Parenteral Manual

Ethacrynic acid

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
August 2005
Revised Date: 
August 2013
  • Rapid and intense diuresis for reduction of edema secondary to cardiac, hepatic, or renal dysfunction
  • Useful in the treatment of acute congestive heart failure and pulmonary edema
  • May be used in patients refractory to other diuretics
Reconstitution and Stability: 
  • Sterile powder is stable at room temperature
  • Reconstitute with 50 mL of D5W or NS for a 1mg/mL solution.  DO NOT use if resultant solution is hazy or opalescent.
  • Reconstituted solutions are relatively stable for short periods of time at pH 7 and at room temperature; discard after 24 hours.

- Solutions Compatible: D5W, NS, D5NS, ringer's solution, ringer's lactate

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: KCl (up to 40 mmol/L)

- Incompatible: blood or blood derivatives, acidic solutions (pH <5)


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct

YES. Not recommended
Usual dilution: 1 mg/mL
Infusion time: 3-5 minutes
Infusion rate: do not exceed 10 mg/minute

IV Intermittent Infusion YES
Usual dilution: 1 mg/mL
Infusion time: 20-30 minutes
Infusion rate: do not exceed 10 mg/minute
IV Continuous Infusion NO

(For neonatal dosages, refer to Neonatal IV Drug Manual.)


  • 0.5-1 mg/kg/dose IV Q 8-12 hours if necessary
  • Maximum: 2 mg/kg/dose up to 100 mg/dose


  • 0.5-1 mg/kg/dose; may repeat Q 8-12 hours if necessary
  • Maximum: 100 mg/dose


  • Should not be given if CrCl < 10 mL/minute
Potential hazards of parenteral administration: 
  • Maximum rate of injection is 10 mg per minute - too rapid injection has been associate with reversible deafness, acute vertigo and tinnitus
  • Hypotension
  • Anorexia, malaise, abdominal discomfort or pain, dysphagia, nausea, vomiting,  severe diarrhea, GI bleeding, pancreatitis
  • Electrolyte disturbances - hypokalemia, hyponatremia, hypochloremic alkalosis, hyperuricemia
  • Excessive diuresis may cause dehydration
  • SC and IM administration not recommended as they cause local pain and irritation
  • Using  a new site for each dose is recommended to avoid extravasation
  • Routine monitoring of electrolytes, renal function, blood pressure and hearing
  • Avoid using with other ototoxic drugs such as gentamicin, tobramycin because of tinnitus, vertigo and temporary or permanent deafness
  • Contraindicated in infants, patients with anuria, severe watery diarrhea, pregnancy, increasing azotemia and/or oliguria
  • Avoid in renal impairment

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