Drug Index

Amiloride

Mechanism :

Amiloride is a potassium-conserving drug that possesses weak natriuretic, diuretic and antihypertensive activity. Co-administration with a thiazide or loop diuretic, decreases the urinary excretion of magnesium which occurs when a thiazide or loop diuretic is used alone. Amiloride has potassium-conserving activity in patients receiving kaliuretic-diuretic agents.


Indication :

  • Hypokalemia when thiazides or other kaliuretic diuretics are used
  • Nephrogenic diabetes insipidus
  • Hypertension (off-label)

Contraindications :

Hyperkalemia

Antikaliuretic Therapy or Potassium Supplementation

Nephrogenic diabetes insipidus in infants


Dosing :

Safety and efficacy for use in pediatric patients has not yet been established.0.625 mg/kg PO given once daily; gradually dose can be increased. Maximum dosage: 20 mg/day.
Nephrogenic diabetes insipidus (along with hydrochlorothiazide):
0.3 mg/kg/day in divided doses 3 times daily.

Adverse Effect :

Hyperkalemia, nausea, anorexia, abdominal pain, flatulence, diarrhea, constipation, appetite changes, muscle cramps, dizziness, encephalopathy, cough, dyspnea.


Interaction :

Angiotensin-converting enzyme inhibitor: Risk of hyperkalemia may be increased.
Lithium: Reduce its renal clearance and add a high risk of lithium toxicity.
NSAIDS: Reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Use 50% of dose
10-20Use 50% of dose
<10Avoid

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot applicable. Avoid
HDNot applicable. Avoid
HDF/High fluxNot applicable. Avoid
CAV/VVHDUnknown dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

No dosage adjustments are recommended. Diuretics should be used with caution in patients with liver disease since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.
07/02/2024 23:22:44 Amiloride
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