ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Amiloride: Drug information

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

For abbreviations, symbols, and age group definitions used in Lexicomp (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
Pharmacologic Category
  • Antihypertensive;
  • Diuretic, Potassium Sparing
Dosing: Adult
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: Hepatic Impairment: Adult

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

Dosing: Older Adult

Older adults also show decreased clearance of amiloride; avoid use in patients with CrCl <30 mL/minute. If being treated for hypertension, avoid in those with CrCl <45 mL/minute. Refer to adult dosing (Ref).

Dosing: Pediatric

(For additional information see "Amiloride: Pediatric drug information")

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).

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).

Nephrogenic diabetes insipidus, congenital

Nephrogenic diabetes insipidus, congenital: Limited data available: Infants, Children, and Adolescents: Oral: 0.3 mg/kg/day in divided doses 3 times daily or 20 mg/1.73 m2/day in combination with hydrochlorothiazide; dosing based on a retrospective descriptive analysis (n=30, age range: 1 month to 40 years), two pediatric case series (n=4 and n=5), and a case report (Ref).

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

Dosing: Hepatic Impairment: Pediatric

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%:

Central nervous system: Dizziness, fatigue, headache

Endocrine & metabolic: Hyperkalemia (up to 10%; risk reduced in patients receiving kaliuretic diuretics), dehydration, gynecomastia, hyperchloremic metabolic acidosis, hyponatremia

Gastrointestinal: Abdominal pain, change in appetite, constipation, diarrhea, gas pain, nausea, vomiting

Genitourinary: Impotence

Neuromuscular & skeletal: Muscle cramps, weakness

Respiratory: Cough, dyspnea

<1%, postmarketing, and/or case reports: Alopecia, bladder spasm, cardiac arrhythmia, chest pain, dysuria, gastrointestinal hemorrhage, increased intraocular pressure, jaundice, orthostatic hypotension, palpitations, polyuria

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

Administration: Adult

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

Administration: Pediatric

Oral: Administer with food or milk

Use: Labeled Indications

Hypertension, chronic: 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.

Note: Potassium-sparing diuretics are not recommended for the initial treatment of hypertension (ACC/AHA [Whelton 2018]).

Use: Off-Label: Adult

Ascites; Hypokalemia due to chronic stable renal potassium wasting (eg, certain tubulopathies, chronic kaliuretic diuretic use), treatment

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 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 Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect 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 enhance the adverse/toxic effect of Ammonium Chloride. Specifically the risk of systemic acidosis. Risk C: Monitor therapy

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Angiotensin II Receptor Blockers: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Angiotensin-Converting Enzyme Inhibitors: Potassium-Sparing Diuretics may enhance the hyperkalemic effect of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

CycloSPORINE (Systemic): Potassium-Sparing Diuretics may enhance the hyperkalemic effect of CycloSPORINE (Systemic). Risk X: Avoid combination

Desmopressin: Hyponatremia-Associated Agents may enhance the hyponatremic effect of Desmopressin. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

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

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

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

Drospirenone-Containing Products: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Finerenone: Potassium-Sparing Diuretics may enhance the hyperkalemic effect of Finerenone. Risk C: Monitor therapy

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Heparin: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Management: Monitor serum potassium concentrations closely. The spironolactone Canadian product monograph lists its combination with heparin or low molecular weight heparins as contraindicated. Risk C: Monitor therapy

Heparins (Low Molecular Weight): May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Management: Monitor serum potassium concentrations closely. The spironolactone Canadian product monograph lists its combination with heparin or low molecular weight heparins as contraindicated. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

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

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: May diminish the antihypertensive effect of Potassium-Sparing Diuretics. Nonsteroidal Anti-Inflammatory Agents may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect 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 enhance the adverse/toxic effect of Diuretics. Opioid Agonists may diminish the therapeutic effect of Diuretics. Risk C: Monitor therapy

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Diuretics may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Potassium Salts: May enhance the hyperkalemic effect 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 enhance the hyperkalemic effect of other Potassium-Sparing Diuretics. Risk X: Avoid combination

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

QuiNIDine: AMILoride may enhance the adverse/toxic effect of QuiNIDine. AMILoride may diminish the therapeutic effect of QuiNIDine. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

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

Tacrolimus (Systemic): Potassium-Sparing Diuretics may enhance the hyperkalemic effect of Tacrolimus (Systemic). Risk C: Monitor therapy

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Tolvaptan: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

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).

Breastfeeding Considerations

It is not known if amiloride is present in breast milk.

In general, diuretics have the potential to decrease milk volume and suppress lactation; use should be avoided when possible (ACOG 2019; WHO 2002). Due to the potential for serious adverse reactions in the breastfeeding infant, a decision should be made to discontinue breastfeeding or to discontinue the drug, taking into account the importance of treatment to the mother.

Dietary Considerations

Do not use potassium-containing salt substitutes.

Monitoring Parameters

BP, serum electrolytes (especially potassium), kidney function.

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 | Wu dou li;
  • (CZ) Czech Republic: Amiclaran;
  • (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;
  • (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: Midamor;
  • (PL) Poland: Amiclaran | Midamor | Modamide;
  • (PR) Puerto Rico: Amiloride HCL | Midamor;
  • (SE) Sweden: Amilorid Merck NM | Amilorid mylan | Midamor;
  • (SK) Slovakia: Amiclaran;
  • (TH) Thailand: Amiloride;
  • (TW) Taiwan: Amitride | Edepin | Kaluril;
  • (ZW) Zimbabwe: Amiloride
  1. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  2. Al Shibli A, Narchi H. Bartter and Gitelman syndromes: spectrum of clinical manifestations caused by different mutations. World J Methodol. 2015;5(2):55-61. doi:10.5662/wjm.v5.i2.55 [PubMed 26140272]
  3. American College of Obstetricians and Gynecologists (ACOG). ACOG practice bulletin no. 203: chronic hypertension in pregnancy. Obstet Gynecol. 2019;133(1):e26-e50. doi:10.1097/AOG.0000000000003020 [PubMed 30575676]
  4. Amiloride [prescribing information]. Bensalem, PA: Sigmapharm Laboratories LLC; March 2021.
  5. Angeli P, Dalla Pria M, De Bei E, et al. Randomized clinical study of the efficacy of amiloride and potassium canrenoate in nonazotemic cirrhotic patients with ascites. Hepatology. 1994;19(1):72-79. [PubMed 8276370]
  6. Aronoff GR, Bennett WM, Berns JS, et al. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children. 5th ed. American College of Physicians; 2007.
  7. Asmar A, Mohandas R, Wingo CS. A physiologic-based approach to the treatment of a patient with hypokalemia. Am J Kidney Dis. 2012;60(3):492-497. doi:10.1053/j.ajkd.2012.01.031 [PubMed 22901631]
  8. Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(2):1014-1048. doi:10.1002/hep.31884 [PubMed 33942342]
  9. Blanchard A, Vargas-Poussou R, Vallet M, et al. Indomethacin, amiloride, or eplerenone for treating hypokalemia in Gitelman syndrome. J Am Soc Nephrol. 2015;26(2):468-475. [PubMed 25012174]
  10. Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(2):364-389. doi:10.1210/jc.2015-1710 [PubMed 26760044]
  11. Brook RD, Townsend RR. Treatment of resistant hypertension. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 15, 2022.
  12. Calò LA, Caielli P. Gitelman's syndrome and pregnancy: new potential pathophysiological influencing factors, therapeutic approach and materno-fetal outcome. J Matern Fetal Neonatal Med. 2012;25(8):1511-1513. doi:10.3109/14767058.2011.629254 [PubMed 21999963]
  13. Clase CM, Carrero JJ, Ellison DH, et al; Conference Participants. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2020;97(1):42-61. doi:10.1016/j.kint.2019.09.018 [PubMed 31706619]
  14. European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69(2):406-460. [PubMed 29653741]
  15. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53(3):397-417. [PubMed 20633946]
  16. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute (NHLBI). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128(Suppl 5):S213-S256. http://www.nhlbi.nih.gov/guidelines/cvd_ped/peds_guidelines_full.pdf. [PubMed 22084329]
  17. Forestiero V, Sconfienza E, Mulatero P, Monticone S. Primary aldosteronism in pregnancy. Rev Endocr Metab Disord. Published online May 10, 2022. doi:10.1007/s11154-022-09729-6 [PubMed 35536535]
  18. Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi:10.1210/jc.2015-4061 [PubMed 26934393]
  19. George CF. Amiloride handling in renal failure. Br J Clin Pharmacol. 1980;9(1):94-95. [PubMed 7356897]
  20. Griffing GT, Aurecchia SA, Sindler BH, Melby JC. The effect of amiloride on the renin-aldosterone system in primary hyperaldosteronism and Bartter's syndrome. J Clin Pharmacol. 1982a;22(11-12):505-512. doi:10.1002/j.1552-4604.1982.tb02643.x [PubMed 6761369]
  21. Griffing GT, Komanicky P, Aurecchia SA, Sindler BH, Melby JC. Amiloride in Bartter's syndrome. Clin Pharmacol Ther. 1982b;31(6):713-718. doi:10.1038/clpt.1982.100 [PubMed 7075119]
  22. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 [PubMed 35363499]
  23. Inder WJ, Meyer C, Hunt PJ. Management of hypertension and heart failure in patients with Addison's disease. Clin Endocrinol (Oxf). 2015;82(6):789-792. doi:10.1111/cen.12592 [PubMed 25138826]
  24. Jaffey L, Martin A. Malignant hyperkalaemia after amiloride/hydrochlorothiazide treatment. Lancet. 1981;1(8232):1272. doi:10.1016/s0140-6736(81)92450-8 [PubMed 6112601]
  25. 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) [published online December 18, 2013]. JAMA. [PubMed 24352797]
  26. Kirchlechner V, Koller DY, Seidl R, Waldhauser F. Treatment of nephrogenic diabetes insipidus with hydrochlorothiazide and amiloride. Arch Dis Child. 1999;80(6):548-552. [PubMed 10332005]
  27. Kleyman TR, Cragoe EJ Jr. The Mechanism of Action of Amiloride. Semin Nephrol. 1988;8(3):242-248. [PubMed 2849182]
  28. Kliegman RM, Stanton BMD, St. Geme J, Schor NF, eds. Nelson' s Textbook of Pediatrics. 20th ed. Saunders Elsevier; 2016.
  29. Knoers N, Monnens LA. Amiloride-hydrochlorothiazide versus indomethacin-hydrochlorothiazide in the treatment of nephrogenic diabetes insipidus. J Pediatr. 1990;117(3):499-502. [PubMed 2391611]
  30. Macfie HL, Colvin CL, Anderson PO. New drug evaluations amiloride (Midamor, Merck, Sharp and Dohme). Drug Intell Clin Pharm. 1981;15(2):94-98. [PubMed 7274028]
  31. Magee LA, Smith GN, Bloch C, et al. Guideline no. 426: hypertensive disorders of pregnancy: diagnosis, prediction, prevention, and management. J Obstet Gynaecol Can. 2022;44(5):547-571.e1. doi:10.1016/j.jogc.2022.03.002 [PubMed 35577426]
  32. Mann JFE, Flack JM. Choice of drug therapy in primary (essential) hypertension. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed March 7, 2023.
  33. Mathen S, Venning M, Gillham J. Outpatient management of Gitelman's syndrome in pregnancy. BMJ Case Rep. 2013;2013:bcr2012007927. doi:10.1136/bcr-2012-007927 [PubMed 23355577]
  34. Mount DB. Clinical manifestations and treatment of hypokalemia in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 29, 2022.
  35. Moustakakis MN, Bockorny M. Gitelman syndrome and pregnancy. Clin Kidney J. 2012;5(6):552-555. doi:10.1093/ckj/sfs126 [PubMed 26064481]
  36. Murdoch DL, Forrest G, Davies DL, McInnes GT. A comparison of the potassium and magnesium-sparing properties of amiloride and spironolactone in diuretic-treated normal subjects. Br J Clin Pharmacol. 1993;35(4):373-378. doi:10.1111/j.1365-2125.1993.tb04153.x [PubMed 8485017]
  37. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114(2)(suppl):555-576. [PubMed 15286277]
  38. National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management. www.nice.org.uk/guidance/ng133. Published June 25, 2019. Accessed December 1, 2022.
  39. National Institutes of Health, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. Clinical Practice Guidelines, 2011. http://www.nhlbi.nih.gov/guidelines/cvd_ped/peds_guidelines_full.pdf. Date accessed: June 11, 2012.
  40. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39(34):3165-3241. doi:10.1093/eurheartj/ehy340 [PubMed 30165544]
  41. Runyon BA; American Association for the Study of Liver Diseases Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: Update 2012. Hepatology. https://www.aasld.org/sites/default/files/2019-06/141020_Guideline_Ascites_4UFb_2015.pdf. Accessed April 24, 2015.
  42. Sanga V, Rossitto G, Seccia TM, Rossi GP. Management and outcomes of primary aldosteronism in pregnancy: a systematic review. Hypertension. 2022:101161HYPERTENSIONAHA12118858. doi:10.1161/HYPERTENSIONAHA.121.18858 [PubMed 35686552]
  43. Shahzad MA, Mukhtar M, Ahmed A, Ullah W, Saeed R, Hamid M. Gitelman syndrome: a rare cause of seizure disorder and a systematic review. Case Rep Med. 2019;2019:4204907. doi:10.1155/2019/4204907 [PubMed 30867665]
  44. Tetti M, Monticone S, Burrello J, et al. Liddle syndrome: review of the literature and description of a new case. Int J Mol Sci. 2018;19(3):812. doi:10.3390/ijms19030812 [PubMed 29534496]
  45. Uyeki TM, Barry FL, Rosenthal SM, Mathias RS. Successful treatment with hydrochlorothiazide and amiloride in an infant with congenital nephrogenic diabetes insipidus. Pediatr Nephrol. 1993;7(5):554-556. [PubMed 8251321]
  46. van der Vorst MM, Kist JE, van der Heijden AJ, et al. Diuretics in Pediatrics: Current Knowledge and Future Prospects. Paediatr Drugs. 2006;8(4):245-264. [PubMed 16898855]
  47. van Lieburg AF, Knoers NV, Monnens LA. Clinical presentation and follow-up of 30 patients with congenital nephrogenic diabetes insipidus. J Am Soc Nephrol. 1999;10(9):1958-1964. [PubMed 10477148]
  48. 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). 2014;16(1):14-26. [PubMed 24341872]
  49. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Hypertension. 2018;71(6):e13‐e115. doi:10.1161/HYP.0000000000000065 [PubMed 29133356]
  50. World Health Organization (WHO). Breastfeeding and maternal medication, recommendations for drugs in the eleventh WHO model list of essential drugs. 2002. https://apps.who.int/iris/handle/10665/62435
Topic 8550 Version 262.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟