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Amiloride: Pediatric drug information

Amiloride: Pediatric drug information
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For additional information see "Amiloride: Drug information" and "Amiloride: Patient drug information"

For abbreviations, symbols, and age group definitions show table
ALERT: US Boxed Warning
Hyperkalemia:

Like other potassium-conserving agents, amiloride may cause hyperkalemia (serum potassium levels greater than 5.5 mEq per liter) which, if uncorrected, is potentially fatal. 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 amiloride is used concomitantly with a thiazide diuretic in patients without these complications, the risk of hyperkalemia is reduced to about 1% to 2%. 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.

Brand Names: Canada
  • Midamor
Therapeutic Category
  • Antihypertensive Agent;
  • Diuretic, Potassium Sparing
Dosing: Pediatric
Edema

Edema: Limited data available: Children and Adolescents: Oral: 0.625 mg/kg/day divided every 12 to 24 hours; maximum daily dose: 20 mg/day (Ref).

Hypertension

Hypertension: Limited data available: Children and Adolescents: Oral: Initial: 0.4 to 0.625 mg/kg/dose once daily; maximum daily dose: 20 mg/day (Ref).

Nephrogenic diabetes insipidus, congenital

Nephrogenic diabetes insipidus, congenital: Limited data available: Infants, Children, and Adolescents: Oral: 0.3 mg/kg/day in divided doses 1 to 3 times daily or 20 mg/1.73 m2/day in combination with hydrochlorothiazide (Ref). Doses as high as 0.6 mg/kg/day have also been reported (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no pediatric specific dosage adjustments provided in the manufacturer's labeling; in adults, use is contraindicated in patients with anuria or acute or chronic kidney insufficiency.

Dosing: Liver Impairment: Pediatric

There are no dosage adjustments in the manufacturer's labeling.

Dosing: Adult

(For additional information see "Amiloride: Drug information")

Ascites

Ascites (off-label use): Initial: 10 mg twice daily. If no response, increase every 4 days in increments of 10 mg twice daily to a maximum dosage of 30 mg twice daily (Ref). American Association for the Study of Liver Diseases (AASLD) guidelines recommend a dosage range of 10 to 40 mg daily (Ref).

Hypertension, chronic

Hypertension, chronic (alternative agent):

Note: Not recommended for initial management but may be considered as additional therapy in patients with resistant hypertension who do not respond adequately to optimal combination therapy with preferred agents. An aldosterone receptor antagonist (eg, spironolactone) is typically preferred for resistant hypertension that does not respond to preferred agents; amiloride is an alternative. May be used in patients who develop hypokalemia due to other diuretics (Ref).

Oral: Initial: 5 mg once daily; evaluate response after ~2 to 4 weeks and increase dose as needed to 10 mg daily in 1 or 2 divided doses (Ref).

Hypokalemia due to chronic stable renal potassium wasting, treatment

Hypokalemia due to chronic stable renal potassium wasting (eg, certain tubulopathies, chronic kaliuretic diuretic use), treatment (off-label use):

Note: In patients with renal potassium wasting, amiloride may be more effective and better tolerated than oral potassium supplementation (Ref).

Oral: Initial: 5 to 10 mg once daily; if needed, may gradually increase dose (eg, every 1 to 2 weeks based on serum potassium monitoring) in 5 mg/day increments based on response and tolerability up to 40 mg/day (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

Manufacturer's labeling: Use of amiloride in patients with diabetes mellitus, SCr >1.5 mg/dL, or BUN >30 mg/dL should be done with caution and careful monitoring; use is contraindicated in patients with anuria, acute or chronic renal insufficiency, or evidence of diabetic nephropathy.

Alternate recommendations:

CrCl 10 to 50 mL/minute: Administer at 50% of normal dose (Ref). The Beers Criteria recommends avoiding use in older adults ≥65 years of age with a CrCl <30 mL/minute due to the risk of hyperkalemia and hyponatremia (Ref). The 2017 guideline for the prevention, detection, evaluation, and management of high blood pressure in adults recommends avoiding use in patients with significant chronic kidney disease (eg, GFR <45 mL/minute) (Ref).

CrCl <10 mL/minute: Avoid use (Ref).

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling; use with caution.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Cardiovascular: Angina pectoris (≤1%), cardiac arrhythmia (≤1%), chest pain (≤1%), orthostatic hypotension (≤1%), palpitations (≤1%)

Dermatologic: Alopecia (≤1%), pruritus (≤1%), skin rash (≤1%)

Endocrine & metabolic: Decreased libido (≤1%), gynecomastia (≤1%), hyperkalemia (~10%), increased thirst (≤1%)

Gastrointestinal: Abdominal pain (<3%), anorexia (≤8%), change in appetite (<3%), constipation (<3%), diarrhea (3% to 8%), dyspepsia (≤1%), flatulence (≤1%), gas pain (<3%), gastrointestinal distress (≤1%), gastrointestinal fullness (≤1%), gastrointestinal hemorrhage (≤1%), heartburn (≤1%), nausea (≤8%), vomiting (3% to 8%), xerostomia (≤1%)

Genitourinary: Bladder spasm (≤1%), dysuria (≤1%), erectile dysfunction (<3%), polyuria (≤1%), urinary frequency (≤1%)

Hepatic: Jaundice (≤1%)

Nervous system: Asthenia (<3%), confusion (≤1%), depression (≤1%), dizziness (<3%), drowsiness (≤1%), encephalopathy (<3%), fatigue (<3%), headache (3% to 8%), insomnia (≤1%), nervousness (≤1%), paresthesia (≤1%), tremor (≤1%), vertigo (≤1%)

Neuromuscular & skeletal: Arthralgia (≤1%), back pain (≤1%), limb pain (≤1%), lower extremity pain (≤1%), muscle cramps (<3%), neck and shoulder pain (≤1%)

Ophthalmic: Increased intraocular pressure (≤1%), visual disturbance (≤1%)

Otic: Tinnitus (≤1%)

Respiratory: Cough (<3%), dyspnea (≤3%), nasal congestion (≤1%)

Postmarketing:

Gastrointestinal: Peptic ulcer (exacerbation)

Hematologic & oncologic: Aplastic anemia, neutropenia

Hepatic: Abnormal liver function

Contraindications

Hypersensitivity to amiloride or any component of the formulation; presence of elevated serum potassium levels (>5.5 mEq/L); if patient is receiving other potassium-conserving agents (eg, spironolactone, triamterene) or potassium supplementation (medicine, potassium-containing salt substitutes, potassium-rich diet) except in severe and/or refractory cases of hypokalemia; anuria; acute or chronic renal insufficiency; evidence of diabetic nephropathy. Patients with evidence of renal impairment (blood urea nitrogen [BUN] >30 mg/dL or serum creatinine >1.5 mg/dL) or diabetes mellitus should not receive amiloride without close, frequent monitoring of serum electrolytes and renal function.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Warnings/Precautions

Concerns related to adverse effects:

• Fluid/electrolyte changes: May decrease sodium and chloride and increase BUN, especially with concomitant diuretic therapy; close medical supervision and dose evaluation are required. Watch for and correct electrolyte disturbances; adjust dose to avoid dehydration.

• Hyperkalemia: [US Boxed Warning]: Hyperkalemia (serum potassium levels >5.5 mEq/L) may occur, which can be fatal if not corrected; patients at higher risk include those with renal impairment, diabetes, and the elderly. Serum potassium levels must be monitored at frequent intervals especially when therapy is initiated, when dosages are changed or with any illness that may cause renal dysfunction. Risk of hyperkalemia may be increased when used concomitantly with other medications that may increase potassium (eg, angiotensin agents). Signs/symptoms of hyperkalemia include paresthesias, muscle weakness, fatigue, flaccid paralysis of limbs, bradycardia, shock, and ECG abnormalities. If hyperkalemia occurs, discontinue amiloride immediately and manage hyperkalemia as clinically appropriate.

Disease-related concerns:

• Adrenal insufficiency: Avoid use of diuretics for treatment of elevated blood pressure in patients with primary adrenal insufficiency (Addison disease). Adjustment of glucocorticoid/mineralocorticoid therapy and/or use of other antihypertensive agents is preferred to treat hypertension (Bornstein 2016; Inder 2015).

• Cirrhosis: In cirrhosis, avoid electrolyte and acid/base imbalances that might lead to hepatic encephalopathy.

• Diabetes: If possible, avoid use in patients with diabetes mellitus; if cannot be avoided, use with extreme caution and monitor electrolytes and renal function closely. Discontinue amiloride at least 3 days prior to glucose tolerance testing.

• Metabolic/respiratory acidosis: Use with caution in patients who are at risk for metabolic or respiratory acidosis (eg, cardiopulmonary disease, poorly controlled diabetes); monitor acid base balance frequently.

• Renal impairment: Amiloride is primarily eliminated renally; patients with renal impairment are at greater risk for toxicities.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as hydrochloride:

Generic: 5 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (aMILoride HCl Oral)

5 mg (per each): $0.23 - $1.29

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as hydrochloride:

Midamor: 5 mg

Extemporaneous Preparations

1 mg/mL Oral Suspension

A 1 mg/mL oral suspension may be made with tablets. Crush ten 5 mg tablets in a mortar and reduce to a fine powder. Add small proportions up to 20 mL of Glycerin BP or Glycerin, USP and mix to uniform paste; mix while adding sterile water in incremental proportions to almost 50 mL; transfer to a calibrated bottle, rinse mortar with sterile water, and add quantity of sterile water sufficient to make 50 mL. Label "shake well" and "refrigerate." Stable for 21 days.

Nahata MC, Pai VB, Hipple TF. Pediatric Drug Formulations. 5th ed. Harvey Whitney Books Co; 2004.
Administration: Pediatric

Oral: Administer with food.

Administration: Adult

Oral: Administer with food or meals to avoid GI upset.

Storage/Stability

Store at 20°C to 25°C (68°F to 77°F). Avoid freezing or excessive heat. Protect from moisture.

Use

Counteracts potassium loss induced by other diuretics in the treatment of hypertension or heart failure; usually used in conjunction with more potent diuretics, such as thiazides or loop diuretics (FDA approved in adults); has also been used for management of edema and congenital nephrogenic diabetes insipidus

Medication Safety Issues
Sound-alike/look-alike issues:

AMILoride may be confused with amiodarone, amLODIPine, inamrinone

Older Adult: High-Risk Medication:

Beers Criteria: Diuretics are identified in the Beers Criteria as potentially inappropriate medications to be used with caution in patients 65 years and older due to the potential to cause or exacerbate syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatremia; monitor sodium concentration closely when initiating or adjusting the dose in older adults (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Substrate of MATE1/2-K, OCT2;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program

Alfuzosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Aliskiren: Potassium-Sparing Diuretics may increase hyperkalemic effects of Aliskiren. Risk C: Monitor

Amifostine: Blood Pressure Lowering Agents may increase hypotensive effects of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider Therapy Modification

Ammonium Chloride: Potassium-Sparing Diuretics may increase adverse/toxic effects of Ammonium Chloride. Specifically the risk of systemic acidosis. Risk C: Monitor

Amphetamines: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Angiotensin II Receptor Blockers: Potassium-Sparing Diuretics may increase hyperkalemic effects of Angiotensin II Receptor Blockers. Risk C: Monitor

Angiotensin-Converting Enzyme Inhibitors: Potassium-Sparing Diuretics may increase hyperkalemic effects of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may increase hypotensive effects of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor

Arginine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Barbiturates: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Benperidol: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Brigatinib: May decrease antihypertensive effects of Antihypertensive Agents. Brigatinib may increase bradycardic effects of Antihypertensive Agents. Risk C: Monitor

Brimonidine (Topical): May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Bromperidol: May decrease hypotensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase hypotensive effects of Bromperidol. Risk X: Avoid

CycloSPORINE (Systemic): Potassium-Sparing Diuretics may increase hyperkalemic effects of CycloSPORINE (Systemic). Risk X: Avoid

Desmopressin: Hyponatremia-Associated Agents may increase hyponatremic effects of Desmopressin. Risk C: Monitor

Dexmethylphenidate: May decrease therapeutic effects of Antihypertensive Agents. Risk C: Monitor

Diacerein: May increase therapeutic effects of Diuretics. Specifically, the risk for dehydration or hypokalemia may be increased. Risk C: Monitor

Diazoxide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Digitoxin: Potassium-Sparing Diuretics may increase adverse/toxic effects of Digitoxin. Potassium-Sparing Diuretics may decrease therapeutic effects of Digitoxin. Risk C: Monitor

Dofetilide: AMILoride may increase serum concentration of Dofetilide. Risk C: Monitor

Drospirenone-Containing Products: May increase hyperkalemic effects of Potassium-Sparing Diuretics. Risk C: Monitor

DULoxetine: Blood Pressure Lowering Agents may increase hypotensive effects of DULoxetine. Risk C: Monitor

Finerenone: Potassium-Sparing Diuretics may increase hyperkalemic effects of Finerenone. Risk C: Monitor

Flunarizine: May increase therapeutic effects of Antihypertensive Agents. Risk C: Monitor

Heparin: May increase hyperkalemic effects of Potassium-Sparing Diuretics. Risk C: Monitor

Heparins (Low Molecular Weight): May increase hyperkalemic effects of Potassium-Sparing Diuretics. Risk C: Monitor

Herbal Products with Blood Pressure Increasing Effects: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Herbal Products with Blood Pressure Lowering Effects: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Hypotension-Associated Agents: Blood Pressure Lowering Agents may increase hypotensive effects of Hypotension-Associated Agents. Risk C: Monitor

Iloperidone: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Indoramin: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Isocarboxazid: May increase hypotensive effects of Diuretics. Risk X: Avoid

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may increase hypotensive effects of Levodopa-Foslevodopa. Risk C: Monitor

Lithium: Potassium-Sparing Diuretics may decrease serum concentration of Lithium. Potassium-Sparing Diuretics may increase serum concentration of Lithium. Risk C: Monitor

Loop Diuretics: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Lormetazepam: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Metergoline: May decrease antihypertensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase orthostatic hypotensive effects of Metergoline. Risk C: Monitor

Methylphenidate: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Molsidomine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Naftopidil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicergoline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicorandil: May increase hyperkalemic effects of Potassium-Sparing Diuretics. Risk C: Monitor

Nicorandil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nitroprusside: Blood Pressure Lowering Agents may increase hypotensive effects of Nitroprusside. Risk C: Monitor

Nonsteroidal Anti-Inflammatory Agents: May increase hyperkalemic effects of Potassium-Sparing Diuretics. Nonsteroidal Anti-Inflammatory Agents may decrease antihypertensive effects of Potassium-Sparing Diuretics. Risk C: Monitor

Obinutuzumab: May increase hypotensive effects of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider Therapy Modification

Opioid Agonists: May increase adverse/toxic effects of Diuretics. Opioid Agonists may decrease therapeutic effects of Diuretics. Risk C: Monitor

Pentoxifylline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Perazine: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Pholcodine: Blood Pressure Lowering Agents may increase hypotensive effects of Pholcodine. Risk C: Monitor

Phosphodiesterase 5 Inhibitors: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Piperacillin: May increase hypokalemic effects of Diuretics. Risk C: Monitor

Polyethylene Glycol-Electrolyte Solution: Diuretics may increase nephrotoxic effects of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor

Potassium Salts: May increase hyperkalemic effects of AMILoride. Management: Amiloride and potassium supplements should not be used except in severe or refractory cases of hypokalemia. If coadministered, monitor serum potassium closely as rapid increases in potassium are possible. Risk D: Consider Therapy Modification

Potassium-Sparing Diuretics: May increase hyperkalemic effects of Potassium-Sparing Diuretics. Risk X: Avoid

Prazosin: Antihypertensive Agents may increase hypotensive effects of Prazosin. Risk C: Monitor

Prostacyclin Analogues: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Quinagolide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

QuiNIDine: AMILoride may increase adverse/toxic effects of QuiNIDine. AMILoride may decrease therapeutic effects of QuiNIDine. Risk C: Monitor

Silodosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Sodium Phosphates: Diuretics may increase nephrotoxic effects of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor

Tacrolimus (Systemic): Potassium-Sparing Diuretics may increase hyperkalemic effects of Tacrolimus (Systemic). Risk C: Monitor

Terazosin: Antihypertensive Agents may increase hypotensive effects of Terazosin. Risk C: Monitor

Tolvaptan: May increase hyperkalemic effects of Potassium-Sparing Diuretics. Risk C: Monitor

Trimethoprim: May increase hyperkalemic effects of Potassium-Sparing Diuretics. Risk C: Monitor

Urapidil: Antihypertensive Agents may increase hypotensive effects of Urapidil. Risk C: Monitor

Dietary Considerations

Do not use potassium-containing salt substitutes.

Reproductive Considerations

Medications considered acceptable for the treatment of chronic hypertension during pregnancy may generally be continued in patients trying to conceive. Diuretics are second-line agents for the treatment of hypertension in pregnant patients (ACC/AHA [Whelton 2018]; ACOG 2019; NICE 2019; SOGC [Magee 2022]).

Pregnancy Considerations

Chronic maternal hypertension is associated with adverse events in the fetus/infant. Chronic maternal hypertension may increase the risk of birth defects, low birth weight, premature delivery, stillbirth, and neonatal death. Actual fetal/neonatal risks may be related to the duration and severity of maternal hypertension. Untreated chronic hypertension may also increase the risks of adverse maternal outcomes, including gestational diabetes, preeclampsia, delivery complications, stroke, and myocardial infarction (ACOG 2019; SOGC [Magee 2022]); however, data related to the use of amiloride during pregnancy are insufficient and other agents may be preferred (ESC [Regitz-Zagrosek 2018]).

Case reports describe the use of potassium-sparing diuretics such as amiloride for the adjunctive treatment of Gitleman syndrome during pregnancy (Calò 2012; Moustakakis 2012; Shahzad 2019). Use of amiloride may be considered in some pregnant patients for the treatment of primary aldosteronism (PA). Although data specific to the treatment of PA in pregnancy are limited, adjunctive therapy with amiloride may be initiated in the second or third trimester (ES [Funder 2016]; Forestiero 2022; Sanga 2022).

Monitoring Parameters

Serum potassium, sodium, creatinine, BUN, blood pressure, fluid balance

Mechanism of Action

Blocks epithelial sodium channels in the late distal convoluted tubule (DCT), and collecting duct which inhibits sodium reabsorption from the lumen. This effectively reduces intracellular sodium, decreasing the function of Na+/K+ATPase, leading to potassium retention and decreased calcium, magnesium, and hydrogen excretion. As sodium uptake capacity in the DCT/collecting duct is limited, the natriuretic, diuretic, and antihypertensive effects are generally considered weak.

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Within 2 hours; Peak effect: 6 to 10 hours

Duration: ~24 hours

Absorption: 30% to 90% (Macfie 1981)

Distribution: Vd: 350 to 380 L (Macfie 1981)

Protein binding: Minimal (Macfie 1981)

Metabolism: Does not undergo hepatic metabolism

Half-life elimination: Normal renal function: 6 to 9 hours; Renal impairment (CrCl <50 mL/minute): 21 to 144 hours (George 1980)

Time to peak, serum: 3 to 4 hours

Excretion: Urine (~50%; as unchanged drug); feces (~40%)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AR) Argentina: Bisdiur;
  • (AT) Austria: Midamor;
  • (AU) Australia: Kaluril | Midamor | Midoride;
  • (CH) Switzerland: Midamor;
  • (CN) China: Amiloride | Bi da shu | Wu dou li;
  • (CZ) Czech Republic: Amiclaran;
  • (EE) Estonia: Amiloride | Modamide;
  • (FI) Finland: Medamor | Puritrid;
  • (FR) France: Modamide;
  • (GB) United Kingdom: Amiloride | Amiloride almus | Amiloride aps | Amiloride arrow | Amiloride astec | Amiloride berk | Amiloride cox | Amiloride dc | Amiloride kent | Amiloride sandoz | Amiloride wyeth | Amilospare | Midamor;
  • (HK) Hong Kong: Midamor;
  • (ID) Indonesia: Amiloride | Puritrid;
  • (IE) Ireland: Amiloride;
  • (IN) India: Amiur;
  • (KR) Korea, Republic of: Amilo | Korasik | Ride;
  • (LT) Lithuania: Amiclaran | Amiloride | Midamor;
  • (LV) Latvia: Amiclaran | Midamor;
  • (NG) Nigeria: Amiloride;
  • (NO) Norway: Amikal | Amiloride par pharmaceutical | Midamor | Modamide | Nirulid;
  • (NZ) New Zealand: Amiloride perrigo | Midamor;
  • (PL) Poland: Amiclaran | Midamor | Modamide;
  • (PR) Puerto Rico: Amiloride HCL | Midamor;
  • (QA) Qatar: Modamide;
  • (SE) Sweden: Amilorid Merck NM | Amilorid mylan | Midamor;
  • (SK) Slovakia: Amiclaran;
  • (TH) Thailand: Amiloride;
  • (TW) Taiwan: Amitride | Edepin | Kaluril;
  • (ZW) Zimbabwe: Amiloride
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