If you receive an order for ethacrynic acid, ensure the following are in place prior to verifying the order.  In addition, please contact the clinical pharmacist on call to approve this order prior to dispensing.

• The patient has a documented diagnosis of heart failure
• The patient has evidence of fluid overload ( i.e. documentation of pulmonary edema on chest XRAY or  peripheral edema on physical exam in physician notes, elevated BNP)
• The patient has a documented sulfa allergy. If the patient has tolerated other sulfa derived medications on prior admission or is presently taking other sulfa containing medications without complications (i.e. celecoxib, tamsulosin, thiazides, sulfamethoxazole, sulfonylureas, loop diuretics, etc.); this is not considered a true sulfa allergy.

• UpToDate
• FDA Package Inserts