FDA-filed SPL labeling · retrieved through openFDA

Ethacrynic Acid

Ethacrynic acid is a potent loop diuretic (water pill) used to treat fluid buildup (edema) caused by congestive heart failure, liver cirrhosis, and kidney disease, among other conditions.

Brand name Edecrin
Drug class Loop Diuretic
Rx Form 1 Route Oral
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 10 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveAug 31, 2020
Clinical labels in scope 10
AvailabilityRx
Earliest approval/marketing year 1967
FDA-listed product records 35
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Ethacrynic Acid at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Ethacrynic acid is a powerful diuretic reserved for fluid buildup that hasn't responded to milder water pills. It requires careful dose management and regular monitoring because it can cause significant electrolyte imbalances, blood pressure drops, and — in some cases — hearing loss. Always take it exactly as prescribed, report unusual symptoms quickly, and keep all follow-up appointments so your levels can be checked.

📖 Ethacrynic Acid: Patient Information Guide

A plain-language walkthrough of Ethacrynic Acid — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Ethacrynic acid is a potent loop diuretic used when stronger-than-usual fluid removal is needed. Supported uses across the available products include:

  • Edema (fluid buildup) caused by congestive heart failure
  • Edema caused by cirrhosis of the liver
  • Edema caused by kidney disease, including nephrotic syndrome
  • Short-term management of ascites (fluid in the abdomen) due to malignancy (cancer)
  • Short-term management of idiopathic edema (swelling with no identified cause)
  • Short-term management of lymphedema (swelling from lymph system blockage)
  • Short-term management of edema in hospitalized pediatric patients (not infants) with congenital heart disease or nephrotic syndrome — as supported by Edecrin and Ethacrynic Acid tablet labeling
⚙️How it works

Ethacrynic acid is a loop diuretic — it works deep in the kidney at a segment called the ascending limb of the loop of Henle, as well as in the proximal and distal tubules. It blocks the kidney from reabsorbing sodium and chloride back into the bloodstream. When these electrolytes stay in the urine, water follows them out of the body — producing a strong and rapid increase in urine output. This effect can be several times more powerful than thiazide diuretics.

Because it acts differently from older diuretic classes, it remains effective even in patients with significant kidney insufficiency. It does not work by inhibiting carbonic anhydrase (a mechanism used by some other drugs), and it does not cross into the brain.

💊How it's taken

Ethacrynic acid tablets are taken by mouth, generally after a meal. Dosing is always individualized — your prescriber starts low and adjusts gradually to find the smallest dose that produces steady, controlled fluid loss (roughly 1 to 2 pounds per day). Daily weighing under consistent conditions is typically recommended to guide adjustments.

  • Dosing may be once daily or split into morning and evening doses, depending on response
  • Once the target fluid level is reached, an every-other-day or intermittent schedule is often used to help protect electrolyte balance
  • In children (not infants), dosing starts lower and is increased in small steps under close supervision
  • Follow your prescriber's and pharmacist's instructions exactly — do not adjust your dose on your own
🤒Side effects — in detail

Like all strong diuretics, ethacrynic acid can cause a range of side effects, most commonly affecting the digestive system and electrolyte balance:

  • Nausea, vomiting, stomach discomfort, or loss of appetite
  • Diarrhea — mild to moderate is common; severe watery diarrhea requires stopping the drug immediately
  • Headache, fatigue, or confusion
  • Ringing in the ears (tinnitus), dizziness, or hearing changes
  • Blurred vision
  • Skin rash, fever, or chills
  • Elevated uric acid levels, which can trigger gout attacks
  • Blood in the urine (hematuria)

Serious reactions — including permanent hearing loss, dangerous drops in potassium, severe blood count changes, and acute pancreatitis — require immediate medical attention. If you notice sudden hearing changes, extreme weakness, or an irregular heartbeat, call your doctor or seek emergency care right away.

⚠️Warnings & precautions
  • Electrolyte imbalance: Ethacrynic acid can cause large losses of potassium, sodium, and chloride. In patients taking digoxin, severe potassium loss can trigger life-threatening heart arrhythmias. In patients with liver cirrhosis, it can worsen or trigger hepatic coma (brain dysfunction from liver failure).
  • Hearing loss: Deafness, tinnitus (ringing), and vertigo have been reported — most often in patients with kidney impairment or those also taking ototoxic drugs (antibiotics that affect hearing). Some hearing loss has been permanent.
  • Rapid fluid loss and low blood pressure: Too-aggressive diuresis can cause a sudden dangerous drop in blood pressure. In elderly patients with heart conditions, rapid plasma volume reduction can increase the risk of blood clots in the brain or lungs.
  • Cirrhosis patients: Starting therapy in a hospital is recommended for patients with cirrhosis and ascites. Ammonium chloride supplements should NOT be given to patients with cirrhosis.
  • Severe diarrhea: A few patients have developed severe watery diarrhea. If this occurs, stop the medication and do not restart it.
  • Critically ill patients: A number of deaths have been reported in critically ill patients, particularly those with severe heart disease on digoxin (from low potassium and fatal arrhythmia) and those with decompensated liver cirrhosis with electrolyte imbalance.
🔀What it interacts with

Ethacrynic acid has several important drug interactions that can be serious:

  • Lithium — ethacrynic acid reduces how the kidneys clear lithium, sharply raising blood lithium levels and the risk of lithium toxicity; this combination is generally avoided
  • Aminoglycoside antibiotics (e.g., gentamicin, tobramycin) and certain cephalosporins — combining these with ethacrynic acid greatly increases the risk of hearing damage; concurrent use should be avoided
  • Warfarin — ethacrynic acid can displace warfarin from blood proteins, increasing its effect; anticoagulant doses may need to be reduced
  • NSAIDs (ibuprofen, naproxen, etc.) — can blunt the diuretic and blood-pressure-lowering effects of ethacrynic acid; if used together, the diuretic effect should be monitored closely
  • Digoxin (digitalis) — potassium loss from ethacrynic acid raises the risk of digoxin toxicity and dangerous heart rhythm problems
  • Potassium-depleting corticosteroids — may worsen potassium loss when used with ethacrynic acid
  • Other diuretics — additive effects can occur; doses may need careful adjustment to avoid excessive fluid and electrolyte loss

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Anuria (no urine output): Ethacrynic acid must not be used if you are not producing urine — this is an absolute contraindication
  • Liver cirrhosis: Use with great caution; starting in a hospital is recommended, and the drug can trigger hepatic encephalopathy (brain confusion from liver disease)
  • Kidney disease: Effective in many kidney patients but requires very careful monitoring; worsening kidney function during treatment may require stopping the drug
  • Hearing problems: Tell your doctor if you already have any hearing loss or ringing in the ears — this drug can worsen hearing, especially with kidney impairment
  • Infants: Ethacrynic acid is contraindicated in infants
  • Older adults with heart disease: Rapid fluid loss can increase the risk of dangerous blood clots; close monitoring is needed
  • People taking digoxin or potassium-depleting steroids: Extra vigilance for low potassium is essential
  • Previous severe diarrhea from this drug: Do not use again if you previously had to stop due to severe watery diarrhea
  • Hypersensitivity: Do not take if you are allergic to any ingredient in the product
🚑If you take too much

Taking too much ethacrynic acid can cause excessive urination leading to severe dehydration and dangerous loss of electrolytes (such as potassium and sodium), which can affect the heart and brain. If an overdose is suspected, get emergency medical help right away — treatment focuses on correcting fluid and electrolyte imbalances, and may include inducing vomiting or gastric lavage (stomach pumping) if appropriate. Do not try to manage an overdose at home.

📡Pharmacodynamics — effects in the body

Ethacrynic acid produces a strong increase in urine output by preventing the kidneys from reabsorbing sodium, chloride, and water — an effect that can be several times greater than that of thiazide diuretics. Initially, both sodium and chloride are lost in large amounts; with longer use, chloride loss tends to decrease while potassium and hydrogen ion loss may increase, which can lead to a condition called metabolic alkalosis (a shift in the body's acid-base balance). The drug is effective regardless of whether the patient has acidosis or alkalosis at the time of treatment.

🔬Pharmacokinetics — how your body processes it

After an oral dose of ethacrynic acid tablets, the diuretic effect typically begins within 30 minutes, reaches its peak at around 2 hours, and lasts approximately 6 to 8 hours. The drug acts on specific segments of the kidney tubule — the ascending limb of the loop of Henle, and both the proximal and distal tubules — and does not cross the blood-brain barrier. It has little to no effect on overall blood flow through the kidneys under normal conditions.

📦How to store it

Store in a tightly closed container at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F) . Dispense in a well-closed container.

📄 Written from Ethacrynic Acid’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

201

Supplements & herbs that interact with Ethacrynic Acid

201 supplements and herbal products have documented interactions with Ethacrynic Acid in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 7
  • Moderate · 170
  • Minor · 24
Every supplement checked against Ethacrynic Acid — ranked by severity The full interaction hub: 7 major · 170 moderate · 24 minor · every one linked to its full report. Check Ethacrynic Acid against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

8

Nutrient depletion considerations

Ethacrynic Acid has been associated with lower levels of 8 nutrients in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.

Evidence & significance mix
  • Higher significance · 2
  • Moderate · 3
  • Unrated · 3
See the full Ethacrynic Acid nutrient depletion report

Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Ethacrynic Acid — the kind of thing our pharmacy team would talk through with you at the counter.

Why was I prescribed ethacrynic acid instead of a regular water pill?
Ethacrynic acid is reserved for situations where milder diuretics — like furosemide or hydrochlorothiazide — aren't working well enough. It's a more potent option that's especially useful when you have significant fluid buildup from conditions like heart failure, liver cirrhosis, or kidney disease. Your doctor chose it because your situation calls for stronger fluid removal.
Should I take it with food or on an empty stomach?
Take it after a meal. Ethacrynic acid can be hard on the stomach, and eating first helps reduce nausea and digestive upset. Your prescriber or pharmacist will tell you whether to take it once a day or split into morning and evening doses — stick to that schedule consistently.
How will I know if it's working?
The clearest sign is a gradual drop in your weight — usually about 1 to 2 pounds per day when the dose is right. Your doctor will likely ask you to weigh yourself every day under the same conditions (same time, similar clothing). You'll also notice you're urinating more, especially in the first few hours after your dose. Rapid or dramatic weight loss is actually a warning sign, not a good thing — let your doctor know if that happens.
What symptoms should make me call my doctor or go to the ER?
Call your doctor right away if you notice sudden hearing loss or severe ringing in your ears — this can be a serious side effect. Also act quickly if you have severe muscle cramps, extreme weakness, an irregular heartbeat, or feel faint when standing up. And if you develop severe, watery diarrhea, stop the medication and contact your doctor before taking another dose.
Are there any medications I absolutely cannot take with this?
Two combinations stand out as especially risky. First, lithium — ethacrynic acid raises lithium levels in your blood to potentially toxic levels, so this combination is generally avoided. Second, certain antibiotics (especially aminoglycosides like gentamicin) — taking them together can significantly increase your risk of hearing damage. Always tell every provider and pharmacist you see that you're on ethacrynic acid so they can check for interactions before adding anything new.
Will I need to eat more bananas or take potassium supplements?
Possibly, but not automatically. Ethacrynic acid can cause you to lose potassium in your urine, especially with higher doses or prolonged use. Whether you need potassium supplements or potassium-sparing medications depends on your situation — your doctor will check your blood levels and decide. Patients with liver disease (cirrhosis) or kidney disease (nephrotic syndrome), and those taking digoxin, are especially likely to need potassium support. Don't start supplements on your own without checking first.
Is Ethacrynic Acid available over the counter?
Ethacrynic Acid is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Ethacrynic Acid first available?
Ethacrynic Acid has been available in the United States since at least 1967, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Ethacrynic Acid?
Ethacrynic Acid is supplied by 18 manufacturers listed in the FDA NDC Directory, including Upsher-Smith Laboratories, LLC, Amneal Pharmaceuticals NY LLC, Trupharma Llc.

💬 Answers drafted from Ethacrynic Acid’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Ethacrynic Acid comes

Ethacrynic Acid is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
Brands Edecrin
How this form is used
What it may be used for
  • Edecrin tablets are used to treat edema associated with congestive heart failure, cirrhosis of the liver, and kidney disease including nephrotic syndrome
  • Edecrin tablets are used for short-term management of ascites due to malignancy, idiopathic edema, and lymphedema
  • Ethacrynic Acid tablets are indicated for the same edema conditions, including short-term use in hospitalized children (not infants) with congenital heart disease or nephrotic syndrome
  • Edecrin tablets are used for short-term management of hospitalized pediatric patients (excluding infants) with congenital heart disease or nephrotic syndrome
Important instructions
  • Edecrin and Ethacrynic Acid tablets are taken by mouth after a meal to reduce stomach upset
  • Doses are started low and increased gradually — your prescriber will adjust based on your daily weight and response
  • Once the target fluid loss is reached, dosing may shift to an every-other-day or intermittent schedule to help prevent electrolyte imbalances
  • Weigh yourself under consistent conditions (same time, same clothing) each day as directed to track fluid changes
Available strengths 1 strength
28 FDA-listed product records

📊 Ethacrynic Acid across the U.S. market

How Ethacrynic Acid appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
18
Manufacturers
2
Brand names
35
FDA-listed product records
1967
First marketed

Also listed with the FDA, not a patient dose form: Powder (7) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Upsher-Smith Laboratories, LLC11%
Amneal Pharmaceuticals NY LLC9%
Trupharma Llc9%
St. Mary's Medical Park Pharmacy9%
Oceanside Pharmaceuticals9%
Edenbridge Pharmaceuticals LLC.9%
Other makers46%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Ethacrynic Acid is used

A general measure of how commonly Ethacrynic Acid is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Ethacrynic Acid is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

192
Medicaid prescriptions filled (Q1–Q4 2025)
$29,498 gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Ethacrynic Acid prescribed? Of the 1,596 medications we measure, Ethacrynic Acid ranks #1,453 by Medicaid prescriptions — more than 9% of them.

Where Ethacrynic Acid ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Ethacrynic Acid product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

ethacrynic acid 25 MG Oral Tablet

192 Medicaid prescriptions (Q1–Q4 2025) 100% of Ethacrynic Acid prescriptions shown $29,498 gross reimbursement (before rebates) ≈ $154 per prescription (gross)

Summed across the 4 of 20 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1251903

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Ethacrynic Acid, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 4 of 20 listed Ethacrynic Acid NDCs with Medicaid activity.

🔍 Compare Ethacrynic Acid products

A representative set of FDA-listed product records for Ethacrynic Acid — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 35 of 35 products — FDA National Drug Code Directory. See every product, package size and price: browse all 35 Ethacrynic Acid NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Ethacrynic Acid RxCUI 62349 2 dose forms · 3 strengths
  1. Dose form (SCDF) Injection RxCUI 1729078 No current FDA listing
    Clinical drug / strength (SCD) sodium 50 MG RxCUI 617325
  2. Dose form (SCDF) Oral Tablet RxCUI 617327 In current FDA listings
    Clinical drug / strength (SCD) ethacrynic acid 25 MG RxCUI 1251903 ethacrynic acid 50 MG RxCUI 1251907

Look up RxCUI 62349 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Edecrin

🏭 Manufacturers & labelers

Upsher-Smith Laboratories, LLC 4 Amneal Pharmaceuticals NY LLC 3 Trupharma Llc 3 St. Mary's Medical Park Pharmacy 3 Oceanside Pharmaceuticals 3 Edenbridge Pharmaceuticals LLC. 3 Lupin Pharmaceuticals, Inc. 2 Olon S.p.A. 2 ScieGen Pharmaceuticals Inc 2 Bausch Health US, LLC 2 Egis Pharmaceuticals PLC 1 Enaltec Labs Private Limited 1 Bryant Ranch Prepack 1 Sionc Pharmaceutical Private Limited 1 Apicore Pharmaceuticals Private Limited 1 Agnitio Inc. 1 West-Ward Pharmaceuticals Corp. 1 Zydus Lifesciences Limited 1

RxNorm drug class

Ethacrynic Acid belongs to the Loop Diuretic class.

Pharmacologic class Loop Diuretic
Drug family (ATC) Aryloxyacetic acid derivatives

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Aug 31, 2020
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Ethacrynic Acid.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Ethacrynic Acid after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
10
NDC products indexed
35
Distinct labelers/manufacturers represented
18
Linked representative label
Bausch Health US, LLC
Linked label effective
Aug 31, 2020
Composite sections available
17
Linked SPL Set ID
1efe378e-fee1-4ae9-8ea5-0fe2265fe2d8
Linked SPL Document ID
4c442b87-1bbd-40e6-8c40-004f5f46e996
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 10 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Bausch Health US, LLC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.