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Ethacrynic acid is a loop diuretic (water pill) used to treat fluid retention (edema) associated with congestive heart failure, liver disease, kidney disease (including nephrotic syndrome), and other conditions. It is also used in cases where a stronger diuretic effect is required or when patients are allergic to sulfa-containing drugs, as ethacrynic acid does not contain a sulfa moiety[1][3][5][6]. The drug acts by inhibiting the Na⁺-K⁺-2Cl⁻ symporter (NKCC2) in the thick ascending limb of the loop of Henle and macula densa in the kidney, leading to increased excretion of sodium, potassium, chloride, and water[4][5][6]. This results in reduced extracellular fluid volume and decreased blood pressure. Ethacrynic acid can be administered orally or intravenously; IV administration provides rapid relief from pulmonary congestion. Adverse effects include electrolyte imbalances such as hypokalemia and hyponatremia, ototoxicity (hearing loss), gastrointestinal disturbances like diarrhea or intestinal bleeding at high doses, metabolic alkalosis, and potential liver toxicity at very high doses[5][6][8]. Developed by: Merck
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