hydrochlorothiazide and amiloride

Generic Name: hydrochlorothiazide and amiloride (hy dro klor oh THI a zide and a MIL o ride)
Brand Names: Moduretic 5-50

What is hydrochlorothiazide and amiloride?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Amiloride is a potassium sparing-diuretic that also prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

The combination of hydrochlorothiazide and amiloride is used to treat fluid retention (edema) and high blood pressure (hypertension).

Hydrochlorothiazide and amiloride may also be used for purposes not listed in this medication guide.

What is the most important information I should know about hydrochlorothiazide and amiloride?

You should not use this medication if you have kidney disease, urination problems, diabetes, or high levels of potassium in your blood. Do not use potassium supplements while you are taking hydrochlorothiazide and amiloride.

Before using this medication, tell your doctor if you have heart disease, cirrhosis or other liver disease, glaucoma, a breathing disorder, gout, lupus, an allergy to sulfa drugs or penicillin, or a pancreas disorder. Tell your doctor if you use steroids or other blood pressure medicines.

Drinking alcohol can increase certain side effects of hydrochlorothiazide and amiloride. Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking hydrochlorothiazide and amiloride.

There are many other drugs that can interact with hydrochlorothiazide and amiloride. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

What should I discuss with my doctor before taking hydrochlorothiazide and amiloride?

You should not use this medication if you are allergic to hydrochlorothiazide or amiloride, or if you have:

• kidney disease or are unable to urinate;

• high potassium levels (hyperkalemia); or

• if you are taking potassium supplements.

To make sure you can safely take hydrochlorothiazide and amiloride, tell your doctor if you have any of these other conditions:

• diabetes;

• heart disease;

• cirrhosis or other liver disease;

• glaucoma;

• a breathing disorder;

• gout;

• lupus;

• an allergy to sulfa drugs or penicillin;

• a pancreas disorder; or

• if you are using another blood pressure medication or a steroid.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Hydrochlorothiazide can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using hydrochlorothiazide and amiloride.

How should I take hydrochlorothiazide and amiloride?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take hydrochlorothiazide and amiloride with food.

Your blood pressure will need to be checked often. Your blood and urine may also be tested if you have been vomiting or are dehydrated. Visit your doctor regularly.

Hydrochlorothiazide can interfere with the results of a thyroid test. Tell any doctor who treats you that you are using a thiazide diuretic.

If you need surgery, tell the surgeon ahead of time that you are using hydrochlorothiazide and amiloride. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light. Do not freeze.

See also: Hydrochlorothiazide and amiloride dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include dizziness, thirst, feeling light-headed, slow heartbeat, or fainting.

What should I avoid while taking hydrochlorothiazide and amiloride?

Drinking alcohol can increase certain side effects of hydrochlorothiazide and amiloride. Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking hydrochlorothiazide and amiloride.

Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Hydrochlorothiazide and amiloride side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have a serious side effect such as:

• eye pain, vision problems;

• numbness or tingly feeling;

• muscle pain or weakness;

• slow, fast, or uneven heartbeat;

• feeling drowsy, restless, or light-headed;

• urinating less than usual or not at all;

• dry mouth, increased thirst, tiredness, nausea, vomiting;

• shallow breathing;

• tremors, confusion; or

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• mild nausea or vomiting;

• gas, stomach pain; or

• skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: hydrochlorothiazide and amiloride side effects (in more detail)

Hydrochlorothiazide and amiloride Dosing Information

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 1 tablet orally once a day with meals.
Maintenance dose: 1 to 2 tablets once a day or 1 tablet twice a day.
The maximum recommended dose is 2 tablets/day.

Usual Adult Dose for Hypertension:

Initial dose: 1 tablet orally once a day with meals.
Maintenance dose: 1 to 2 tablets once a day or 1 tablet twice a day.
The maximum recommended dose is 2 tablets/day.

What other drugs will affect hydrochlorothiazide and amiloride?

Tell your doctor if you regularly use other medicines that make you light-headed (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to the side effects of hydrochlorothiazide and amiloride.

Tell your doctor about all other medicines you use, especially:

• cyclosporine (Neoral, Sandimmune, Gengraf);

• tacrolimus (Prograf);

• lithium (Eskalith, LithoBid);

• digoxin (Lanoxin);

• steroids (prednisone and others);

• a blood thinner such as warfarin (Coumadin, Jantoven);

• insulin or oral diabetes medication;

• other blood pressure medications;

• an ACE inhibitor such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others;

• candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), or valsartan (Diovan); or

• indomethacin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.

This list is not complete and other drugs may interact with hydrochlorothiazide and amiloride. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about hydrochlorothiazide and amiloride.