Trade Names:Moduretic- Tablets 5 mg amiloride/50 mg hydrochlorothiazideApo-Amilzide (Canada)Gen-Amilazide (Canada)Moduret (Canada)Nu-Amilzide (Canada)
Interferes with sodium reabsorption at distal tubule, resulting in increased water and sodium excretion and decreased potassium excretion.Hydrochlorothiazide
Increases chloride, sodium, and water excretion by interfering with transport of sodium ions across renal tubular epithelium.
Treatment of hypertension or congestive heart failure in patients who develop hypokalemia when thiazide or other kaliuretic diuretics are used alone, or in patients in whom maintenance of normal serum potassium levels is clinically important (eg, digitalized patients); alone or as adjunctive treatment with other antihypertensive agents.
Hyperkalemia (serum potassium levels greater than 5.5 mEq/L); concurrently with other potassium-sparing diuretics (eg, spironolactone), potassium supplements (including potassium-rich diet) except in severe or refractory cases of hypokalemia; impaired renal function; sensitivity to any components of product.
PO 1 to 2 tablets (5 mg amiloride/50 mg hydrochlorothiazide) daily with meals.
Store tablets at controlled room temperature (59° to 86°F). Protect from moisture, freezing, and excessive heat.
May result in severely elevated potassium levels.Potassium preparations
May severely increase serum potassium levels, possibly resulting in cardiac arrhythmias or cardiac arrest. Do not coadminister.Hydrochlorothiazide Bile acid sequestrants
May reduce thiazide absorption; give thiazide at least 2 h before sequestrant.Diazoxide
May cause hyperglycemia.Digitalis glycosides
Diuretic-induced hypokalemia and hypomagnesemia may lead to digitalis-induced arrhythmias.Lithium
Renal excretion of lithium may be reduced.Loop diuretics (eg, furosemide)
Synergistic effects may occur, resulting in profound diuresis and serious electrolyte abnormalities.Sulfonylureas (eg, chlorpropamide)
Hypoglycemic effect of sulfonylurea may be decreased, necessitating an increase in sulfonylurea dosage.
Hydrochlorothiazide may decrease serum protein-bound iodine levels without signs of thyroid disturbances. May cause diagnostic interference of serum electrolyte levels, blood and urine glucose levels, serum bilirubin levels, and serum uric acid levels.
Arrhythmia, tachycardia, palpitations (amiloride).
Headache, fatigue, tiredness, weakness, dizziness, encephalopathy, tremors, decreased libido (amiloride); restlessness (hydrochlorothiazide).
Mild skin rash, pruritus, alopecia (amiloride); urticaria, purpura (hydrochlorothiazide).
Increased ocular pressure, tinnitus (amiloride); transient blurred vision, xanthopsia (hydrochlorothiazide).
Nausea, anorexia, GI and abdominal pain, flatulence, activation of peptic ulcer, dyspepsia, heartburn, dry mouth (amiloride); pancreatitis, cramping, GI irritation, sialadenitis (hydrochlorothiazide).
Bladder spasm, polyuria, urinary frequency (amiloride); interstitial nephritis (hydrochlorothiazide).
Aplastic anemia, neutropenia (amiloride); agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia (hydrochlorothiazide).
Hyperkalemia, hyperglycemia, glucosuria, hyperuricemia (hydrochlorothiazide).
Shortness of breath, cough (amiloride); respiratory distress, including pneumonitis and pulmonary edema (hydrochlorothiazide).
Leg pain, painful extremities, neck/shoulder ache, fatigue, itching (amiloride); anaphylactic reactions, necrotizing angiitis, photosensitivity, fever (hydrochlorothiazide).
Ensure that serum electrolytes, BUN, and creatinine are monitored periodically.
Category B .
Amiloride: undetermined; hydrochlorothiazide: excreted in breast milk.
Safety and efficacy not established.
Hyperkalemia may occur. The risk of hyperkalemia may be increased in patients with renal impairment or diabetes mellitus. If possible, avoid use in patients with renal impairment or diabetes mellitus.
Dehydration, electrolyte imbalance (eg, hyperkalemia), electrolyte depletion (hypokalemia, hypochloremia, hyponatremia).
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