Amiloride 5mg / HCTZ 50mg Tabs

Amiloride is a potassium-sparing diuretic that acts on the distal convoluted tubule and collecting duct to inhibit sodium reabsorption and potassium excretion by blocking epithelial sodium channels (ENaC). Hydrochlorothiazide is a thiazide diuretic that inhibits the reabsorption of sodium and chloride ions in the distal convoluted tubule, leading to increased excretion of sodium, chloride, and water, and to a lesser extent, potassium and magnesium. The combination provides additive diuretic and antihypertensive effects while minimizing potassium loss.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of fluid and electrolyte problems, such as:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or passing out
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or change in the amount of urine produced
+ Dry mouth
+ Dry eyes
+ Severe upset stomach or throwing up
Signs of too much acid in the blood (acidosis), including:
+ Confusion
+ Fast breathing
+ Fast heartbeat
+ A heartbeat that does not feel normal
+ Very bad stomach pain, upset stomach, or throwing up
+ Feeling very sleepy
+ Shortness of breath
+ Feeling very tired or weak
Signs of kidney problems, such as:
+ Unable to pass urine
+ Change in how much urine is passed
+ Blood in the urine
+ A big weight gain
Eye problems, which can lead to lasting eyesight loss if left untreated. If you experience any of the following symptoms, contact your doctor right away:
+ Change in eyesight
+ Eye pain (usually occurs within hours to weeks of starting this medication)
Rarely, certain types of skin cancer have been reported in people taking hydrochlorothiazide. To minimize your risk:
+ Protect your skin from the sun
+ Have your skin checked as advised by your doctor
+ Contact your doctor immediately if you notice any changes in the color or size of a mole, or any new or changing skin lump or growth

Other Possible Side Effects

While many people may not experience any side effects or only minor ones, it's essential to be aware of the following potential side effects:

Feeling dizzy, tired, or weak
Headache
Decreased appetite
Upset stomach
Stomach pain
* Gas

If any of these side effects or any others bother you or do not go away, contact your doctor or seek medical help. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
A known sulfa allergy.
Certain health conditions, including:
+ Diabetes
+ High potassium levels
+ Kidney disease
+ Urination problems
If you are unable to urinate.
Your diet, particularly if it is rich in potassium.
Any medications you are taking, including:
+ Spironolactone
+ Triamterene
+ Potassium-containing drugs
+ Salt substitutes
+ Dofetilide
+ Lithium

Please note that this is not an exhaustive list of potential interactions. It is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist to ensure safe use. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, avoid driving and other activities that require alertness until you understand how it affects you. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and be cautious when climbing stairs.

If you have diabetes, closely monitor your blood sugar levels as directed by your healthcare provider. Regularly check your blood pressure as advised, and have blood tests done as recommended by your doctor. Discuss any concerns or questions with your doctor.

Be aware that this medication may interfere with certain laboratory tests. Inform all your healthcare providers and laboratory personnel that you are taking this medication.

If you have high blood pressure, consult your doctor before using over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

This medication may increase your risk of sunburn. Take precautions when exposed to the sun, and notify your doctor if you experience excessive sunburn.

Before consuming alcohol, marijuana, or other forms of cannabis, or taking prescription or OTC medications that may cause drowsiness, discuss the potential risks with your doctor.

If you experience excessive sweating, fluid loss, vomiting, or diarrhea, inform your doctor, as these symptoms may lead to low blood pressure.

If you are on a low-sodium or sodium-free diet, consult your doctor for guidance. If you take cholestyramine or colestipol, consult your pharmacist about the best way to take these medications with this drug, and be aware of the potential for gout attacks.

If you have lupus, this medication may cause your condition to become active or worsen. Immediately report any new or worsening symptoms to your doctor. Additionally, this medication may cause elevated cholesterol and triglyceride levels; discuss this risk with your doctor.

If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.

If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the benefits and risks of this medication with your doctor to ensure the best possible outcome for you and your baby.

• Potassium supplements
• Other potassium-sparing diuretics (e.g., spironolactone, triamterene)
• Anuria
• Acute renal failure
• Hyperkalemia

• ACE inhibitors (e.g., lisinopril, enalapril) - increased risk of hyperkalemia
• Angiotensin Receptor Blockers (ARBs) (e.g., losartan, valsartan) - increased risk of hyperkalemia
• NSAIDs (e.g., ibuprofen, naproxen) - reduced diuretic/antihypertensive effect, increased risk of renal dysfunction
• Lithium - reduced renal clearance of lithium, increased risk of lithium toxicity
• Digoxin - HCTZ-induced hypokalemia can increase digoxin toxicity
• Corticosteroids - enhanced potassium loss

• Antidiabetic agents (insulin, oral hypoglycemics) - HCTZ may decrease glucose tolerance, requiring dose adjustment
• Cholestyramine, Colestipol - reduced absorption of HCTZ
• Neuromuscular blocking agents (e.g., tubocurarine) - prolonged effect due to HCTZ-induced electrolyte imbalance
• Pressor amines (e.g., norepinephrine) - decreased arterial responsiveness

• Alcohol, Barbiturates, Narcotics - additive orthostatic hypotensive effects

• Dizziness
• Lightheadedness
• Weakness
• Muscle cramps or pain
• Irregular heartbeat (palpitations)
• Excessive thirst
• Dry mouth
• Nausea or vomiting
• Unusual fatigue
• Swelling in ankles or feet (if edema persists)

Category D. Not recommended for routine use in pregnancy. Hydrochlorothiazide can cross the placental barrier and may cause fetal or neonatal jaundice, thrombocytopenia, and other adverse reactions. Amiloride is Category B, but the combination is rated based on the higher risk component.

Both amiloride and hydrochlorothiazide are excreted into breast milk. Hydrochlorothiazide can suppress lactation. Due to the potential for serious adverse effects in the nursing infant (e.g., electrolyte disturbances, jaundice), a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Safety and efficacy have not been established in pediatric patients. Use is generally not recommended.

Elderly patients may be more sensitive to the effects of diuretics and are at increased risk for electrolyte imbalances (especially hyperkalemia with amiloride and hyponatremia/hypokalemia with HCTZ), dehydration, and renal impairment. Start with lower doses and monitor closely.

• Always check serum potassium levels before initiating therapy and regularly thereafter, especially in patients with renal impairment or those on ACE inhibitors/ARBs.
• Advise patients to avoid potassium-rich foods and potassium supplements unless specifically instructed by their physician.
• Take the medication in the morning to prevent nocturia (frequent urination at night).
• Hydrochlorothiazide can cause photosensitivity; advise patients to use sunscreen and protective clothing.
• May exacerbate or precipitate gout due to HCTZ-induced hyperuricemia.
• Monitor blood glucose levels in diabetic patients, as HCTZ can impair glucose tolerance.
• This combination is particularly useful for patients who experience hypokalemia with thiazide monotherapy.

• Other classes of antihypertensives (e.g., ACE inhibitors, ARBs, Calcium Channel Blockers, Beta-blockers)
• Loop diuretics (e.g., furosemide, torsemide) for more potent diuresis
• Other potassium-sparing diuretics (e.g., spironolactone, eplerenone) as monotherapy or with other diuretics

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.