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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