Amiloride Hydrochloride
Pronunciation: (uh-MILL-oh-ride HIGH-droe-KLOR-ide)Class: Potassium-sparing diuretic
Trade Names:
Midamor
- Tablets 5 mg
Pharmacology
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 User Reviews & Ratings
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Interferes with sodium reabsorption at distal tubule, resulting in increased excretion of water and sodium and decreased excretion of potassium.
Pharmacokinetics
Absorption
15% to 25% is absorbed; t max is 3 to 4 h.
Distribution
About 23% is protein bound.
Metabolism
Not metabolized.
Elimination
T 1/2 is 6 to 9 h. About 50% is excreted unchanged in the urine; about 40% in the feces.
Onset
Within 2 h.
Peak
6 to 10 h.
Duration
24 h.
Indications and Usage
Treatment of CHF or hypertension (in combination with thiazide or loop diuretics) and diuretic-induced hypokalemia.
Unlabeled Uses
Reduction of lithium-induced polyuria; slowed reduction of pulmonary function in patients with cystic fibrosis (aerosol form).
Contraindications
Serum potassium more than 5.5 mEq/L; potassium supplementation; impaired renal function: spironolactone or triamterene therapy.
Dosage and Administration
AdultPO 5 to 10 mg/day.
Lithium-Induced PolyuriaPO 10 to 20 mg/day.
Cystic FibrosisDissolve in 0.3% saline and deliver by nebulizer.
Storage/Stability
Store in tightly closed container in cool location.
Drug Interactions
Angiotensin-converting enzyme inhibitorsMay result in severely elevated serum potassium levels.
Potassium preparationsMay severely increase serum potassium levels, possibly resulting in cardiac arrhythmias or cardiac arrest. Do not administer to patients taking potassium preparations.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Angina pectoris; orthostatic hypotension; arrhythmia.
CNS
Headache; dizziness; encephalopathy; paresthesia; tremors; vertigo; nervousness; mental confusion; insomnia; decreased libido; depression.
Dermatologic
Skin rash; itching; pruritus.
EENT
Visual disturbances; tinnitus; nasal congestion.
GI
Nausea; anorexia; diarrhea; vomiting; abdominal pain; gas pain; appetite changes; constipation; GI bleeding; abdominal fullness; thirst; dry mouth; heartburn; flatulence.
Genitourinary
Impotence; polyuria; dysuria; urinary frequency.
Hematologic
Aplastic anemia; neutropenia.
Hepatic
Jaundice.
Metabolic
Increased serum potassium levels.
Respiratory
Cough; dyspnea.
Miscellaneous
Musculoskeletal (eg, weakness; fatigue; muscle cramps; joint/back/chest pain; neck or shoulder ache).
Precautions
MonitorHyperkalemiaMonitor for signs of hyperkalemia (eg, fatigue, muscle weakness, cardiac irregularities). |
Pregnancy
Category B .
Lactation
Undetermined.
Children
Safety and efficacy not established.
Renal Function
Use cautiously in patients with this condition.
Hepatic Function
With severe liver disease, hepatic encephalopathy (eg, tremors, confusion, coma, jaundice) may occur.
Diabetes mellitus
Hyperkalemia may occur.
ECG change
If ECG changes occur (eg, peaked T waves, abnormal S or P waves), withhold dose and notify health care provider.
Electrolyte imbalances and BUN increase
Hyperkalemia, hyponatremia, hypochloremia, and increases in BUN may occur.
Serum potassium levels
If sudden elevation in serum potassium level (more than 5.5 mEq/L) occurs, withhold dose and notify health care provider.
Patient Information
- Explain that dietary considerations are very important while taking this medication. Advise patient to avoid the following: Eating excessive amounts of potassium-rich foods (bananas, citrus fruits, raisins, nuts), using salt substitutes, taking medications high in potassium and eating foods high in sodium (tomatoes, pickled foods, canned foods, luncheon meats).
- Teach patient to monitor BP daily.
- Instruct patient to take medication as directed, even if feeling well.
- Encourage patient to avoid sudden changes in position to prevent orthostatic hypotension.
- Advise patient that drug may cause dizziness and blurred vision, and to use caution while driving or performing other tasks requiring mental alertness.
- Inform patient that this medication causes increased urine output.
- Teach patient signs and symptoms of hyperkalemia and hyponatremia.
- Caution patient to notify health care provider or dentist about taking this medication and notify health care provider of cramps or chronic fatigue and weakness, which are serious side effects.
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