HEALTHY LIFESTYLE




Amiloride hydrochloride
Amiloride hydrochloride.JPG

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                           : 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 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
  • other drugs