Etacrynsäure

Generic name
Etacrynsäure
Brand name
ATC Code
C03CC01
Compare …

Etacrynsäure

Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

No specific pediatric pharmacokinetic parameters available.

The active form of EA is a cysteine complex that must be secreted to the tubular lumen. In neonates glomerular filtration and active secretion in the tubule are both immature. This may result in a prolonged and less intense diuretic action in neonates compared to adults. 

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Overfilling and oedema
  • Intravenous
    • Gestational age < 37 weeks
      • 1 mg/kg/dose, once only.

      • The evidence base for the use of etacrynic acid in preterm neonates is limited.

    • Term neonate
      • 1 mg/kg/dose, once only. Alternatively: continuous infusion: 0,1 – 0,4 mg/kg/h, titrate on effect, in exceptional cases max. 0,8 mg/kg/h.

      • The evidence base for the use of etacrynic acid in neonates is limited.

    • 1 month up to 18 years
      • 0.5 - 1 mg/kg/dose, bolus. Max: 50 mg/dose. Repeat every 8-24 hours if necessary. Alternatively: continuous infusion: 0,1 – 0,4 mg/kg/h, titrate on effect, in exceptional cases max. 0,8 mg/kg/h.

Renal impaiment in children > 3 months

No information available on dose adjustment in renal impairment.

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Electrolytic imbalance (hypochloremia, hyponatremia, hypokalemia) and metabolic alkalosis occurred frequently, especially in high dosages [Laudignon et al. 1989, Miller et al. 2014, Ricci et al. 2015].

Etacrynic acid can potentially cause ototoxicity [Haiberger et al. 2016].

 

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

If necessary, administer the second dose at a new injection site, to avoid possible thrombophlebitis [SmPC Edecrin USA 08/2020].

Monitor serum electrolytes (sodium, potassium, chloride, hydrogen ions) closely due to potential potassium loss and risk of metabolic alkalosis.

Etacrynic acid may increase the ototoxic potential of other drugs (e.g. aminoglycosides). Their concurrent use should be avoided [SmPC Edecrin USA 08/2020].

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

HIGH-CEILING DIURETICS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Sulfonamides, plain
C03CA02
C03CA01
C03CA04

References

  1. Laudignon, N., et al., Furosemide and ethacrynic acid: risk factors for the occurrence of serum electrolyte abnormalities and metabolic alkalosis in newborns and infants., Acta Paediatr Scand, 1989, 78(1), 133-135
  2. Haiberger, R., et al., Clinical Factors Associated with Dose of Loop Diuretics After Pediatric Cardiac Surgery: Post Hoc Analysis, Pediatr Cardiol, 2016, 37(5), 913-918
  3. Bioindustria Laboratorio Italiano Medicinali S.p.A, SmPC Reomax (Italy), 2012
  4. Bausch Health Companies, SmPC Edecrin (USA), 08/2020
  5. Sparrow, AW., et al., The use of ethacrynic acid in infants and children with congestive heart failure, Pediatrics, 1968, 24(2), 291-302
  6. Ricci, Z., et al., Furosemide versus ethacrynic acid in pediatric patients undergoing cardiac surgery: a randomized controlled trial, Crit Care, 2015, 19(1), 2
  7. Scalais,EA,. et al., Effects of ethacrynic acid in the newborn infant, J Pediatr, 1984, 104(6), 947-950
  8. Chemtob S et al., Alternating sequential dosing with furosemide and ethacrynic acid in drug tolerance in the newborn, Am J Dis Child, 1989, 143(7), 850-854
  9. Miller, JL., et al., Ethacrynic Acid continuous infusions in critically ill pediatric patients, J Pediatr Pharmacol Ther, 2014, 19(1), 49-55

Changes

Therapeutic Drug Monitoring


Overdose