Amiloride hydrochloride

CLINICAL USE

Oedema

Potassium conservation with thiazide andloop diuretics

DOSE IN NORMAL RENAL FUNCTION

5–10 mg daily; maximum 20 mg daily

PHARMACOKINETICS

Molecular weight :
302.1

%Protein binding :
30–40

%Excreted unchanged in urine :
50

Volume of distribution (L/kg) :
5

half-life – normal/ESRD (hrs) :
6–20/100

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Use 50% of dose

10 to 20 : Use 50% of dose

<10 :
Avoid

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :
Not applicable. Avoid

HD :
Not applicable. Avoid

HDF/high flux :
Not applicable. Avoid

CAV/VVHD :
Unknown dialysability. Dose as in
GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

ACE inhibitor and angiotensin-II antagonists: increased risk of
hyperkalaemia and hypotension
Antibacterials: avoid concomitant use with

lymecycline

Antidepressants: increased risk of posturalhypotension with tricyclics; enhanced
hypotensive effect with MAOIs
Antihypertensives: enhanced hypotensive

effect

Ciclosporin: increased risk ofhyperkalaemia and nephrotoxicity
Lithium excretion reduced

NSAIDS: increased risk of hyperkalaemia;increased risk of

nephrotoxicity;
antagonism of diuretic effect

Potassium salts: increased risk ofhyperkalaemia

Tacrolimus: increased risk ofhyperkalaemia

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Monitor for hyperkalaemia

Greatly increased risk of hyperkalaemia inpatients with a GFR<30 mL/min, especially
in diabetics

Increased risk of hyperchloraemic

metabolic acidosis in patients with
reduced GFR

Bioavailability is 50% and can be reducedby administering with food

Reduced natriuretic effect once theGFR<50 mL/min

Diuretic effect starts 2 hours after

administration, peaks after 6–10 hours
and can last up to 24 hours

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