Ethacrynic acid and Proprinal
Determining the interaction of Ethacrynic acid and Proprinal and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Before taking ethacrynic acid, tell your doctor if you also use ibuprofen. You may need dose adjustments or special tests in order to safely take both medications together. If you are receiving this combination drink plenty of water. Blood pressure and kidney function should be monitored as well. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.
Professional:MONITOR: Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and diuretics may adversely affect renal function due to NSAID inhibition of the renal synthesis of prostaglandins that help maintain renal perfusion in dehydrated states. The risk may be increased in patients on dietary sodium restriction. At the same time, hypotensive effect of the diuretics may be reduced because inhibition of prostaglandins can lead to unopposed pressor activity and, consequently, elevation in blood pressure. Natriuretic and diuretic effects may also be reduced, as NSAIDs have been reported to cause sodium and water retention, which may account for the increased risk of congestive heart failure associated with the combination. One study showed an increase in the incidence density of congestive heart failure (in patients over 55 years of age) from 9.3 per 1,000 person-years in patients on diuretics to 23.3 per 1,000 person-years in patients on both diuretic and NSAID therapy. NSAIDs may also increase the risk of hyperkalemia associated with potassium-sparing diuretics.
MANAGEMENT: In patients receiving both diuretic and NSAID therapy, management consists of avoiding dehydration and carefully monitoring the patient's renal function and blood pressure. If renal insufficiency or hyperkalemia develops, both drugs should be discontinued until the condition is corrected.
- Muller FO, Schall R, Devaal AC, Groenewoud G, Hundt HKL, Middle MV "Influence of meloxicam on furosemide pharmacokinetics and pharmacodynamics in healthy volunteers." Eur J Clin Pharmacol 48 (1995): 247-51
- McCarthy JT, Torres VE, Romero JC, et al "Acute intrinsic renal failure induced by indomethacin." Mayo Clin Proc 57 (1982): 289-96
- Brater DC, Fox WR, Chennavasin P "Interaction studies with bumetanide and furosemide: effects of probenecid and of indomethacin on response to bumetanide in man." J Clin Pharmacol 21 (1981): 647-53
- Allan SG, Knox J, Kerr F "Interaction between diuretics and indomethacin." Br Med J 283 (1981): 1611
- Desaulles E, Schwartz J "A comparative study of the action of frusemide and methyclothiazide on renin release by rat kidney slices and the interaction with indomethacin." Br J Pharmacol 65 (1979): 193-6
- Favre L, Glasson P, Vallotton MB "Reversible acute renal failure from combined triamterene and indomethacin." Ann Intern Med 96 (1982): 317-20
- Mor R, Pitlik S, Rosenfeld JB "Indomethacin- and Moduretic--induced hyperkalemia." Isr J Med Sci 19 (1983): 535-7
- Poe TE, Scott RB, Keith JF Jr "Interaction of indomethacin with furosemide." J Fam Pract 16 (1983): 610-6
- Pedrinelli R, Magagna A, Arzilli F, et al "Influence of indomethacin on the natriuretic and renin-stimulating effect of bumetanide in essential hypertension." Clin Pharmacol Ther 28 (1980): 722-31
- Kaufman J, Hamburger R, Matheson J, Flamenbaum W "Bumetanide-induced diuresis and natriuresis: effect of prostaglandin synthetase inhibition." J Clin Pharmacol 21 (1981): 663-7
- Gehr T, Sica DA, Steigler BW, Marshall C "Interaction of triamterene-hydrochlorothiazide (T-H) and ibuprofen (I)." Clin Pharmacol Ther 47 (1990): 200
- Bennett WM "Drug interactions and consequences of sodium restriction." Am J Clin Nutr 65 (1997): S678-81
- Marcy TR, Ripley TL "Aldosterone antagonists in the treatment of heart failure." Am J Health Syst Pharm 63 (2006): 49-58
- Dixey JJ, Noormohamed FH, Lant AF, Brewerton DA "The effects of naproxen and sulindac on renal function and their interaction with hydrochlorothiazide and piretanide in man." Br J Clin Pharmacol 23 (1987): 55-63
- Gurwitz JH, Everitt DE, Monane M, et al "The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons." J Gerontol A Biol Sci Med Sci 51 (1996): m74-9
- Smith DE, Brater DC, Lin ET, Benet LZ "Attenuation of furosemide's diuretic effect by indomethacin: pharmacokinetic evaluation." J Pharmacokinet Biopharm 7 (1979): 265-74
- Leary WP, Reyes AJ "Drug interactions with diuretics." S Afr Med J 65 (1984): 455-61
- Weinberg MS, Quigg RJ, Salant DJ, Bernard DB "Anuric renal failure precipitated by indomethacin and triamterene." Nephron 40 (1985): 216-8
- Ripley EB, Gehr TW, Wallace H, Wade J, Kish C, Sica DA "The effect of nonsteroidal agents (NSAIDs) on the pharmacokinetics and pharmacodynamics of metolazone." Int J Clin Pharmacol Ther 32 (1994): 12-8
- "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
- Perazella MA "Drug-induced hyperkalemia: old culprits and new offenders." Am J Med 109 (2000): 307-14
- Watkins J, Abbot EC, Hensby CN, Webster J, Dollery CT "Attenuation of hypotensive effect of propranolol and thiazide diuretics by indomethacin." Br Med J 281 (1980): 702-5
- Favre L, Glasson P, Riondel A, Vallotton MB "Interaction of diuretics and non-steroidal anti-inflammatory drugs in man." Clin Sci 64 (1983): 407-15
- Ahmad S "Indomethacin-bumetanide interaction: an alert." Am J Cardiol 54 (1984): 246-7
- Heerdink ER, Leufkens HG, Herings RM, Ottervanger JP, Stricker BH, Bakker A "NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics." Arch Intern Med 158 (1998): 1108-12
- Furst DE "Clinically important interactions of nonsteroidal antiinflammatory drugs with other medications." J Rheumatol Suppl 17 (1988): 58-62
Generic Name: ethacrynic acid
Brand name: Edecrin, Edecrin Sodium, Sodium Edecrin
Synonyms: Ethacrynic Acid
Generic Name: ibuprofen
Brand name: Advil, Genpril, Ibu, Midol IB, Motrin IB, Proprinal, Smart Sense Children's Ibuprofen, Advil Liqui-Gels, Midol, Motrin, Motrin Migraine Pain, PediaCare Children’s Pain Reliever/Fever Reducer, PediaCare Infant’s Pain Reliever/Fever Reducer, Caldolor, NeoProfen, Children's Motrin, Motrin Junior Strength
Synonyms: n.a.
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
- Ethacrynic acid-Propulsid
- Ethacrynic acid-Propulsid (Cisapride Suspension)
- Ethacrynic acid-Propulsid (Cisapride Tablets)
- Ethacrynic acid-Propylhexedrine
- Ethacrynic acid-Propylthiouracil
- Ethacrynic acid-ProQuad
- Proprinal-Ethacrynic Acid Injection
- Proprinal-Ethacrynic Acid Tablets
- Proprinal-Ethacrynic Sodium
- Proprinal-Ethacrynic Sodium Injection
- Proprinal-Ethambutol
- Proprinal-Ethambutol Hydrochloride