Amiloride and Hydrochlorothiazide

Amiloride and Hydrochlorothiazide Brand Name– Moduretic

What is Amiloride and Hydrochlorothiazide

Amiloride and hydrochlorothiazide are diuretics used together to treat hypertension and edema.

Amiloride is a potassium-sparing diuretic, and hydrochlorothiazide (HCTZ) is a thiazide diuretic.

Although amiloride has little antihypertensive or diuretic activity compared with other diuretics, some additive effects have been noted when it is used concurrently with hydrochlorothiazide.

Amiloride is added to counteract the potassium loss caused by hydrochlorothiazide.

The combination may be helpful in patients requiring thiazide diuretics with hypokalemia who cannot tolerate or have been unresponsive to potassium supplements.

Amiloride and hydrochlorothiazide (Moduretic) was approved by the FDA in 1981.

Indications

1. edema
2. heart failure
3. hypertension

For the treatment of hypertension, peripheral edema, or edema associated with heart failure in patients who develop hypokalemia when thiazides (or other kaliuretic diuretics) are used alone, or in patients with significant risks for hypokalemia (e.g., digitalized, cardiac arrhythmias)

Side Effects

1. abdominal pain
2. agranulocytosis
3. alopecia
4. anaphylactoid reactions
5. angina
6. anorexia
7. aplastic anemia
8. azotemia
9. back pain
10. bladder spasm
11. blurred vision
12. bradycardia
13. chest pain (unspecified)
14. confusion
15. constipation
16. depression
17. diaphoresis
18. diarrhea
19. dizziness
20. drowsiness
21. dyspepsia
22. dyspnea
23. dysuria
24. encephalopathy
25. erythema multiforme
26. exfoliative dermatitis
27. fatigue
28. fever
29. flatulence
30. flushing
31. GI bleeding
32. glycosuria
33. gout
34. headache
35. hemolytic anemia
36. hiccups
37. hyperbilirubinemia
38. hypercalcemia
39. hypercholesterolemia
40. hyperglycemia
41. hyperkalemia
42. hypertriglyceridemia
43. hyperuricemia
44. hypochloremia
45. hypokalemia
46. hypomagnesemia
47. hyponatremia
48. hypovolemia
49. impotence (erectile dysfunction)
50. increased urinary frequency
51. insomnia
52. interstitial nephritis
53. jaundice
54. leukopenia
55. libido decrease
56. malaise
57. metabolic acidosis
58. muscle cramps
59. myopia
60. nausea
61. neutropenia
62. nocturia
63. ocular hypertension
64. orthostatic hypotension
65. palpitations
66. pancreatitis
67. pancytopenia
68. paresthesias
69. peptic ulcer
70. photosensitivity
71. pneumonitis
72. polyuria
73. pruritus
74. pulmonary edema
75. purpura
76. pyrosis (heartburn)
77. rash
78. renal failure (unspecified)
79. restlessness
80. sialadenitis
81. sinus tachycardia
82. Stevens-Johnson syndrome
83. syncope
84. thrombocytopenia
85. tinnitus
86. toxic epidermal necrolysis
87. tremor
88. urinary incontinence
89. urticaria
90. vasculitis
91. vertigo
92. visual impairment
93. vomiting
94. weakness
95. xanthopsia
96. xerostomia

Monitoring Parameters

• blood glucose
• ECG
• serum calcium
• serum creatinine/BUN
• serum electrolytes
• serum magnesium
• serum uric acid

Contraindications

• acid/base imbalance
• anuria
• asthma
• breast-feeding
• children
• diabetes mellitus
• diabetic nephropathy
• electrolyte imbalance
• geriatric
• gout
• hepatic disease
• hepatic encephalopathy
• hypercalcemia
• hyperkalemia
• hyperuricemia
• hyponatremia
• hypotension
• hypovolemia
• jaundice
• metabolic acidosis
• neonates
• orthostatic hypotension
• pancreatitis
• penicillin hypersensitivity
• preeclampsia
• pregnancy
• renal disease
• renal failure
• renal impairment
• respiratory acidosis
• sulfonamide hypersensitivity
• sunlight (UV) exposure
• sympathectomy
• syncope
• systemic lupus erythematosus (SLE)
• thiazide diuretic hypersensitivity

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