7 mins read

Overview: Ethacrynic acid is a medicine that is used to reduce extra fluid in the body if you have certain heart, liver, or kidney problems. Common side effects include an increase in how much you pee and dizziness or lightheadedness. Keep all appointments with your health care provider, including for bloodwork, while taking ethacrynic acid. This medicine can cause serious side effects that can be found through testing of your blood or pee (urine).

Uses

What is ethacrynic acid used for?

Ethacrynic acid is a diuretic, also called a water pill, that is commonly used to reduce edema (fluid retention) caused by the following conditions.

  • Congestive heart failure, which is a condition where the heart is not pumping as well as it should
  • A buildup of fluid (ascites) that can be caused by liver problems, cancer, and other conditions such as swelling from too much fluid called lymph (lymphedema)  
  • Kidney disease, including protein in the urine (nephrotic syndrome)
  • Certain heart conditions in children, such as those discovered at birth (congenital) 

Ethacrynic acid may also be used for other conditions as determined by your health care provider.

How does ethacrynic acid work (mechanism of action)?

Ethacrynic acid works by increasing how much you pee. It does this by helping the kidneys remove electrolytes, such as sodium (salt), and water from the body.

How is ethacrynic acid supplied (dosage forms)?

Brands and other names

  • Edecrin

Dosage forms and strengths

  • 25 mg oral tablets

Ethacrynic acid is also available in injectable forms.

How should I store ethacrynic acid?

Ethacrynic acid should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep tightly closed.

Side Effects

What are the most common side effects of ethacrynic acid?

The most common side effects of ethacrynic acid are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • An increase in how much you pee
  • Low blood pressure (see below)
  • Electrolyte changes and increased blood sugar (see below)
  • Pain, itching, swelling, or redness near the injection site (injectable)

There may be other side effects of ethacrynic acid that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of ethacrynic acid?

While less common, the most serious side effects of ethacrynic acid are described below, along with what to do if they happen.

Low Blood Pressure with Worsening Kidney Function. Water loss from ethacrynic acid can lower your blood pressure too much and cause dehydration. Both may lead to problems that are more serious than lightheadedness. Poor blood flow to important organs such as your kidneys can occur, especially if you are older. Drink enough water to stay hydrated, especially if you have excess sweating, vomiting, or diarrhea. Get out of bed or from a seated position slowly. Tell your health care provider right away if you have any of the following symptoms.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired
  • Reduced need to pee
  • Sudden weight gain
  • Increased thirst
  • Dark or strong-smelling pee
  • Dry mouth
  • Sunken eyes
  • Headache
  • Fast heartbeat

Electrolyte Changes and Increased Blood Sugar. Ethacrynic acid may increase your blood sugar (glucose) levels and cause changes to the levels of certain minerals in your body, called electrolytes. For example, it may cause low potassium levels (hypokalemia), low sodium levels (hyponatremia), low magnesium levels (hypomagnesemia), low calcium levels (hypocalcemia), low chloride levels (hypochloremia), or high glucose levels (hyperglycemia). These changes can be serious. Your health care provider will do bloodwork to check your glucose and electrolyte levels, especially if you take certain other medicines. Keep your appointments to have your blood checked. Call your health care provider if you have any of the following symptoms.

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation
  • Nausea, vomiting, or loss of appetite
  • Dizziness
  • Restlessness or irritability
  • Difficulty breathing
  • Confusion or decreased alertness
  • Abnormal heart rhythm
  • Seizures

Hearing Loss. Ethacrynic acid may be associated with hearing loss, which is also called ototoxicity. Tell your health care provider right away if you have hearing loss or if you hear a ringing or roaring sound in your ears while using ethacrynic acid.

Severe Diarrhea. Ethacrynic acid can cause severe, watery diarrhea. Stop using ethacrynic acid and call your health care provider right away if you have severe diarrhea or if you have more than two bowel movements in one day.

Severe Allergic Reactions. Ethacrynic acid may cause allergic reactions, which can be serious. Stop taking/using [brand or generic drug] and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use ethacrynic acid?

Allergies to Ingredients. People who are allergic to any of the following should not use ethacrynic acid.

  • Ethacrynic acid
  • Edecrin
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific ethacrynic acid products they stock.

No Urine Production. Do not use ethacrynic acid if you are making very little to no pee. This condition is also called anuria.

Very Low Electrolytes. If you have low electrolytes, including low sodium or potassium, ethacrynic acid may not be safe to use.  Your health care provider may measure your electrolytes before starting ethacrynic acid.  Low electrolytes are not usually something you can feel, so it is important to make it to your scheduled blood work appointments.

Severe Diarrhea. Do not use ethacrynic acid if you had severe, watery diarrhea when using it.

What should I know about ethacrynic acid before using it?

Do not use ethacrynic acid unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share ethacrynic acid with other people, even if they have the same condition as you. It may harm them.

Keep ethacrynic acid out of the reach of children.

Ethacrynic acid can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how ethacrynic acid affects you. 

People who are age 65 or older can be at greater risk for some side effects from ethacrynic acid. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using ethacrynic acid?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if ethacrynic acid is right for you.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart failure
  • Liver problems
  • Kidney problems
  • Persistent or severe diarrhea or vomiting, which can lead to dehydration
  • Electrolyte imbalance, such as low levels of sodium or potassium
  • Abnormal heart rhythm (arrhythmias)
  • Diabetes 
  • Gout

Other Medicines and Supplements. Ethacrynic acid may interact with other medicines and supplements. Before using ethacrynic acid, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how ethacrynic acid could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. 

Breastfeeding. It is not known if ethacrynic acid passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop ethacrynic acid.

Interactions

Does ethacrynic acid interact with foods or drinks?

There are no known interactions between ethacrynic acid and foods or drinks. However, since ethacrynic acid affects electrolytes, it is important to discuss your intake of electrolytes, including sodium and potassium, with your health care provider.

It is unknown if drinking alcohol will affect ethacrynic acid. The risk of dizziness may be increased if you drink alcohol while using ethacrynic acid.

Does ethacrynic acid interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using ethacrynic acid.

  • Any aminoglycoside antibiotic, such as neomycin or gentamicin, which is a medicine usually given by injection to treat infections
  • Lithium, which is a medicine commonly used for certain mental health conditions
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
  • A medicine for high blood pressure
  • Any other diuretic, or water pill
  • Warfarin (Coumadin), which is a blood thinner

This may not be a complete list of medicines that can interact with ethacrynic acid. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much ethacrynic acid?

If you or someone else has used too much ethacrynic acid, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of ethacrynic acid?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.