Alternate Name(s):
SODIUM ETHACRYNATE, EDECRIN®
Classification:
Diuretic
Original Date:
August 2005
Revised Date:
August 2013
Indications:
- 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
- RESTRICTED TO PICU/NICU
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.
Compatibility:
- 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)
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
YES. Not recommended |
| 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 |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- 0.5-1 mg/kg/dose IV Q 8-12 hours if necessary
- Maximum: 2 mg/kg/dose up to 100 mg/dose
Adolescent/Adult:
- 0.5-1 mg/kg/dose; may repeat Q 8-12 hours if necessary
- Maximum: 100 mg/dose
DOSAGE ADJUSTMENT IN RENAL IMPAIRMENT:
- 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
Notes:
- 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
References: