Amiloride hydrochloride

CLINICAL USE

Oedema

Potassium conservation with thiazide and

loop diuretics

DOSE IN NORMAL RENAL FUNCTION

5–10 mg daily; maximum 20 mg daily

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
302.1

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
30–40

%Excreted unchanged in urine &nbsp &nbsp :
50

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
5

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Use 50% of dose

10 to 20 &nbsp &nbsp : Use 50% of dose

<10 &nbsp &nbsp &nbsp &nbsp &nbsp :
Avoid

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
Not applicable. Avoid

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
Not applicable. Avoid

HDF/high flux &nbsp :
Not applicable. Avoid

CAV/VVHD &nbsp &nbsp &nbsp:
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 postural

hypotension with tricyclics; enhanced
hypotensive effect with MAOIs
Antihypertensives: enhanced hypotensive

effect

Ciclosporin: increased risk of

hyperkalaemia and nephrotoxicity
Lithium excretion reduced

NSAIDS: increased risk of hyperkalaemia;

increased risk of

nephrotoxicity;
antagonism of diuretic effect

Potassium salts: increased risk of

hyperkalaemia

Tacrolimus: increased risk of

hyperkalaemia

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Monitor for hyperkalaemia

Greatly increased risk of hyperkalaemia in

patients 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 reduced

by administering with food

Reduced natriuretic effect once the

GFR<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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