Ethacrynic Acid in Pregnancy and Breastfeeding
Fetal Risk Summary
Ethacrynic acid is a potent diuretic. It has been used for toxemia, pulmonary edema, and diabetes insipidus during pregnancy (1,2,3,4,5,6,7,8,9 and 10).
Reproduction studies in mice and rabbits at doses up to 50 times the human dose showed no evidence of external malformations (11). Doses of 10 or 2.5 times the human dose in rats and dogs, respectively, did not impair fertility or growth and development of pups (11). Intrauterine growth retardation was observed in the offspring of rats at a dose 50 times the human dose, but there was no effect on survival or postnatal development (11).
Although limited 1st trimester human experience has not shown an increased incidence of malformations, ethacrynic acid is not recommended for use in pregnant women (12). Diuretics do not prevent or alter the course of toxemia, but they may decrease placental perfusion (see also Chlorothiazide) (13,14 and 15). In general, diuretics are not recommended for the treatment of pregnancy-induced hypertension because of the maternal hypovolemia characteristic of this disease.
Ototoxicity has been observed in a mother and her newborn following the use of ethacrynic acid and kanamycin during the 3rd trimester (see also Kanamycin) (16).
[*Risk Factor D if used in pregnancy-induced hypertension.]
Breast Feeding Summary
No reports describing the use of ethacrynic acid during lactation have been located (see also Chlorothiazide). The manufacturer recommends that ethacrynic acid not be used in nursing mothers (11).
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- Product information. Edecrin. Merck, 2000.
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