Reomax - General Information
A compound that inhibits symport of sodium, potassium, and chloride primarily in the ascending limb of Henle, but also in the proximal and distal tubules. This pharmacological action results in excretion of these ions, increased urinary output, and reduction in extracellular fluid. This compound has been classified as a loop or high ceiling diuretic. [PubChem]
Pharmacology of Reomax
Reomax is a monosulfonamyl loop or high ceiling diuretic. Reomax acts on the ascending limb of the loop of Henle and on the proximal and distal tubules. Urinary output is usually dose dependent and related to the magnitude of fluid accumulation. Water and electrolyte excretion may be increased several times over that observed with thiazide diuretics, since ethacrynic acid inhibits reabsorption of a much greater proportion of filtered sodium than most other diuretic agents. Therefore, ethacrynic acid is effective in many patients who have significant degrees of renal insufficiency. Reomax has little or no effect on glomerular filtration or on renal blood flow, except following pronounced reductions in plasma volume when associated with rapid diuresis.
Reomax for patients
Lithium generally should not be given with diuretics because they reduce its renal clearance and add a high risk of lithium toxicity. Read circulars for lithium preparations before use of such concomitant therapy.
EDECRIN may increase the ototoxic potential of other drugs such as aminoglycoside and some cephalosporin antibiotics. Their concurrent use should be avoided.
A number of drugs, including ethacrynic acid, have been shown to displace warfarin from plasma protein; a reduction in the usual anticoagulant dosage may be required in patients receiving both drugs.
In some patients, the administration of a non- steroidal antiinflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium- sparing and thiazide diuretics. Therefore, when EDECRIN and non- steroidal anti- inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of the diuretic is obtained.
All diuretics, including ethacrynic acid, are contraindicated in anuria. If increasing electrolyte imbalance, azotemia, and/ or oliguria occur during treatment of severe, progressive renal disease, the diuretic should be discontinued.
In a few patients this diuretic has produced severe, watery diarrhea. If this occurs, it should be discontinued and not used again.
Until further experience in infants is accumulated, therapy with oral and parenteral EDECRIN is contraindicated.
Hypersensitivity to any component of this product.
Additional information about Reomax
Reomax Indication: For the treatment of high blood pressure and edema caused by diseases like congestive heart failure, liver failure, and kidney failure.
Mechanism Of Action: Reomax inhibits symport of sodium, potassium, and chloride primarily in the ascending limb of Henle, but also in the proximal and distal tubules. This pharmacological action results in excretion of these ions, increased urinary output, and reduction in extracellular fluid. Diuretics also lower blood pressure initially by reducing plasma and extracellular fluid volume; cardiac output also decreases, explaining its antihypertensive action. Eventually, cardiac output returns to normal with an accompanying decrease in peripheral resistance. Its mode of action does not involve carbonic anhydrase inhibition.
Drug Interactions: Amikacin Increased ototoxicity
Anisindione Reomax increases the anticoagulant effect
Cisplatin Increased ototoxicity
Deslanoside Possible electrolyte variations and arrhythmias
Dicumarol Reomax increases the anticoagulant effect
Digitoxin Possible electrolyte variations and arrhythmias
Digoxin Possible electrolyte variations and arrhythmias
Gentamicin Increased ototoxicity
Ginseng Ginseng decreases the therapeutic effect of diuretic
Ibuprofen The NSAID decreases the diuretic and antihypertensive effects of the loop diuretic
Indomethacin The NSAID decreases the diuretic and antihypertensive effects of the loop diuretic
Kanamycin Increased ototoxicity
Netilmicin Increased ototoxicity
Streptomycin Increased ototoxicity
Sulindac The NSAID decreases the diuretic and antihypertensive effects of the loop diuretic
Tobramycin Increased ototoxicity
Warfarin Reomax increases the anticoagulant effect
Acenocoumarol Reomax increases the anticoagulant effect
Food Interactions: Take with food to reduce irritation.
Generic Name: Ethacrynic acid
Synonyms: Methylenebutyrylphenoxyacetic acid; Etacrinic acid; Etacrynic acid; Etakrinic acid; Ethacrynate
Drug Category: Diuretics; Enzyme Inhibitors
Drug Type: Small Molecule; Approved
Absorption: Onset of action is rapid, usually within 30 minutes after an oral dose of ethacrynic acid or within 5 minutes after an intravenous injection of ethacrynic acid.
Toxicity (Overdose): Overdosage may lead to excessive diuresis with electrolyte depletion.
Protein Binding: > 98%
Half Life: Not Available
Dosage Forms of Reomax: Powder, for solution Intravenous
Chemical IUPAC Name: 2-[2,3-dichloro-4-(2-methylidenebutanoyl)phenoxy]acetic acid
Chemical Formula: C13H12Cl2O4
Ethacrynic acid on Wikipedia: https://en.wikipedia.org/wiki/Ethacrynic_acid
Organisms Affected: Humans and other mammals