Amiloride
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gerald Chi
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Black Box Warning
See full prescribing information for complete Boxed Warning.
* Like other potassium-conserving agents, amiloride may cause hyperkalemia (serum potassium levels greater than 5.5 mEq per liter) which, if uncorrected, is potentially fatal. Hyperkalemia occurs commonly (about 10%) when amiloride is used without a kaliuretic diuretic. This incidence is greater in patients with renal impairment, diabetes mellitus (with or without recognized renal insufficiency), and in the elderly. When amiloride is used concomitantly with a thiazide diuretic in patients without these complications, the risk of hyperkalemia is reduced to about 1-2 percent. It is thus essential to monitor serum potassium levels carefully in any patient receiving amiloride, particularly when it is first introduced, at the time of diuretic dosage adjustments, and during any illness that could affect renal function.
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Overview
Amiloride is a potassium-sparing diuretic that is FDA approved for the {{{indicationType}}} of congestive heart failure or hypertension adjunctive with thiazide diuretics or other kaliuretic-diuretic agents. There is a Black Box Warning for this drug as shown here. Common adverse reactions include rash, diarrhea, loss of appetite, nausea, vomiting, asthenia, cramp, dizziness, headache, cough, and dyspnea.
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
Congestive Heart Failure or Hypertension
- Dosing Information
- 5 mg tablet daily, should be added to the usual antihypertensive or diuretic dosage of a kaliuretic diuretic.
- The dosage may be increased to 10 mg per day, if necessary.
- More than two 5 mg tablets of amiloride daily usually are not needed, and there is little controlled experience with such doses.
- If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes.
- In treating patients with congestive heart failure after an initial diuresis has been achieved, potassium loss may also decrease and the need for amiloride should be re-evaluated.
- Dosage adjustment may be necessary. Maintenance therapy may be on an intermittent basis.
- If it is necessary to use amiloride alone, the starting dosage should be one 5 mg tablet daily. This dosage may be increased to 10 mg per day, if necessary.
- More than two 5 mg tablets usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes.
Off-Label Use and Dosage (Adult)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Amiloride in adult patients.
Non–Guideline-Supported Use
Edema, Associated with Thiazolidinedione Use
- Dosing Information
- 10 mg once daily[1]
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
Safety and effectiveness in pediatric patients have not been established.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
There is limited information regarding Off-Label Guideline-Supported Use of Amiloride in pediatric patients.
Non–Guideline-Supported Use
Condition1
- Dosing Information
- Dosage
Condition2
There is limited information regarding Off-Label Non–Guideline-Supported Use of Amiloride in pediatric patients.
Contraindications
- Condition1
Warnings
See full prescribing information for complete Boxed Warning.
* Like other potassium-conserving agents, amiloride may cause hyperkalemia (serum potassium levels greater than 5.5 mEq per liter) which, if uncorrected, is potentially fatal. Hyperkalemia occurs commonly (about 10%) when amiloride is used without a kaliuretic diuretic. This incidence is greater in patients with renal impairment, diabetes mellitus (with or without recognized renal insufficiency), and in the elderly. When amiloride is used concomitantly with a thiazide diuretic in patients without these complications, the risk of hyperkalemia is reduced to about 1-2 percent. It is thus essential to monitor serum potassium levels carefully in any patient receiving amiloride, particularly when it is first introduced, at the time of diuretic dosage adjustments, and during any illness that could affect renal function.
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Description
Adverse Reactions
Clinical Trials Experience
There is limited information regarding Clinical Trial Experience of Amiloride in the drug label.
Central Nervous System
Cardiovascular
Respiratory
Gastrointestinal
Hypersensitivity
Miscellaneous
Postmarketing Experience
There is limited information regarding Postmarketing Experience of Amiloride in the drug label.
Central Nervous System
Cardiovascular
Respiratory
Gastrointestinal
Hypersensitivity
Miscellaneous
Drug Interactions
- Drug
- Description
Use in Specific Populations
Pregnancy
Pregnancy Category (FDA):
There is no FDA guidance on usage of Amiloride in women who are pregnant.
Pregnancy Category (AUS):
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Amiloride in women who are pregnant.
Labor and Delivery
There is no FDA guidance on use of Amiloride during labor and delivery.
Nursing Mothers
There is no FDA guidance on the use of Amiloride with respect to nursing mothers.
Pediatric Use
There is no FDA guidance on the use of Amiloride with respect to pediatric patients.
Geriatic Use
There is no FDA guidance on the use of Amiloride with respect to geriatric patients.
Gender
There is no FDA guidance on the use of Amiloride with respect to specific gender populations.
Race
There is no FDA guidance on the use of Amiloride with respect to specific racial populations.
Renal Impairment
There is no FDA guidance on the use of Amiloride in patients with renal impairment.
Hepatic Impairment
There is no FDA guidance on the use of Amiloride in patients with hepatic impairment.
Females of Reproductive Potential and Males
There is no FDA guidance on the use of Amiloride in women of reproductive potentials and males.
Immunocompromised Patients
There is no FDA guidance one the use of Amiloride in patients who are immunocompromised.
Administration and Monitoring
Administration
Oral
Intravenous
Monitoring
Condition1
Description
IV Compatibility
There is limited information regarding IV Compatibility of Amiloride in the drug label.
Overdosage
Acute Overdose
Signs and Symptoms
Description
Management
Description
Chronic Overdose
There is limited information regarding Chronic Overdose of Amiloride in the drug label.
Pharmacology
There is limited information regarding Amiloride Pharmacology in the drug label.
Mechanism of Action
There is limited information regarding Amiloride Mechanism of Action in the drug label.
Structure
There is limited information regarding Structure of Amiloride in the drug label.
Pharmacodynamics
There is limited information regarding Pharmacodynamics of Amiloride in the drug label.
Pharmacokinetics
There is limited information regarding Pharmacokinetics of Amiloride in the drug label.
Nonclinical Toxicology
There is limited information regarding Nonclinical Toxicology of Amiloride in the drug label.
Clinical Studies
There is limited information regarding Clinical Studies of Amiloride in the drug label.
Condition1
Description
How Supplied
There is limited information regarding Amiloride How Supplied in the drug label.
Storage
There is limited information regarding Amiloride Storage in the drug label.
Images
Drug Images
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Package and Label Display Panel
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Patient Counseling Information
There is limited information regarding Amiloride Patient Counseling Information in the drug label.
Precautions with Alcohol
Alcohol-Amiloride interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
Brand Names
Midamor®
Look-Alike Drug Names
- aMILoride — amLODIPine[2]
Drug Shortage Status
Price
References
The contents of this FDA label are provided by the National Library of Medicine.
- ↑ Viswanathan, V.; Mohan, V.; Subramani, P.; Parthasarathy, N.; Subramaniyam, G.; Manoharan, D.; Sundaramoorthy, C.; Gnudi, L.; Karalliedde, J. (2013). "Effect of spironolactone and amiloride on thiazolidinedione-induced fluid retention in South Indian patients with type 2 diabetes". Clin J Am Soc Nephrol. 8 (2): 225–32. doi:10.2215/CJN.06330612. PMID 23184569. Unknown parameter
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