Maximum 20 mg daily recommended by some experts. For the long test, correction of hypokalemia and hypertension provides presumptive evidence of primary hyperaldosteronism. Used concomitantly with a thiazide diuretic mainly to prevent or treat diuretic-induced hypokalemia. a b See Hypokalemia Induced by Kaliuretic Diuretics under Uses. price atorvastatin wiki atorvastatin
Has been used in combination with hydrochlorothiazide in patients with recurrent calcium nephrolithiasis. Duration of therapy: When given as the sole diuretic, continue the initial dose for at least 5 days, after which the initial dose may be adjusted to an optimal maintenance dose. Increases urinary excretion of sodium, calcium, and bicarbonate with little, if any, increase in chloride excretion.
However, some clinicians state maximum effective dosage may be as high as 40 mg daily. May be particularly useful for preventing diuretic-induced hypokalemia in patients in whom the clinical consequences of hypokalemia represent an important risk, such as patients receiving cardiac glycosides or those with cardiac arrhythmias. Increase dosage as necessary up to a maximum of 20 mg once daily. MIDAMOR should be administered with food. Exclusivity is the sole marketing rights granted by the FDA to a manufacturer upon the approval of a drug and may run simultaneously with a patent. Exclusivity periods can run from 180 days to seven years depending upon the circumstance of the exclusivity grant.
Maintenance dose: 100 to 400 mg orally per day until surgery; may be used long-term at the lowest effective dose in patients deemed unsuitable for surgery. Do not take other medicines unless they have been discussed with your doctor. Distributed into milk in animals. a b c Discontinue nursing or the drug.
Importance of informing patients of other important precautionary information. a See Cautions. Duration of therapy: Treatment should be continued for at least 2 weeks to achieve a maximum response. Subsequently, the dose may be adjusted according to patient response. Midamor exerts its potassium sparing effect through the inhibition of sodium reabsorption at the distal convoluted tubule, cortical collecting tubule and collecting duct; this decreases the net negative potential of the tubular lumen and reduces both potassium and hydrogen secretion and their subsequent excretion. This mechanism accounts in large part for the potassium sparing action of amiloride. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Distributed into milk in animals; not known whether distributed into human milk. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Drugs. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Treatment of edematous conditions in patients with nephrotic syndrome when treatment of the underlying disease, restriction of fluid and sodium intake, and the use of other diuretics do not provide an adequate response. This medicine may increase the amount of potassium in your blood. Safety and effectiveness in pediatric patients have not been established. Store at room temperature away from moisture, heat, or freezing temperatures. What happens if I miss a dose?
Lithium generally should not be given with diuretics because they reduce its renal clearance and add a high risk of lithium toxicity. Read circulars for lithium preparations before use of such concomitant therapy. All medicines may cause side effects, but many people have no, or minor, side effects. Wilson JR, Reichek N, Dunkman WB et al. Effect of diuresis on the performance of the failing left ventricle in man. Am J Med. Renal clearance may be reduced in patients with renal impairment. Does not inhibit carbonic anhydrase and has no effect on free water clearance or concentrating mechanisms. doxepin
NDC 0574-0291-01 bottles of 100. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA. Midamor should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. Monitor serum electrolyte and BUN concentrations closely in patients with hepatic cirrhosis with ascites and metabolic alkalosis receiving amiloride in combination with other diuretics. Inc. Midamor amiloride HCl tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Potassium-sparing effect of amiloride is additive with that of spironolactone. a May be effective in some patients unresponsive to spironolactone; unlike spironolactone, diuretic effect of amiloride is independent of aldosterone concentrations. Your doctor may recommend you eat certain foods or take supplements to keep your potassium from getting too low. Follow the diet and medication plan created for you by your doctor or nutrition counselor. Cardiovascular side effects are mainly limited to the increased risk of hyperkalemia-induced arrhythmias in patients at risk for arrhythmias. Angina pectoris, arrhythmias, and orthostatic hypotension are reported in less than 1% of patients. Consult WARNINGS section for additional precautions. Not metabolized in the liver. Zinc can attach to tetracyclines in the stomach. This decreases the amount of tetracyclines that can be absorbed. Taking zinc with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction, take tetracyclines 2 hours before or 4-6 hours after taking zinc supplements. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.
The risk of hyperkalemia may be increased when potassium-conserving agents, including Midamor, are administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, cyclosporine or tacrolimus. If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Richardson A, Bayliss J, Scriven AJ et al. Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. Lancet. Midamor, one 5 mg tablet daily, should be added to the usual antihypertensive or diuretic dosage of a kaliuretic diuretic. The dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets of Midamor daily usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective. When amiloride HCl is administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, cyclosporine or tacrolimus, the risk of hyperkalemia may be increased. Therefore, if concomitant use of these agents is indicated because of demonstrated hypokalemia, they should be used with caution and with frequent monitoring of serum potassium. See Specific Drugs, Foods, and Laboratory Tests under Interactions. Other adverse experiences that have been reported with amiloride are generally those known to be associated with diuresis, or with the underlying disease being treated. Anuria, acute or chronic renal insufficiency, and evidence of diabetic nephropathy are contraindications to the use of Midamor. ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension ESH and of the European Society of Cardiology ESC. J Hypertens. Administer orally with food. Used in fixed combination with hydrochlorothiazide for treatment of edema in patients who require a thiazide diuretic and in whom the development of hypokalemia cannot be risked. Davidson C, Burkinshaw L, Morgan DB "The effects of potassium supplements, spironolactone or amiloride on the potassium status of patients with heart failure. where to purchase norfloxacin pills
If hypokalemia persists after an adequate trial of 10 mg daily, may increase dosage to 15 and then 20 mg daily. Food decreases the extent of GI absorption to about 30%, but does not affect the rate of absorption. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs. Diarrhea; headache; loss of appetite; nausea; weakness. According to some clinicians, amiloride hydrochloride dosage should be reduced to the lowest effective level in any disease state, following initial diuresis with a kaliuretic diuretic. Clinical studies of Midamor did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy. Treatment or prevention of hypokalemia induced by thiazide or other kaliuretic diuretics in patients with heart failure or hypertension. Midamor usually begins to act within 2 hours after an oral dose. Its effect on electrolyte excretion reaches a peak between 6 and 10 hours and lasts about 24 hours. Peak plasma levels are obtained in 3 to 4 hours and the plasma half-life varies from 6 to 9 hours. If it is necessary to use MIDAMOR alone see the starting dosage should be one 5 mg tablet daily. This dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. Not all side effects for Midamor may be reported. You should always consult a doctor or healthcare professional for medical advice. Potassium-sparing diuretic; pyrazinecarbonyl guanidine derivative. Such measures include the intravenous administration of sodium bicarbonate solution or oral or parenteral glucose with a rapid-acting insulin preparation. If needed, a cation exchange resin such as sodium polystyrene sulfonate may be given orally or by enema. Patients with persistent hyperkalemia may require dialysis. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Use appropriate replacement therapy in those who are sodium depleted. a Use water restriction rather than replacement of sodium chloride in edematous patients with dilutional hyponatremia during hot weather, except in rare instances when hyponatremia is life-threatening. Products meeting necessary bioequivalence requirements.
Importance of avoiding ingestion of potassium supplements, salt substitutes, or excessive amounts of potassium-rich foods. Use Midamor with caution in the ELDERLY; they may be more sensitive to its effects. Has been used to correct the metabolic alkalosis produced by thiazides and other kaliuretic diuretics. If it is necessary to use Midamor alone see the starting dosage should be one 5 mg tablet daily. This dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. Appropriate studies have not been performed on the relationship of age to the effects of amiloride in the pediatric population. Zinc might decrease blood sugar in people with type 2 diabetes. Diabetes medications are also used to lower blood sugar. Taking zinc along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed. lamictal cost at rite aid
Adjust dosage by administering each drug separately. a If the optimum maintenance dosage corresponds to the ratio in the commercial combination preparation, the fixed combination may be used. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Dosages exceeding 10 mg daily usually are not necessary, and there is little controlled clinical experience with dosages exceeding 10 mg daily. In treating patients with congestive heart failure after an initial diuresis has been achieved, potassium loss may also decrease and the need for Midamor should be re-evaluated. Dosage adjustment may be necessary. Maintenance therapy may be on an intermittent basis. About 50% of an oral dose is absorbed. If you have any questions about Midamor, please talk with your doctor, pharmacist, or other health care provider. For the eating disorder anorexia nervosa: 100 mg of zinc gluconate daily. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. Ask your health care provider any questions you may have about how to use Midamor. Monitor serum potassium and other electrolyte concentrations following changes in dosage or with concurrent illness or drug therapy. a b See Hyperkalemia under Cautions and also see Interactions.
If hyperkalemia occurs in patients taking Midamor, the drug should be discontinued immediately. Amiloride should rarely be used alone, because such use may result in increased risk of hyperkalemia. a b Use alone only when persistent hypokalemia has been documented. To increase growth and weight gain in children with sickle cell disease who have not reached puberty: 10 mg elemental zinc per day. The presence of other medical problems may affect the use of this medicine. When abnormal, the ECG in hyperkalemia is characterized primarily by tall, peaked T waves or elevations from previous tracings. There may also be lowering of the R wave and increased depth of the S wave, widening and even disappearance of the P wave, progressive widening of the QRS complex, prolongation of the PR interval, and ST depression. Warning signs of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, and shock. Has been used for the management of lithium-induced polyuria secondary to lithium-induced nephrogenic diabetes insipidus. 100 a See Specific Drugs, Foods, and Laboratory Tests under Interactions. Crosses the placenta in animals; not known whether crosses placenta in humans. Also useful in patients with hypokalemia who do not respond to potassium supplements or those who cannot tolerate potassium supplements. Although amiloride usually prevents hypokalemia associated with thiazide diuretics, some clinicians using the fixed-dose combination of amiloride and hydrochlorothiazide have questioned whether 5 mg of amiloride hydrochloride is sufficient to counteract the potassium loss produced by 50 mg of hydrochlorothiazide. Renal side effects including renal insufficiency is unusual after amiloride the active ingredient contained in Midamor monotherapy because it is only a weak diuretic. Midamor should rarely be used alone. It has weak compared with thiazides diuretic and antihypertensive effects. Used as single agents, potassium sparing diuretics, including Midamor, result in an increased risk of hyperkalemia approximately 10% with amiloride. Midamor should be used alone only when persistent hypokalemia has been documented and only with careful titration of the dose and close monitoring of serum electrolytes. Evaluate BUN and serum potassium and creatinine concentrations regularly, especially in patients with suspected or confirmed renal insufficiency. a b Monitor serum potassium concentrations closely in geriatric and diabetic patients. a b Avoid use in diabetic patients, if possible, because of the risk of hyperkalemia. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs including any herbal medicines or supplements or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. For treating age-related macular degeneration AMD: elemental zinc 80 mg plus vitamin C 500 mg, vitamin E 400 IU, and beta-carotene 15 mg daily. furadantin
Vidt DG "Mechanism of action, pharmacokinetics, adverse effects, and therapeutic uses of amiloride hydrochloride, a new potassium-sparing diuretic. Keep out of the reach of children. Drinking alcohol with this medicine can cause side effects. Teratogenicity studies with amiloride HCl in rabbits and mice given 20 and 25 times the maximum human dose, respectively, revealed no evidence of harm to the fetus, although studies showed that the drug crossed the placenta in modest amounts. Reproduction studies in rats at 20 times the expected maximum daily dose for humans showed no evidence of impaired fertility. At approximately 5 or more times the expected maximum daily dose for humans, some toxicity was seen in adult rats and rabbits and a decrease in rat pup growth and survival occurred. Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
Concomitant administration with a more potent natriuretic diuretic results in approximately additive effects of the drugs on urinary sodium excretion and an antagonistic effect on potassium excretion. Safety and efficacy have not been established in patients younger than 18 years. Lynn KL, Bailey RR, Swainson CP, Sainsbury R, Low WI "Renal failure with potassium-sparing diuretics. Initially, 5 mg daily; a b 524 increase dosage as necessary to 10 mg daily. Patient advice: Advise patients to avoid potassium supplements and foods containing high levels of potassium, including salt substitutes. L may occur with all potassium-sparing agents, including amiloride. a b c See Boxed Warning. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Reevaluate need for amiloride therapy following initial diuresis with a kaliuretic diuretic, since potassium loss may decrease. a Subsequent dosage adjustment may be necessary, or amiloride may be used intermittently. Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking amiloride. fluoxetine shop preisvergleich
James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee JNC 8. JAMA. Initial diagnostic measure to provide presumptive evidence of primary hyperaldosteronism while patients are on normal diets. Gastrointestinal complaints of diarrhea, nausea, constipation, anorexia, and general abdominal pain occur less than 5% of patients. The fixed-combination preparation with hydrochlorothiazide should be used for initial antihypertensive therapy only in selected patients in whom the potential development of thiazide-induced hypokalemia cannot be risked. a c See General under Dosage and Administration. MIDAMOR, one 5 mg tablet daily, should be added to the usual antihypertensive or diuretic dosage of a kaliuretic diuretic. The dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets of MIDAMOR daily usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. If you miss a dose of Midamor, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. Millar JA, Fraser R, Mason P, Leckie B, Cumming AM, Robertson JI "Metabolic effects of high dose amiloride and spironolactone: a comparative study in normal subjects. For treating acne: 30-135 mg elemental zinc daily. Amiloride is a type of diuretic water pill that helps prevent your body from losing too much potassium. Known hypersensitivity to amiloride or any ingredient in the formulation. The information contained in the Truven Health Micromedex products as delivered by Drugs. Take Midamor by mouth with food. Titrate dosage carefully and monitor serum electrolytes closely because of increased risk of hyperkalemia with monotherapy. Hyperkalemia has been associated with cardiac irregularities. a b ECG changes associated with hyperkalemia are mainly characterized by tall, peaked T waves or elevations since previous tracings. No data are available in regard to overdosage in humans. Protect from moisture, freezing and excessive heat. Amiloride HCl was devoid of mutagenic activity in various strains of Salmonella typhimurium with or without a mammalian liver microsomal activation system Ames test. TUMORIGENICITY: This drug has been shown to be a tumorigen in chronic toxicity studies of rats. This drug should be used only for its indicated conditions and unnecessary use should be avoided. how omeprazole from canada
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Inc. Moduretic amiloride HCl-hydrochlorothiazide tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. According to some clinicians, maximum effective daily dosage may be as high as 40 mg daily. Does not appear to be diabetogenic or to alter carbohydrate metabolism in humans. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens Greenwich. neho.info bicalutamide
Midamor Amiloride HCl is available for oral use as tablets containing 5 mg of anhydrous amiloride HCl. Use with caution in patients with cardiopulmonary disease or uncontrolled diabetes mellitus because of risk of developing metabolic or respiratory acidosis, which may result in rapid increases in serum potassium concentration. a b Monitor acid-base balance frequently in such patients. Cisplatin -AQ is used to treat cancer. Taking zinc along with EDTA and cisplatin Platinol-AQ might inactivate cisplatin Platinol-AQ therapy. It is not known for sure, though, if the amount of interference caused by zinc is significant.
Midamor is not an aldosterone antagonist and its effects are seen even in the absence of aldosterone. Metabolic side effects are the most common. Amiloride may cause hyperkalemia in up to 10% of patients, although the risk is decreased to about 1% to 2% when thiazide or loop diuretics are coadministered. Patients with diabetes or who are on other potassium-sparing therapy, ACE inhibitors, or potassium supplementation are predisposed to amiloride-induced hyperkalemia. Importance of taking drug with food to help avoid stomach upset. glucophage
May increase urinary aldosterone and plasma renin concentrations, probably as a compensatory feedback mechanism caused by potassium retention and natriuresis. Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake. Co. Midamor amiloride hydrochloride tablets prescribing information. West Point, PA; 1992 Apr.