Etacrynic acid

C4H7CIO 141-75-3) see Bunazosin ButofiIolol Etacrynic acid Telmisartan... 

Aromatase inhibitors (including anastrozole, letrozole, aminoglutethimide, exemestane, formestane, testolactone), selective estrogen receptor modulators—SERMs (including raloxifene, tamoxifen, toremifene), clomiphene, cyclofenil, fulvestrant Diuretics, amiloride, bumetanide, canrenone, chlorthalidone, etacrynic acid, furosemide, indapamide, metolazone, spironolactone, thiazides, triamterene... 

Michael addition of 1,3-dimethylbarbituric acid to etacrynic acid 384 gave the addition product 385, which upon fusion with ammonium acetate yielded the annulated pyridopyrimidinedione 386 (Scheme 14) <1997PHA97>. 

Like other diuretics etacrynic acid can impair glucose tolerance in patients with type 2 diabetes mellitus (384). Non-ketotic hyperglycemia has also been reported (385). However, hypoglycemia has also been reported in two patients with uremia (386). 

There has been an anecdotal report of hyperuricemia and acute gout in a patient taking etacrynic acid (387). 

C1120 50-00-0) see Aciclovir Alclofenac Alminoprofen Alpidein Altretamine Amodiaquine Azithromycin Bromperidol Budipine Calcium pantothenate Cicloxilic acid Clofedanol, Clomocycline Cortivazol Dextropropoxyphene Dichlorophen Domiphen bromide Edetic acid Eperisone Eprozincrl Etacrynic acid ... 

The loop diuretics increase the renal excretion of lithium after single-dose intravenous administration in both animals (711) and man (712). Furosemide has been used to treat lithium intoxication (713). The effect of etacrynic acid is larger than those of furosemide and bumetanide (712). However, long-term treatment with furosemide and bumetanide can cause lithium intoxication in some patients (714,715), perhaps by causing sodium depletion and a secondary increase in lithium reabsorption. An adverse interaction of lithium during long-term therapy with etacrynic acid is therefore theoretically likely. 

Etacrynic acid, especially in combination with spironolactone and xipamide, markedly enhances natriuresis and diuresis. The dosage is increased as required (e.g. 1 X 25 mg or 50 mg to 2 x 50 mg per day). With a low-dose application in the form of a combined diuretic therapy, there is usually no risk of hepatic encephalopathy developing. The effect of etacrynic acid sets in at the ascending branch of the loop of Henle (active chloride transport). Renovascular resistance is lowered due to enzymatic activity, presumably as a result of a rise in the release of prostaglandin. 

Among the agents that promote the nephrotoxic effects of the aminoglycosides, the loop diuretics furosemide and etacrynic acid are often mentioned. However, this... 

Etacrynic acid Potentiation possible (167) Unknown Anecdotal... 

Etacrynic acid can cause excessive diuresis, natriuresis, and kaliuresis, leading respectively to dehydration and sodium and potassium depletion (12-17). 

Nausea, abdominal pain (22), and diarrhea are relatively common with etacrynic acid (23,24), more so than with other loop diuretics. Data from the Boston Drug Surveillance Program showed that intravenous etacrynic acid was associated with an increased incidence of gastrointestinal bleeding (25,26). Overall 20% of the patients treated with etacrynic acid bled, compared with 5% of those who received furosemide. With intravenous etacrynic acid the risk of gastrointestinal hemorrhage was 26%, compared with 10% after oral administration. However, 12 of 28 patients who bled did so before etacrynic acid had been given (27), and it is not clear whether there is a true difference in risk with the different routes of administration. 

Like other diuretics etacrynic acid can precipitate hepatic encephalopathy in the treatment of ascites in patients with hepatic cirrhosis (28). There has been an anecdotal report of focal hepatic necrosis in a patient taking etacrynic acid (29). 

Intravenous administration of etacrynic acid causes burning at the site of injection (18). 

Etacrynic acid potentiates aminoglycoside ototoxicity by facilitating the entry of the antibiotics from the systemic circulation into the endolymph (33). Animal evidence suggests that this effect may be potentiated by glutathione depletion (34). Conversely, neomycin can enhance the penetration of etacrynic acid into the inner ear (35). 

Etacrynic acid potentiates the actions of cardiac glycosides if it causes potassium depletion. 

A patient developed digitahs intoxication and quini-dine-induced cardiac dysrhjdhmias when hypokalemia occurred during etacrynic acid therapy (36). 

In rats etacrynic acid inhibited the absorption of digitoxin from the small intestine (37), but an interaction of this sort has not been described in man. 

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