Substantially eliminated by kidneys; assess renal function periodically since geriatric patients are more likely to have decreased renal function. 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. JAMA. 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. costco pharmacy lisinopril cost lisinopril
Therapeutic Equivalence-Related Terms, Pharmaceutical Equivalents generally will be coded AB if a study is submitted demonstrating bioequivalence. Store at room temperature away from moisture, heat, or freezing temperatures. What happens if I miss a dose? Not all side effects for Midamor may be reported. You should always consult a doctor or healthcare professional for medical advice.
For sickle cell disease: zinc sulfate 220 mg three times daily. 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. Gastrointestinal complaints of diarrhea, nausea, constipation, anorexia, and general abdominal pain occur less than 5% of patients.
When amiloride is used in fixed combination with hydrochlorothiazide, consider the cautions, precautions, and contraindications associated with hydrochlorothiazide. 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. purchase topiramate interaction
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. Management of edema associated with heart failure, cirrhosis of the liver, or secondary hyperaldosteronism. Use amiloride alone only when persistent hypokalemia is documented. 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. Unlike thiazide diuretics, does not consistently inhibit the excretion of uric acid; has variable effects on serum uric acid concentration. Midamor should be administered with food. 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. Has been used for the management of lithium-induced polyuria secondary to lithium-induced nephrogenic diabetes insipidus. 100 a See Specific Drugs, Foods, and Laboratory Tests under Interactions. III to IV when used in addition to standard therapy. Moderate Be cautious with this combination. Vidt DG "Mechanism of action, pharmacokinetics, adverse effects, and therapeutic uses of amiloride hydrochloride, a new potassium-sparing diuretic. Some medical conditions may interact with Midamor. Yellow 10, iron oxide, lactose, magnesium stearate and starch. Registered trademark of Paddock Laboratories, Inc. Midamor exerts its potassium sparing effect through the inhibition of sodium reabsorption at the distal convoluted tubule, cortical collecting tubule and collecting duct; this decreases the net negative potential of the tubular lumen and reduces both potassium and hydrogen secretion and their subsequent excretion. This mechanism accounts in large part for the potassium sparing action of amiloride. Initial diagnostic measure to provide presumptive evidence of primary hyperaldosteronism while patients are on normal diets.
Hummel SL, Konerman MC. Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt? 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. Initially, 5 mg daily; increase dosage as necessary to 10 mg daily. L may occur with all potassium-sparing agents, including amiloride. a b c See Boxed Warning. Also useful in patients with hypokalemia who do not respond to potassium supplements or those who cannot tolerate potassium supplements. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; dry mouth; excessive thirst; slowed heart rate; unusual muscle weakness; unusual tiredness; vomiting. Known hypersensitivity to amiloride or any ingredient in the formulation. Not metabolized in the liver. Midamor should rarely be used alone. It has weak compared with thiazides diuretic and antihypertensive effects. Used as single agents, potassium sparing diuretics, including Midamor, result in an increased risk of hyperkalemia approximately 10% with amiloride. Midamor should be used alone only when persistent hypokalemia has been documented and only with careful titration of the dose and close monitoring of serum electrolytes. 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 substances you are taking, check with your doctor, nurse, or pharmacist. When amiloride HCl is administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, cyclosporine or tacrolimus, the risk of hyperkalemia may be increased. Therefore, if concomitant use of these agents is indicated because of demonstrated hypokalemia, they should be used with caution and with frequent monitoring of serum potassium. American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 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. Midamor Amiloride HCl is available for oral use as tablets containing 5 mg of anhydrous amiloride HCl. How should I take Midamor amiloride? procrit
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. Anuria, acute or chronic renal insufficiency, diabetic nephropathy. If hyperkalemia occurs in patients taking Midamor, the drug should be discontinued immediately. If you have any questions about Midamor, please talk with your doctor, pharmacist, or other health care provider. Talk with your health provider. 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. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. 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. 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. Used in fixed combination with hydrochlorothiazide for treatment of edema in patients who require a thiazide diuretic and in whom the development of hypokalemia cannot be risked. Tarssanen L, Huikko M, Rossi M "Amiloride-induced hyponatremia. Adjust dosage by administering each drug separately. a If the optimum maintenance dosage corresponds to the ratio in the commercial combination preparation, the fixed combination may be used. Contraindicated in patients with anuria, acute renal insufficiency, or significant impairment of renal excretory function. 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. 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.
NDC 0574-0291-01 bottles of 100. Hyperkalemia, b nausea, b vomiting, b diarrhea, b abdominal pain, b flatulence, b anorexia, b mild skin rash, b headache. 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. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Drugs. Some experts state that inclusion in combination drug regimens may be considered in patients with resistant hypertension. Short-term preoperative treatment of patients with primary hyperaldosteronism. Exhibits potassium-sparing effect when used with kaliuretic diuretics. Patient advice: Advise patients to avoid potassium supplements and foods containing high levels of potassium, including salt substitutes. Renal side effects including renal insufficiency is unusual after amiloride the active ingredient contained in Midamor monotherapy because it is only a weak diuretic. Cases of severe hyponatremia have been reported during hydrochlorothiazide-amiloride the active ingredient contained in Midamor therapy. In 3 cases, the patients subsequently did well with hydrochlorothiazide and potassium supplementation, suggesting a significant role for amiloride in the development of their hyponatremia. Administer orally with food. Zinc can attach to tetracyclines in the stomach. This decreases the amount of tetracyclines that can be absorbed. Taking zinc with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction, take tetracyclines 2 hours before or 4-6 hours after taking zinc supplements. Does not appear to be diabetogenic or to alter carbohydrate metabolism in humans. Products meeting necessary bioequivalence requirements. 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. price bupropion through medco
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. AB1, AB2, AB3, etc. Concomitant administration with a more potent natriuretic diuretic results in approximately additive effects of the drugs on urinary sodium excretion and an antagonistic effect on potassium excretion. Titrate dosage carefully and monitor serum electrolytes closely because of increased risk of hyperkalemia with monotherapy. 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. Inc. Midamor amiloride HCl tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. For muscle cramps in zinc deficient people with liver disease: zinc sulfate 220 mg twice daily. Genitourinary problems include rare complaints of impotence. Polyuria and urinary frequency are reported in less than 1% of patients. Appropriate studies have not been performed on the relationship of age to the effects of amiloride in the pediatric population.
Wilson JR, Reichek N, Dunkman WB et al. Effect of diuresis on the performance of the failing left ventricle in man. Am J Med. Midamor should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. Lynn KL, Bailey RR, Swainson CP, Sainsbury R, Low WI "Renal failure with potassium-sparing diuretics. Evaluate BUN and serum potassium and creatinine concentrations regularly, especially in patients with suspected or confirmed renal insufficiency. a b Monitor serum potassium concentrations closely in geriatric and diabetic patients. a b Avoid use in diabetic patients, if possible, because of the risk of hyperkalemia. Does not competitively inhibit aldosterone; activity is independent of aldosterone concentrations. ACE inhibitors, angiotensin II receptor antagonists, calcium-channel blockers, thiazide diuretics are preferred for initial management. Amiloride HCl is not metabolized by the liver but is excreted unchanged by the kidneys. About 50 percent of a 20 mg dose of Midamor is excreted in the urine and 40 percent in the stool within 72 hours. Midamor has little effect on glomerular filtration rate or renal blood flow. Because amiloride HCl is not metabolized by the liver, drug accumulation is not anticipated in patients with hepatic dysfunction, but accumulation can occur if the hepatorenal syndrome develops. 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. Different salt forms provide different amounts of elemental zinc. Zinc sulfate contains 23% elemental zinc; 220 mg zinc sulfate contains 50 mg zinc. 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. For the long test, correction of hypokalemia and hypertension provides presumptive evidence of primary hyperaldosteronism. 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. 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. The dose of this drug should remain unchanged if a second diuretic is added. AMILoride and ethanol may have additive effects in lowering your blood pressure. If hypokalemia persists after an adequate trial of 10 mg daily, may increase dosage to 15 and then 20 mg daily. buy cefuroxime overdose
However, some clinicians state maximum effective dosage may be as high as 40 mg daily. 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. 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. Minor Be cautious with this combination. Treatment of edematous conditions in patients with congestive heart failure who are only partially responsive to or intolerant of other therapeutic measures or who are taking digitalis when other therapies are considered inappropriate. Monitor serum electrolyte and BUN concentrations closely in patients with hepatic cirrhosis with ascites and metabolic alkalosis receiving amiloride in combination with other diuretics. Distributed into milk in animals. a b c Discontinue nursing or the drug. Co. Midamor amiloride hydrochloride tablets prescribing information. West Point, PA; 1992 Apr. Midamor should not be given to patients receiving other potassium-conserving agents, such as spironolactone or triamterene. Symptoms may include lightheadedness; nausea; vomiting; weakness. 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. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. 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. 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. Patent and Trademark Office and assigns exclusive legal right to the patent holder to protect the proprietary chemical formulation. The patent assigns exclusive legal right to the inventor or patent holder, and may include entities such as the drug brand name, trademark, product dosage form, ingredient formulation, or manufacturing process A patent usually expires 20 years from the date of filing, but can be variable based on many factors, including development of new formulations of the original chemical, and patent infringement litigation.
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. Long-term maintenance therapy for patients deemed unsuitable for surgery or those with idiopathic hyperaldosteronism. Yancy CW. The Uncertainty of Sodium Restriction in Heart Failure: We Can Do Better Than This. JACC Heart Fail. 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. Use Midamor with caution in the ELDERLY; they may be more sensitive to its effects. Importance of taking drug with food to help avoid stomach upset. Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective. This information should not be used to decide whether or not to take Midamor or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Midamor. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Midamor. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Midamor. Crosses the placenta in animals; not known whether crosses placenta in humans. The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables. For the short test, increased serum potassium with this drug and a decrease upon discontinuation provide presumptive evidence of primary hyperaldosteronism. 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. Richardson A, Bayliss J, Scriven AJ et al. Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. Lancet. 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. Do not stop taking any medications without consulting your healthcare provider. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. fluoxetine
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C; a protect from moisture, freezing, and excessive heat. McNay JL, Oran E "Possible predisposition of diabetic patients to hyperkalemia following administration of potassium-retaining diuretic, amiloride MK 870. 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. generic alfuzosin pill identifier alfuzosin
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. 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. Inc. Moduretic amiloride HCl-hydrochlorothiazide tablets prescribing information. Whitehouse Station, NJ; 2002 Nov.
Increases urinary excretion of sodium, calcium, and bicarbonate with little, if any, increase in chloride excretion. May increase urinary aldosterone and plasma renin concentrations, probably as a compensatory feedback mechanism caused by potassium retention and natriuresis. Midamor should be discontinued at least three days before glucose tolerance testing. This medicine may increase the amount of potassium in your blood. livep.info cephalexin
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. Food decreases the extent of GI absorption to about 30%, but does not affect the rate of absorption. Are there any interactions with medications?