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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