Maximum 40 mg daily. Take amiloride with food. Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of amiloride in the elderly. Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy.
Administer orally, preferably with food to decrease GI adverse effects. Patterson JH, Adams KF Jr, Applefeld MM et al. Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Pharmacotherapy. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. 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.
If hypokalemia persists after an adequate trial of 10 mg daily, may increase dosage to 15 and then 20 mg daily with careful monitoring of serum electrolytes. Do not keep outdated medicine or medicine no longer needed. For the eating disorder anorexia nervosa: 100 mg of zinc gluconate daily.
Are there any interactions with medications? Excreted in urine 50% as unchanged drug and in feces 40% possibly as unabsorbed drug. For treating the common cold: one zinc gluconate or acetate lozenge, providing 9-24 mg elemental zinc, dissolved in the mouth every two hours while awake when cold symptoms are present. 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.
Midamor is a potassium-conserving antikaliuretic drug that possesses weak compared with thiazide diuretics natriuretic, diuretic, and antihypertensive activity. These effects have been partially additive to the effects of thiazide diuretics in some clinical studies. When administered with a thiazide or loop diuretic, Midamor has been shown to decrease the enhanced urinary excretion of magnesium which occurs when a thiazide or loop diuretic is used alone. Midamor has potassium-conserving activity in patients receiving kaliuretic-diuretic agents. Antikaliuretic therapy should be instituted only with caution in severely ill patients in whom respiratory or metabolic acidosis may occur, such as patients with cardiopulmonary disease or poorly controlled diabetes. If Midamor is given to these patients, frequent monitoring of acid-base balance is necessary. Lab tests, including electrolyte levels and blood pressure monitoring, may be performed while you use Midamor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. According to some clinicians, maximum effective daily dosage may be as high as 40 mg daily. In diabetic patients, hyperkalemia has been reported with the use of all potassium-conserving diuretics, including Midamor, even in patients without evidence of diabetic nephropathy. Therefore, Midamor should be avoided, if possible, in diabetic patients and, if it is used, serum electrolytes and renal function must be monitored frequently. Metabolic: Monitor fluids and electrolytes regularly in all patients. In patients with severe heart failure, monitor potassium and creatinine one week after initiation or a dose increase, monthly for the first 3 months, then quarterly for a year, and then every 6 months. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC VI. Bethesda, MD: National Institutes of Health. NIH publication No. 98-4080. 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. National Library of Medicine and Drugs. Hyponatremia and hypochloremia may occur when Midamor is used with other diuretics and increases in BUN levels have been reported. These increases usually have accompanied vigorous fluid elimination, especially when diuretic therapy was used in seriously ill patients, such as those who had hepatic cirrhosis with ascites and metabolic alkalosis, or those with resistant edema. Therefore, when Midamor is given with other diuretics to such patients, careful monitoring of serum electrolytes and BUN levels is important. In patients with pre-existing severe liver disease, hepatic encephalopathy, manifested by tremors, confusion, and coma, and increased jaundice, have been reported in association with diuretics, including amiloride HCl. Patients with persistent hyperkalemia may require dialysis. To increase growth and weight gain in children with sickle cell disease who have not reached puberty: 10 mg elemental zinc per day. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Midamor is to be used only by the patient for whom it is prescribed. Do not share it with other people. 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.
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. 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. Major Do not take this combination. Midamor Amiloride HCl is available for oral use as tablets containing 5 mg of anhydrous amiloride HCl. Some MEDICINES MAY INTERACT with Midamor. 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. Warning signs or symptoms of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, shock, and ECG abnormalities. Monitoring of the serum potassium level is essential because mild hyperkalemia is not usually associated with an abnormal ECG. 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. National high blood pressure education program working group on hypertension control in children and adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. Monitor serum electrolyte and BUN concentrations closely in patients with hepatic cirrhosis with ascites and metabolic alkalosis receiving amiloride in combination with other diuretics. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Midamor while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking Midamor. If hypokalemia persists after an adequate trial of 10 mg daily may increase dosage to 15 and then 20 mg daily. Tablets Midamor, 5 mg, are yellow, diamond-shaped, compressed tablets, coded MSD 92 on one side and Midamor on the other. actonel
Importance of informing patients of other important precautionary information. a See Cautions. Sherman LG, Liang CS, Baumgardner S et al. Piretanide, a potent diuretic with potassium-sparing properties, for the treatment of congestive heart failure. Clin Pharmacol Ther. C; a protect from moisture, freezing, and excessive heat. 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. Midamor should be discontinued at least three days before glucose tolerance testing. Midamor should be administered with food. Midamor is contraindicated in patients who are hypersensitive to this product. Yellow 10, iron oxide, lactose, magnesium stearate and starch. Registered trademark of Paddock Laboratories, Inc. Long-term maintenance therapy for patients deemed unsuitable for surgery or those with idiopathic hyperaldosteronism. L may occur with all potassium-sparing agents, including amiloride. a b c See Boxed Warning. 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. It is not known whether the drug is dialyzable. 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. American Heart Association Task Force on practice guidelines. Circulation. osef.info disulfiram
Increased BUN concentration may occur, most frequently during forced diuresis in debilitated patients with hepatic cirrhosis with ascites and metabolic alkalosis or in those with resistant edema. a b In such patients, monitor BUN concentration carefully when amiloride is used with other diuretics. Midamor should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. Increases urinary excretion of sodium, calcium, and bicarbonate with little, if any, increase in chloride excretion. Gastrointestinal complaints of diarrhea, nausea, constipation, anorexia, and general abdominal pain occur less than 5% of patients. 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. Potassium-sparing effect of amiloride generally persists during prolonged therapy with the drug, but may diminish with time in some patients. Studies in rats have shown that amiloride is excreted in milk in concentrations higher than those found in blood, but it is not known whether Midamor is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Midamor, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Exerts potassium-sparing effect by decreasing sodium reabsorption in the distal tubule and reducing both potassium and hydrogen secretion and subsequent excretion. Battle DC, von Riotte AB, Gaviria M et al. Amelioration of polyuria by amiloride in patients receiving long-term lithium therapy. N Engl J Med. 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. The most likely signs and symptoms to be expected with overdosage are dehydration and electrolyte imbalance. These can be treated by established procedures. Therapy with Midamor should be discontinued and the patient observed closely. There is no specific antidote. Emesis should be induced or gastric lavage performed. Treatment is symptomatic and supportive. If hyperkalemia occurs, active measures should be taken to reduce the serum potassium levels. The use of potassium-conserving agents is often unnecessary in patients receiving diuretics for uncomplicated essential hypertension when such patients have a normal diet. Midamor has little additive diuretic or antihypertensive effect when added to a thiazide diuretic.
Amiloride Midamor is used as a "water pill" to help remove excess water from the body. Another effect of amiloride Midamor is that it can increase the amount of zinc in the body. Taking zinc supplements with amiloride Midamor might cause you to have too much zinc in your body. Dosing considerations for Zinc. 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. Known hypersensitivity to amiloride or any ingredient in the formulation. Does not inhibit carbonic anhydrase and has no effect on free water clearance or concentrating mechanisms. This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using amiloride. You may need to stop taking amiloride at least 3 days before having a glucose tolerance test. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Has been used in combination with hydrochlorothiazide in patients with recurrent calcium nephrolithiasis. Potassium-sparing diuretic; pyrazinecarbonyl guanidine derivative. Inc. Moduretic amiloride HCl-hydrochlorothiazide tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. Some medical conditions may interact with Midamor. Minor adverse reactions were reported relatively frequently about 20% but the relationship of many of the reports to amiloride HCl is uncertain and the overall frequency was similar in hydrochlorothiazide treated groups. online actonel rx
Monitor serum electrolyte, creatinine, and BUN periodically; some clinicians recommend weekly determinations during initiation of therapy. Patient advice: Advise patients to avoid potassium supplements and foods containing high levels of potassium, including salt substitutes. For the short test, increased serum potassium with this drug and a decrease upon discontinuation provide presumptive evidence of primary hyperaldosteronism. Tarssanen L, Huikko M, Rossi M "Amiloride-induced hyponatremia. Safety and effectiveness in pediatric patients have not been established. Maximum 20 mg once daily. For treating acne: 30-135 mg elemental zinc daily. 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. 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. Lynn KL, Bailey RR, Swainson CP, Sainsbury R, Low WI "Renal failure with potassium-sparing diuretics. 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. In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. 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. 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. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. 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. generic theophylline at walmart
Your doctor may increase your dose if needed. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Midamor may cause drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Midamor with caution. Renal side effects including renal insufficiency is unusual after amiloride the active ingredient contained in Midamor monotherapy because it is only a weak diuretic. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Inc. Midamor amiloride HCl tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. Has been used to control hypertension and correct electrolyte abnormalities associated with primary hyperaldosteronism. Ask your health care provider any questions you may have about how to use Midamor. Diarrhea; headache; loss of appetite; nausea; weakness. If you have any questions about Midamor, please talk with your doctor, pharmacist, or other health care provider. 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. Midamor should not be given to patients receiving other potassium-conserving agents, such as spironolactone or triamterene.
Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. However, some clinicians state maximum effective dosage may be as high as 40 mg daily. McNay JL, Oran E "Possible predisposition of diabetic patients to hyperkalemia following administration of potassium-retaining diuretic, amiloride MK 870. 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. Increase dosage as necessary up to a maximum of 20 mg once daily. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. 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. prescription serophene vs over the counter
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. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Also useful in patients with hypokalemia who do not respond to potassium supplements or those who cannot tolerate potassium supplements. The information contained in the Truven Health Micromedex products as delivered by Drugs. When amiloride is used in fixed combination with hydrochlorothiazide, consider the cautions, precautions, and contraindications associated with hydrochlorothiazide. BUN levels. Potassium retention associated with the use of an antikaliuretic agent is accentuated in the presence of renal impairment and may result in the rapid development of hyperkalemia. Check with your pharmacist about how to dispose of unused medicine. Anuria, acute or chronic renal insufficiency, and evidence of diabetic nephropathy are contraindications to the use of Midamor. Symptoms may include lightheadedness; nausea; vomiting; weakness. Davidson C, Burkinshaw L, Morgan DB "The effects of potassium supplements, spironolactone or amiloride on the potassium status of patients with heart failure. 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. Svendsen UG, Ibsen H, Rasmussen S, Leth A, Nielsen MD, Dige-Petersen H, Giese J "Effects of amiloride on plasma and total body potassium, blood pressure, and the renin-angiotensin-aldosterone system in thiazide-treated hypertensive patients. Safety and efficacy of amiloride alone or in fixed combination with hydrochlorothiazide not established; a b c however, some experts have suggested an amiloride dosage for hypertension based on limited clinical experience. a See Pediatric Patients under Dosage and Administration. Not metabolized in the liver. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses. The adverse reactions for Midamor listed in the following table have been arranged into two groups: 1 incidence greater than one percent; and 2 incidence one percent or less. The incidence for group 1 was determined from clinical studies conducted in the United States 837 patients treated with Midamor. The adverse effects listed in group 2 include reports from the same clinical studies and voluntary reports since marketing. The probability of a causal relationship exists between Midamor and these adverse reactions, some of which have been reported only rarely. order disulfiram safely online
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. 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. Food decreases the extent of GI absorption to about 30%, but does not affect the rate of absorption. Do not take other medicines unless they have been discussed with your doctor. 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. This may not be a complete list of all interactions that may occur. Ask your health care provider if Midamor may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Hummel SL, Konerman MC. Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt? MIDAMOR should be administered with food. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. 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. 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. Contraindicated in patients with anuria, acute renal insufficiency, or significant impairment of renal excretory function. Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Some experts state that inclusion in combination drug regimens may be considered in patients with resistant hypertension. Gupta D, Georgiopoulou VV, Kalogeropoulos AP et al. Dietary sodium intake in heart failure. Circulation.
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. American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA. Richardson A, Bayliss J, Scriven AJ et al. Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. Lancet. Wilson JR, Reichek N, Dunkman WB et al. Effect of diuresis on the performance of the failing left ventricle in man. Am J Med. 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. 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. Hypochloremia usually does not require specific treatment except in patients with severe hepatic or renal disease. 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. Effect on urinary electrolyte excretion persists for about 24 hours. While using amiloride, you will need frequent blood tests. Your heart function may need to be checked using an electrocardiograph or ECG sometimes called an EKG. Used in fixed combination with hydrochlorothiazide for treatment of hypertension in patients who require a thiazide diuretic and in whom the development of hypokalemia cannot be risked and in patients who develop hypokalemia during hydrochlorothiazide monotherapy. Initially, 5 mg daily; increase dosage as necessary to 10 mg daily. 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. Significantly elevated serum uric acid, cholesterol, and triglyceride levels have been associated with combination hydrochlorothiazide-amiloride therapy. These metabolic abnormalities may not be due to amiloride since they are reported during hydrochlorothiazide monotherapy. atarax
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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. The dose of this drug should remain unchanged if a second diuretic is added. Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective. Products meeting necessary bioequivalence requirements. Three-character codes are assigned only in situations when more than one reference listed drug of the same strength has been designated under the same heading. Two or more reference listed drugs are generally selected only when there are at least two potential reference drug products which are not bioequivalent to each other. If a study is submitted that demonstrates bioequivalence to a specific listed drug product, the generic product will be given the same three-character code as the reference listed drug it was compared against.
Use amiloride alone only when persistent hypokalemia is documented. Has been used to correct the metabolic alkalosis produced by thiazides and other kaliuretic diuretics. Unlike thiazide diuretics, does not consistently inhibit the excretion of uric acid; has variable effects on serum uric acid concentration. Hyperkalemia occurs commonly about 10% when amiloride is used without a kaliuretic diuretic. This incidence is greater in patients with renal impairment, diabetes mellitus with or without recognized renal insufficiency and in the elderly. When Midamor is used concomitantly with a thiazide diuretic in patients without these complications, the risk of hyperkalemia is reduced to about 1-2 percent. It is thus essential to monitor serum potassium levels carefully in any patient receiving amiloride, particularly when it is first introduced, at the time of diuretic dosage adjustments, and during any illness that could affect renal function.
Appropriate studies have not been performed on the relationship of age to the effects of amiloride in the pediatric population. Dosages exceeding 10 mg daily usually are not necessary, and there is little controlled clinical experience with dosages exceeding 10 mg daily. For muscle cramps in zinc deficient people with liver disease: zinc sulfate 220 mg twice daily.
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. Penicillamine is used for Wilson's disease and rheumatoid arthritis. Zinc might decrease how much penicillamine your body absorbs and decrease the effectiveness of penicillamine. Take zinc and penicillamine at least 2 hours apart.