Drug Notebook

FDA Alerts

  • Hyperkalemia (i.e., serum potassium concentrations >5.5 mEq/L) may occur with all potassium-sparing agents, including amiloride.
  • Hyperkalemia occurs in about 10% of patients not receiving a kaliuretic diuretic and more frequently in patients with renal impairment or diabetes (even without evidence of renal impairment) and in geriatric patients. In patients without the mentioned complications, incidence of hypercalcemia is reduced to 1–2% by concomitant use of amiloride with a thiazide diuretic.
  • Uncorrected hyperkalemia may be fatal; monitor serum potassium concentrations carefully, especially during initial therapy or dosage adjustments, and in patients with concurrent illness that may affect renal function.

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amiloride
(a MIL o ride)

Before taking this medication, tell your doctor if you are using any of the following drugs:

  • cyclosporine (Neoral, Sandimmune, Gengraf);

  • tacrolimus (Prograf);

  • lithium;

  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others; or

  • indomethacin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Motrin, Advil), diclofenac (Voltaren), naproxen (Aleve, Naprosyn), piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others.

If you are using any of these drugs, you may not be able to use amiloride, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect amiloride. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using this medication and call your doctor at once if you have any of these serious side effects:

  • numbness or tingly feeling;

  • muscle pain or weakness;

  • slow, fast, or uneven heartbeat;

  • feeling drowsy, restless, or light-headed;

  • urinating less than usual or not at all;

  • dry mouth, increased thirst, tiredness, nausea, vomiting;

  • shallow breathing;

  • tremors, confusion; or

  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Continue using amiloride and talk with your doctor if you have any of these less serious side effects:

  • headache;

  • mild nausea, loss of appetite;

  • gas, stomach pain; or

  • skin rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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