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Amiloride
📖 About
Always check the BNF link here (or local formulary) before prescribing.
- 💊 Potassium-sparing diuretic, usually used in combination with other diuretics.
- Helps prevent potassium loss when loop or thiazide diuretics are used.
⚙️ Mode of Action
- Blocks epithelial sodium channels (ENaC) in the late distal convoluted tubule and collecting duct.
- ⬇️ Sodium reabsorption → ⬆️ Sodium + water excretion.
- Reduces potassium excretion → risk of hyperkalaemia.
📋 Indications
- 🫀 Heart failure (usually with loop/thiazide to reduce K⁺ loss).
- 💧 Oedema (hepatic cirrhosis, nephrotic syndrome).
- 🩸 Hypertension (adjunct, rarely used alone).
- ⚠️ Ascites (in cirrhosis, often combined with spironolactone).
💊 Dose
| Name | Dose | Frequency | Route |
|---|---|---|---|
| Amiloride | 2.5 – 10 mg | OD | PO |
🔄 Interactions
- 📉 Monitor U&E and potassium closely.
- ⚠️ Risk of severe hyperkalaemia with other K⁺-sparing drugs (spironolactone, ACE inhibitors, ARBs).
- 💊 Increases risk of lithium toxicity (reduced clearance).
- 🩹 NSAIDs may reduce renal function and blunt diuretic effect.
⛔ Contraindications
- 🚫 Hyperkalaemia.
- 🚫 Severe renal impairment or anuria.
- 🚫 Addison’s disease (already prone to high K⁺).
⚠️ Side Effects
- ⬆️ Hyperkalaemia → risk of arrhythmia.
- ⬇️ Hyponatraemia.
- 💧 Dehydration, dizziness, hypotension.
- 🧠 Lithium toxicity (if co-prescribed).
- 🩺 NSAID-related nephrotoxicity (reduced renal perfusion).
- Rare: GI upset, headache, rash.
📚 References
- BNF: Amiloride
- NICE CKS: Heart failure, Hypertension
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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