BMA Concise Guide to Medicine & Drugs

Amiloride

Brand name Amilamont

Used in the following combined preparations Co-amilofruse, Co-amilozide, Moduretic, Navispare, and others

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Drug group Potassium-sparing diuretic

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Amiloride is a diuretic. It acts on the kidneys to increase the amount of urine that is passed, although the diuretic effect of amiloride is very mild. The drug is used in the treatment of oedema (fluid retention), which can result from heart failure or liver disease and for hypertension (high blood pressure).

Amiloride’s effect on urine flow may last for several hours, so it should be taken in the morning. Amiloride causes the kidneys to conserve potassium (potassium-sparing diuretic) and should not be used when there is a high blood level of potassium. The drug is prescribed with caution in people taking potassium supplements or those with kidney disease. Amiloride is often combined with other diuretics such as furosemide (as co-amilofruse) and hydrochlorothiazide (as co-amilozide).

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, liquid.

Frequency and timing of doses Once or twice daily, usually in the morning.

Adult dosage range 5–20mg daily.

Onset of effect Within 2–4 hours.

Duration of action 12 hours.

Diet advice Avoid foods that are high in potassium – for example, dried fruit, bananas, tomatoes, and “low salt” salt substitutes.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. However, if it is late in the day, do not take the missed dose, or you may need to get up at night to pass urine. Take the next scheduled dose as usual.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to be a cause for concern. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Amiloride has few adverse effects. The main problem is the possibility that potassium may be retained by the body or excessive sodium lost in the urine, causing muscle weakness or heart rhythm problems. Rarely, there may be digestive disturbance, confusion, muscle cramps, dry mouth and thirst, or dizziness; discuss with your doctor if any of these occur. If a rash develops, stop taking the drug and consult your doctor.

INTERACTIONS

Lithium Amiloride may increase the blood levels of lithium, leading to an increased risk of lithium toxicity.

ACE inhibitors, angiotensin II blockers, renin inhibitors (e.g. aliskiren), ciclosporin, drosperinone, tacrolimus, and NSAIDs These drugs may increase the risk of potassium retention if taken with amiloride.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have long-term liver or kidney problems.

· You are taking other medicines.

Pregnancy Not usually prescribed. May cause a reduction in the blood supply to the developing baby. Discuss with your doctor.

Breast-feeding Not usually prescribed during breast-feeding. Discuss with your doctor.

Infants and children Not recommended.

Over 60 Increased likelihood of adverse effects. Reduced dose may be necessary.

Driving and hazardous work No known problems.

Alcohol No special problems.

PROLONGED USE

Monitoring Blood tests may be carried out to monitor levels of body salts.