Amiloride and hydrochlorothiazide (Oral)
Generic name: amiloride and hydrochlorothiazide [ a-MIL-oh-ride-hye-droe-KLOR-ide, hye-droe-klor-oh-THYE-a-zide ]
Drug class: Potassium sparing diuretics with thiazides
Medically reviewed by Drugs.com. Last updated on Apr 26, 2023.
May cause hyperkalemia, which is potentially fatal if uncorrected. The risk is higher in patients with renal impairment or diabetes mellitus. Monitor serum potassium levels carefully in any patient receiving therapy. .
Uses for amiloride and hydrochlorothiazide
Amiloride and hydrochlorothiazide combination is used alone or with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.
This medicine is also used to treat water retention (edema) in patients with congestive heart failure.
Amiloride and hydrochlorothiazide are both diuretic medicines (water pills). They reduce the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure. Amiloride keeps your body from losing too much potassium when urine flow is increased.
This medicine is available only with your doctor's prescription.
Before using amiloride and hydrochlorothiazide
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of amiloride and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of amiloride and hydrochlorothiazide combination in the elderly. However, elderly patients are more likely to have age-related liver, kidney or heart problems, which may require an adjustment in the dose for patients receiving amiloride and hydrochlorothiazide combination.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Potassium Citrate
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amtolmetin Guacil
- Arsenic Trioxide
- Choline Salicylate
- Enalapril Maleate
- Flufenamic Acid
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glulisine
- Mefenamic Acid
- Niflumic Acid
- Nimesulide Beta Cyclodextrin
- Potassium Phosphate
- Salicylic Acid
- Sodium Salicylate
- Tiaprofenic Acid
- Tolfenamic Acid
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aminolevulinic Acid
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.
- Potassium Containing Food
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Anuria (not able to pass urine) or
- Diabetes or
- Hyperkalemia (high potassium in the blood) or
- Kidney disease (eg, anuria or diabetic nephropathy) or
- Sulfa drug allergy—Should not be used in patients with these conditions.
- Gout or
- Hyperuricemia (high uric acid in the blood) or
- Hypochloremia (low chloride in the blood) or
- Hypokalemia (low potassium in the blood) or
- Hypomagnesemia (low magnesium in the blood) or
- Hyponatremia (low sodium in the blood) or
- Parathyroid disease or
- Systemic lupus erythematosus—Use with caution. This medicine may make these conditions worse.
- Heart disease or
- Liver disease, severe (eg, cirrhosis or hepatic encephalopathy) or
- Lung disease—Use with caution. May increase the chance of side effects.
Proper use of amiloride and hydrochlorothiazide
This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.
In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet .
Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems including heart failure, blood vessel disease, stroke, or kidney disease.
Swallow the tablet whole. Do not break, crush, or chew it. It is best to take this medicine with food.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For hypertension or edema:
- Adults—At first, one tablet once a day. Your doctor may adjust your dose if needed. Each tablet contains 50 milligrams (mg) hydrochlorothiazide and 5 mg amiloride.
- Children—Use and dose must be determined by your doctor.
- For hypertension or edema:
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions while using amiloride and hydrochlorothiazide
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.
Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have stomach pain, confusion, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, trouble breathing, or weakness or heaviness of the legs.
Make sure your doctor knows if you are also taking potassium supplements or salt substitutes containing potassium, or certain diuretics such as spironolactone (Aldactazide®, Aldactone®), triamterene (Dyrenium®), or other products containing amiloride. Using these medicines together may cause serious problems.
This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. Dizziness may be worse if you lose too much water from your body. You can lose water by sweating, having diarrhea, or vomiting. Tell your doctor if this medicine makes you feel lightheaded or dizzy after you have been vomiting or had diarrhea.
This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.
Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.
Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.
Side Effects of amiloride and hydrochlorothiazide
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
- difficulty breathing
- irregular heartbeat
- nausea or vomiting
- numbness or tingling in the hands, feet, or lips
- stomach pain
- trouble breathing
- weakness or heaviness of the legs
- fast or slow heartbeat
- labored breathing
- tightness in the chest
- Ankle, knee, or great toe joint pain
- arm, back, or jaw pain
- blistering, peeling, or loosening of the skin
- bloody or black, tarry stools
- bloody urine
- burning while urinating
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain, discomfort, or heaviness
- cloudy urine
- cold sweats
- cracks in the skin
- decreased awareness or responsiveness
- decreased frequency or amount of urine
- difficult or painful urination
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
- dry mouth
- increase in heart rate
- increased blood pressure
- increased thirst
- joint pain, stiffness, or swelling
- loss of appetite
- loss of heat from the body
- lower back or side pain
- muscle pain or cramps
- pounding heartbeat or pulse
- rapid breathing
- red skin lesions, often with a purple center
- red, irritated eyes
- red, swollen skin
- scaly skin
- severe sleepiness
- severe stomach pain
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- sunken eyes
- swelling of the face, ankles, hands, fingers, or lower legs
- trouble breathing
- unusual tiredness or weakness
- vomiting of blood or material that looks like coffee grounds
- weight gain
- wrinkled skin
Incidence not known
- Persistent non-healing sore
- pink growth
- reddish patch or irritated area
- shiny bump
- white, yellow or scar-like area
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
- mood changes
- pain or weakness in the hands or feet
- weak pulse
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- weight loss
- Leg ache
- Bad taste
- bloated, full feeling
- blurred or loss of vision
- changes in appetite
- decreased interest in sexual intercourse
- disturbed color perception
- double vision
- excess air or gas in the stomach or intestines
- feeling of constant movement of self or surroundings
- feeling of warmth
- feeling sad or empty
- general feeling of discomfort or illness
- hair loss or thinning of hair
- inability to have or keep an erection
- increased sweating
- increased urge to urinate during the night
- loss in sexual ability, desire, drive, or performance
- loss of bladder control
- loss of interest or pleasure
- muscle spasm
- night blindness
- overbright appearance of lights
- passing of gas
- redness of the face, neck, arms, and occasionally upper chest
- seeing halos around lights
- sensation of spinning
- stomach fullness or discomfort
- stuffy nose
- swelling of the breasts or breast soreness in both females and males
- trouble concentrating
- trouble sleeping
- tunnel vision
- unable to sleep
- waking to urinate at night
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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