofen

                ketoprofen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ketorolac

                ketorolac increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ketorolac intranasal

                ketorolac intranasal increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • labetalol

                labetalol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • levalbuterol

                levalbuterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • levodopa

                levodopa increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.

              • lily of the valley

                ethacrynic acid increases toxicity of lily of the valley by Other (see comment). Use Caution/Monitor. Comment: Increased risk of cardiac toxicity due to K+ depletion.

              • lisinopril

                lisinopril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • lornoxicam

                lornoxicam increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • losartan

                losartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lurasidone

                lurasidone increases effects of ethacrynic acid by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

              • maitake

                maitake increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).

              • maraviroc

                maraviroc, ethacrynic acid. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.

              • meclofenamate

                meclofenamate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • mefenamic acid

                mefenamic acid increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • meloxicam

                meloxicam increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metaproterenol

                metaproterenol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • metformin

                ethacrynic acid decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.

              • methyclothiazide

                ethacrynic acid and methyclothiazide both decrease serum potassium. Use Caution/Monitor.

              • metolazone

                ethacrynic acid and metolazone both decrease serum potassium. Use Caution/Monitor.

              • metoprolol

                metoprolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • moexipril

                moexipril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • mometasone inhaled

                mometasone inhaled increases toxicity of ethacrynic acid by Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may increase hypokalemic effect of loop diuretics.

              • nabumetone

                nabumetone increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nadolol

                nadolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • naproxen

                naproxen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nebivolol

                nebivolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nitroglycerin rectal

                nitroglycerin rectal, ethacrynic acid. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .

              • norepinephrine

                norepinephrine and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • oliceridine

                oliceridine decreases effects of ethacrynic acid by Other (see comment). Use Caution/Monitor. Comment: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. Monitor for signs of diminished diuresis and/or effects on blood pressure and increase dosage of the diuretic as needed. .

              • olmesartan

                olmesartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • olodaterol inhaled

                ethacrynic acid and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.

              • oxaprozin

                oxaprozin increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • parecoxib

                parecoxib increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • penbutolol

                penbutolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • perindopril

                perindopril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • pindolol

                pindolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pirbuterol

                pirbuterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • piroxicam

                piroxicam increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • potassium acid phosphate

                potassium acid phosphate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • potassium chloride

                potassium chloride increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • potassium citrate

                potassium citrate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • propranolol

                propranolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • quinapril

                quinapril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • ramipril

                ramipril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • sacubitril/valsartan

                sacubitril/valsartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • salicylates (non-asa)

                salicylates (non-asa) increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • salmeterol

                salmeterol and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • salsalate

                salsalate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ethacrynic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ethacrynic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

                ethacrynic acid and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.

              • sotalol

                sotalol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • spironolactone

                spironolactone increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • succinylcholine

                succinylcholine increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • sulfasalazine

                sulfasalazine increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • sulindac

                sulindac increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tadalafil

                tadalafil increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • telmisartan

                telmisartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • terbutaline

                terbutaline and ethacrynic acid both decrease serum potassium. Use Caution/Monitor.

              • timolol

                timolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tobramycin inhaled

                tobramycin inhaled, ethacrynic acid. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent use if possible; theorized mechanisms include rapid injection of loop diuretics, existing renal impairment, or volume depletion leading to increased aminoglycoside concentration within the nephron.

              • tolfenamic acid

                tolfenamic acid increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tolmetin

                tolmetin increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tolvaptan

                tolvaptan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • torsemide

                ethacrynic acid and torsemide both decrease serum potassium. Use Caution/Monitor.

              • trandolapril

                trandolapril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

              • triamterene

                triamterene increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

              • trientine

                ethacrynic acid decreases levels of trientine by increasing renal clearance. Use Caution/Monitor.

              • umeclidinium bromide/vilanterol inhaled

                umeclidinium bromide/vilanterol inhaled and ethacrynic acid both decrease serum potassium. Modify Therapy/Monitor Closely. Electrocardiographic changes and/or hypokalemia associated with non?potassium-sparing diuretics may worsen with concomitant beta-agonists, particularly if recommended dose is exceeded

              • valsartan

                valsartan increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • vilanterol/fluticasone furoate inhaled

                vilanterol/fluticasone furoate inhaled and ethacrynic acid both decrease serum potassium. Modify Therapy/Monitor Closely. Beta-agonists may acutely worsen ECG changes and/or hypokalemia resulting from non-potassium-sparing diuretics

              • xipamide

                xipamide increases effects of ethacrynic acid by pharmacodynamic synergism. Use Caution/Monitor.

              Minor (71)

              • agrimony

                agrimony increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • albuterol

                albuterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • arformoterol

                arformoterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • birch

                birch increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • bitter melon

                bitter melon, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • brimonidine

                brimonidine increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • budesonide

                budesonide, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • calcium acetate

                ethacrynic acid decreases levels of calcium acetate by increasing renal clearance. Minor/Significance Unknown.

              • calcium carbonate

                ethacrynic acid decreases levels of calcium carbonate by increasing renal clearance. Minor/Significance Unknown.

              • calcium chloride

                ethacrynic acid decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.

              • calcium citrate

                ethacrynic acid decreases levels of calcium citrate by increasing renal clearance. Minor/Significance Unknown.

              • calcium gluconate

                ethacrynic acid decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.

              • carbenoxolone

                ethacrynic acid, carbenoxolone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.

              • corticotropin

                corticotropin, ethacrynic acid. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

              • cortisone

                cortisone, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • cosyntropin

                cosyntropin, ethacrynic acid. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

              • deflazacort

                deflazacort, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • dexamethasone

                dexamethasone, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • dobutamine

                dobutamine, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • dopexamine

                dopexamine, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • duloxetine

                ethacrynic acid, duloxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • entecavir

                ethacrynic acid, entecavir. Either increases levels of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.

              • ephedrine

                ephedrine, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • epinephrine

                epinephrine, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • epinephrine racemic

                epinephrine racemic, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • epoprostenol

                epoprostenol increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

              • escitalopram

                ethacrynic acid, escitalopram. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • fludrocortisone

                fludrocortisone, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • fluoxetine

                ethacrynic acid, fluoxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • fo-ti

                fo-ti increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia (theoretical).

              • folic acid

                ethacrynic acid decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.

              • formoterol

                formoterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • forskolin

                forskolin increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • goldenrod

                goldenrod increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • hydrocortisone

                hydrocortisone, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • isoproterenol

                isoproterenol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • L-methylfolate

                ethacrynic acid decreases levels of L-methylfolate by increasing renal clearance. Minor/Significance Unknown.

              • levalbuterol

                levalbuterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • levomilnacipran

                ethacrynic acid, levomilnacipran. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • magnesium chloride

                ethacrynic acid decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.

              • magnesium citrate

                ethacrynic acid decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.

              • magnesium hydroxide

                ethacrynic acid decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium oxide

                ethacrynic acid decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.

              • magnesium sulfate

                ethacrynic acid decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.

              • metaproterenol

                metaproterenol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • methylprednisolone

                methylprednisolone, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • milnacipran

                ethacrynic acid, milnacipran. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • minoxidil

                ethacrynic acid increases effects of minoxidil by pharmacodynamic synergism. Minor/Significance Unknown.

              • nefazodone

                ethacrynic acid, nefazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • noni juice

                noni juice increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

              • norepinephrine

                norepinephrine, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • octacosanol

                octacosanol increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • paroxetine

                ethacrynic acid, paroxetine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • pirbuterol

                pirbuterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • prednisolone

                prednisolone, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • prednisone

                prednisone, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • reishi

                reishi increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • salmeterol

                salmeterol, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

              • sertraline

                ethacrynic acid, sertraline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • shepherd's purse

                shepherd's purse, ethacrynic acid. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.

              • sulfadiazine

                ethacrynic acid increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • sulfamethoxazole

                ethacrynic acid increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • sulfisoxazole

                ethacrynic acid increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • terbutaline

                terbutaline, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.

                ethacrynic acid, terbutaline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.

              • thiamine

                ethacrynic acid decreases levels of thiamine by increasing renal clearance. Minor/Significance Unknown.

              • tizanidine

                tizanidine increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

              • trazodone

                ethacrynic acid, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • treprostinil

                treprostinil increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • triamcinolone acetonide injectable suspension

                triamcinolone acetonide injectable suspension, ethacrynic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.

              • venlafaxine

                ethacrynic acid, venlafaxine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

              • zoledronic acid

                ethacrynic acid, zoledronic acid. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypocalcemia.

              Previous
              Next:

              Adverse Effects

              Frequency Not Defined

              Injection site reaction

              Hyperuricemia

              Gout

              Hypotension

              Hypokalemia

              Electrolyte abnormalities

              Hyperglycemia/hypoglycemia

              Hyperlipidemia

              Ototoxicity

              Tinnitus

              Photosensitivity

              Muscle cramps

              Dizziness

              Confusion

              Headache

              Nausea/vomiting

              Anorexia

              Dysphagia

              Diarrhea

              Pancreatitis

              Agranulocytosis

              Neutropenia

              Thrombocytopenia

              Hematuria

              Previous
              Next:

              Warnings

              Contraindications

              Hypersensitivity to ethacrynic acid

              Anuria, severe, watery diarrhea

              Use in infants

              Cautions

              Avoid concurrent use with lithium or furosemide

              Diabetes mellitus, geriatrics, liver disease, renal impairment

              Risk of fluid or electrolyte imbalance, hyperglycemia, hyperuricemia, hypotension, metabolic alkalosis

              Risk of ototoxicity (tinnitus, reversible/irreversible hearing impairment)

              Discontinue use if severe, watery diarrhea occurs

              Previous
              Next:

              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: excretion in milk unknown/not recommended

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

              Previous
              Next:

              Pharmacology

              Mechanism of Action

              Loop diuretic acting at Na/2Cl reabsorptive pump at ascending loop of Henle and distal renal tubule. Intereference with the chloride-binding cotransport system, causes increased excretion of water, sodium, chlorine, magnesium, and calcium.

              Pharmacokinetics

              Half-Life: 2-4 hr

              Onset

              • Initial effect: IV: 5-15 min, PO: 30-60 min
              • Max effect: IV: 15 min-3 hr, PO: 2 hr

              Other Information

              Duration: IV: 2-7 hr, PO: 4-8 hr

              Bioavailability: 100%

              Protein Bound: 90%

              Metabolism: conjugation w/ compounds containing sulfhydryl groups, such as cysteine & N-acetylcysteine in liver

              Excretion: urine 66%

              Previous
              Next:

              Administration

              IV Incompatibilities

              Whole blood or its derivatives

              Additive: hydralazine, procainamide, ranitidine, tolazoline, triflupromazine

              IV Compatibilities

              Additive: chlorpromazine, cimetidine, prochlorperazine, promazine

              Y-site: heparin & hydrocortisone Na-succinate, KCl, vit B/C

              IV Administration

              Do not give SC or IM due to local pain & irritation

              Single doses should not exceed 100 mg

              Administer IVP at 10 mg/min

              If second dose needed, a new injection site is recommended to avoid possible thrombophlebitis

              Previous
              Next:

              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              ethacrynic acid oral
              -
              25 mg tablet
              ethacrynic acid oral
              -
              25 mg tablet
              ethacrynic acid oral
              -
              25 mg tablet
              ethacrynic acid oral
              -
              25 mg tablet
              ethacrynic acid oral
              -
              25 mg tablet
              ethacrynic acid oral
              -
              25 mg tablet
              ethacrynic acid oral
              -
              25 mg tablet
              ethacrynic acid oral
              -
              25 mg tablet
              Edecrin oral
              -
              25 mg tablet

              Copyright © 2010 First DataBank, Inc.

              Previous
              Next:

              Patient Handout

              Patient Education
              ethacrynic acid oral

              ETHACRYNIC ACID - ORAL

              (ETH-a-KRIN-ik AS-id)

              COMMON BRAND NAME(S): Edecrin

              USES: Ethacrynic acid is a "water pill" (diuretic) that works in your kidneys to increase the amount of urine you make. This helps your body get rid of extra water. This medication is used to decrease swelling (edema) caused by conditions such as cancer, congestive heart failure, liver disease, and kidney disease. This effect can help your kidneys work better and lessen symptoms such as trouble breathing and swelling in your ankles, feet, hands, or belly.This medication should not be used for infants.

              HOW TO USE: Take this medication by mouth as directed by your doctor, usually once or twice a day after a meal. If you take this drug too close to bedtime, you may need to wake up to urinate. It is best to take this medication at least 4 hours before your bedtime. Consult your doctor or pharmacist if you have questions about your dosing schedule.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Your doctor will adjust your dose based on your medical condition, response to treatment, and lab tests (such as sodium, potassium, chloride levels). Some people may be directed to take this medication every other day or only when needed. Follow your doctor's directions carefully.If your doctor has directed you to take this medication on a regular schedule, take it regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.Tell your doctor if you do not get better or if you get worse.

              SIDE EFFECTS: Dizziness, lightheadedness, weakness, muscle cramps, upset stomach, or diarrhea may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This drug is a strong "water pill" (diuretic) which can cause dehydration and electrolytes imbalance. Tell your doctor right away if you notice any symptoms of dehydration, such as confusion, unusual decreased urination, unusual dry mouth/thirst, fast/irregular heartbeat, or severe dizziness/lightheadedness.Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, feeling of spinning (vertigo), hearing changes (such as ringing or fullness in the ears, decreased hearing/deafness), black/bloody stools, stomach/abdominal pain, vomit that looks like coffee grounds, signs of liver problems (such as nausea/vomiting that doesn't stop, loss of appetite, yellowing eyes/skin, dark urine).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking ethacrynic acid, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: gout, kidney disease, liver disease.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This drug can lower certain salt/mineral levels (such as sodium, potassium) in your blood. Your doctor may tell you to use more salt, eat potassium-rich foods (such as bananas, orange juice), or take a potassium supplement. Ask your doctor for more details.This medication may affect your blood sugar. If you have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially dizziness and water/mineral loss.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: desmopressin, furosemide, lithium.Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.Lab and/or medical tests (such as kidney tests, blood mineral levels such as potassium) should be done while you are taking this medication. Keep all medical and lab appointments.

              MISSED DOSE: If you are taking this drug on a regular schedule and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.