Etacrynic acid

Sensory systems

Etacrynic acid is ototoxic after intravenous administration [ ], an effect that is dose-related. It can sometimes be permanent [ , ]. An association with nystagmus has also been reported [ , ]. The risk has been estimated to be about seven per 1000 injections [ ]. The risk is increased in renal insufficiency and in patients who are also being given aminoglycoside antibiotics. Animal data suggest that etacrynic acid is more ototoxic than furosemide [ ].

Metabolism

Like other diuretics etacrynic acid can impair glucose tolerance in patients with type 2 diabetes mellitus [ ]. Non-ketotic hyperglycemia has also been reported [ ]. However, hypoglycemia has also been reported in two patients with uremia [ ].

There has been an anecdotal report of hyperuricemia and acute gout in a patient taking etacrynic acid [ ].

Electrolyte balance

Etacrynic acid can cause excessive diuresis, natriuresis, and kaliuresis, leading respectively to dehydration and sodium and potassium depletion [ ].

Mineral balance

Etacrynic acid can cause hypocalcemia and hypomagnesemia [ ].

Hematologic

There have been anecdotal reports of agranulocytosis [ , ], hemolytic anemia [ ], and thrombocytopenia [ , ].