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| __NOTOC__
| | #REDIRECT [[Amiloride#Warnings]] |
| {{Amiloride}}
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| {{CMG}}; {{AE}} {{SS}}
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| ==Warnings and Precautions==
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| ===WARNINGS===
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| ====Hyperkalemia====
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| The risk of [[hyperkalemia]]may be increased when potassium-conserving agents, including MIDAMOR, are administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, [[cyclosporine]]or [[tacrolimus]]. (See PRECAUTIONS, Drug Interactions.) Warning signs or symptoms of [[hyperkalemia]]include [[paresthesias]], muscular weakness, [[fatigue]], [[flaccid paralysis]] of the extremities, [[bradycardia]], [[shock]], and ECG abnormalities. Monitoring of the serum potassium level is essential because mild [[hyperkalemia]]is not usually associated with an abnormal ECG.
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| When abnormal, the ECG in [[hyperkalemia]]is characterized primarily by tall, peaked T waves or elevations from previous tracings. There may also be lowering of the R wave and increased depth of the S wave, widening and even disappearance of the P wave, progressive widening of the QRS complex, prolongation of the PR interval, and ST depression.
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| ====Treatment of hyperkalemia====
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| If [[hyperkalemia ]]occurs in patients taking MIDAMOR, the drug should be discontinued immediately. If the serum potassium level exceeds 6.5 mEq per liter, active measures should be taken to reduce it. Such measures include the intravenous administration of sodium bicarbonate solution or oral or parenteral glucose with a rapid-acting insulin preparation. If needed, a cation exchange resin such as sodium polystyrene sulfonate may be given orally or by enema. Patients with persistent [[hyperkalemia ]]may require dialysis.
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| ====Diabetes Mellitus====
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| In diabetic patients, [[hyperkalemia]] has been reported with the use of all potassium-conserving diuretics, including MIDAMOR, even in patients without evidence of diabetic nephropathy. Therefore, MIDAMOR should be avoided, if possible, in diabetic patients and, if it is used, serum electrolytes and renal function must be monitored frequently.
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| MIDAMOR should be discontinued at least three days before glucose tolerance testing.
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| ====Metabolic or Respiratory Acidosis====
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| Antikaliuretic therapy should be instituted only with caution in severely ill patients in whom respiratory or metabolic acidosis may occur, such as patients with cardiopulmonary disease or poorly controlled diabetes. If MIDAMOR is given to these patients, frequent monitoring of acid-base balance is necessary. Shifts in acid-base balance alter the ratio of extracellular/intracellular potassium, and the development of acidosis may be associated with rapid increases in serum potassium levels.
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| ===PRECAUTIONS===
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| ====General====
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| =====Electrolyte Imbalance and BUN Increases=====
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| Hyponatremia and hypochloremia may occur when MIDAMOR is used with other [[diuretics ]]and increases in BUN levels have been reported. These increases usually have accompanied vigorous fluid elimination, especially when diuretic therapy was used in seriously ill patients, such as those who had hepatic cirrhosis with ascites and metabolic alkalosis, or those with resistant [[edema]]. Therefore, when MIDAMOR is given with other [[diuretics ]]to such patients, careful monitoring of serum electrolytes and BUN levels is important. In patients with pre-existing severe liver disease, hepatic encephalopathy, manifested by tremors, confusion, and coma, and increased jaundice, have been reported in association with diuretics, including amiloride HCl.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = MIDAMOR (AMILORIDE HYDROCHLORIDE) TABLET [PADDOCK LABORATORIES, INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f4cde6e4-12cb-4e30-920f-5b94576b4863 | publisher = | date = | accessdate = 26 February 2014 }}</ref>
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| ==References==
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| {{reflist|2}}
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| {{Sodium channel blockers}}
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| {{Diuretics}}
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| [[Category:Potassium-sparing diuretics]]
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| [[Category:Aminopyrazines]]
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| [[Category:Guanidines]]
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| [[Category:World Health Organization essential medicines]]
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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