Drug ID: 1d00000077
Drug Name: Amiloride and Hydrochlorothiazide
Generic Names: Amilochlor Tab | Biduret Tab | Biduret-L Tab | Moduretic
Legal Status: Non Opioid Prescription only drug
Indication for Mother: Category B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Recommended Dose: Per tab contains amiloride 5 mg and hydrochlorothiazide 50 mg: 1-2 tab/day.
Recommended In: This combination medication contains diuretics, prescribed for hypertension and congestive heart failure. It helps the body to get rid of extra salt and water.
Directions For Use: It comes as a tablet to take by mouth, with food.
Storage: Store it at room temperature (15-30°C), and in an airtight container. Keep away from children.
Dosage Forms: Tablet
Side Effects: Body as a Whole - Headache, weakness and fatigue/tiredness.
Heart - Irregular heart rate.
Gastrointestinal - Nausea/loss of appetite, diarrhea, gastrointestinal pain and abdominal pain.
Metabolic - Elevated serum potassium levels.
Musculoskeletal - Leg pain.
Nervous system - Dizziness.
Respiratory - Difficulty in breathing.
Skin - Rash and itching.
In Case of Overdose: The most common signs and symptoms to be expected with overdosage are dehydration and electrolyte imbalance. If hyperkalemia occurs, active measures should be taken to reduce the serum potassium levels.
The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias.
Suggested measures include induction of emesis and/or gastric lavage.
Avoid If: Contraindicated in patients with kidney impairment, increased level of potassium in blood and pregnancy.
Caution should be exercised in patients with history of untreated salt/mineral imbalance (such as high potassium, low sodium level), kidney disease, liver disease, diabetes, loss of water content in body (dehydration), lupus, gout, high levels of fat content in blood, any allergy, who are taking other medications, during pregnancy and breastfeeding.
It may cause dizziness or lightheadedness, do not drive a car or operate machinery, and get up slowly from bed while taking this medication.
Avoid alcohol consumption.
Monitor blood sugar regularly while taking this medication.
Avoid excess dosage.
Avoid long-term use of this medication; otherwise it may lead to increase level of potassium in blood.
Drug Interaction: Amiloride HCl
When amiloride HCl is administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, cyclosporine or tacrolimus, the risk of hyperkalemia may be increased. Therefore, if concomitant use of these agents is indicated because of demonstrated hypokalemia, they should be used with caution and with frequent monitoring of serum potassium.
When given concurrently the following drugs may interact with thiazide diuretics. Alcohol, barbiturates, or narcotics — potentiation of orthostatic hypotension may occur. Antidiabetic drugs (oral agents and insulin) — dosage adjustment of the antidiabetic drug may be required.
Other antihypertensive drugs — additive effect or potentiation.
Cholestyramine and colestipol resins — Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively.
Corticosteroids, ACTH — intensified electrolyte depletion, particularly hypokalemia.
Pressor amines (e.g., norepinephrine) — possible decreased response to pressor amines but not sufficient to preclude their use.
Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine) — possible increased responsiveness to the muscle relaxant.
Lithium — generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity.
Metabolic and Endocrine Effects
In diabetic patients, insulin requirements may be increased, decreased, or unchanged due to the hydrochlorothiazide component. Diabetes mellitus that has been latent may become manifest during administration of thiazide diuretics.
Because calcium excretion is decreased by thiazides, amiloride and hydrochlorothiazide should be discontinued before carrying out tests for parathyroid function. Pathologic changes in the parathyroid glands, with hypercalcemia and hypophosphatemia have been observed in a few patients on prolonged thiazide therapy; however, the common complications of hyperparathyroidism such as renal lithiasis, bone resorption, and peptic ulceration have not been seen.
Hyperuricemia may occur or acute gout may be precipitated in certain patients receiving thiazide therapy.
In patients receiving thiazides, sensitivity reactions may occur with or without a history of allergy or bronchial asthma. The possibility of exacerbation or activation of systemic lupus erythematosus has been reported with the use of thiazides.
Increases in cholesterol and triglyceride levels may be associated with thiazide diuretic therapy.