Amiloride and Hydrochlorothiazide (Oral)

The drug combination of Amiloride and Hydrochlorothiazide is used to treat high blood pressure, as well as edema, in patients who suffer from congestive heart failure. There is a risk of overdose with this drug, and the patient's potassium levels must be regularly monitored.

Overview

This combination of drugs is effective in treating high blood pressure, a condition that can grow very serious over time if not actively managed. If left untreated, hypertension can cause heart failure, a stroke and kidney failure. Increased blood pressure puts a strain on the overall circulation of blood, putting undue pressure on the heart and arteries, and can lead to problems in the heart, kidneys and brain, as well as leading to an increase in the likelihood of heart attack.

Amiloride and Hydrochlorothiazide medications come in tablet form and are only available via prescription from your doctor. The two drugs are essentially diuretics, a drug that reduces unnecessary water and salt in the body. In addition to hypertension, they are also effective in treating edema in patients who suffer from congestive heart failure. The use of Amiloride prevents the body from losing too much potassium as a result of the increased level of urination, and it is important to regularly monitor one's overall potassium levels while taking this medication.

Condition(s) treated

  • Hypertension (high blood pressure)
  • Edema

Type of medicine

  • Diuretic (water pills)
  • Potassium Sparing/Thiazide Combination

Side effects

Use of this drug requires regular monitoring by your physician, which may include blood work to check for elevated amounts of potassium in your system, as this is one of the main side effects of this medication. The major symptoms of too much potassium are abdominal pain, confusion, difficulty breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, and weakness or heaviness of the legs; be sure to notify your physician immediately if you begin to experience any of these symptoms.

There are other side effects that can vary from severe to mild, and some patients do not report disruptive side effects of any type. However, it is best to be aware of the potential side effects and discuss them with your doctor, as they may find it beneficial to alter your dosage or other instructions related to your medication.

Less common side effects include:

  • dizziness
  • tightness in the chest
  • labored breathing
  • fast or slow heartbeat
  • fainting
  • wheezing

Rare side effects are:

  • ankle, knee, or great toe joint pain
  • weight gain
  • vomiting of blood or material that looks like coffee grounds
  • unusual tiredness or weakness
  • bloody or black, tarry stools
  • swelling of the face, ankles, hands, fingers, or lower legs
  • burning while urinating
  • sunken eyes
  • chest pain, discomfort, or heaviness
  • sore throat
  • cloudy urine
  • severe sleepiness
  • coma
  • red, swollen skin
  • convulsions
  • red skin lesions, often with a purple center
  • cracks in the skin
  • pounding heartbeat or pulse
  • decreased frequency or amount of urine
  • lower back or side pain
  • difficult or painful urination
  • loss of appetite
  • dry mouth
  • joint pain, stiffness, or swelling
  • headache
  • increased blood pressure
  • itching
  • increase in heart rate
  • lightheadedness
  • fever
  • loss of heat from the body
  • increased thirst
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • muscle pain or cramps
  • diarrhea
  • rapid breathing
  • decreased awareness or responsiveness
  • red, irritated eyes
  • cough
  • scaly skin
  • constipation
  • severe stomach pain
  • cold sweats
  • sores, ulcers, or white spots in the mouth or on the lips
  • chills
  • sweating
  • burning, crawling, itching, numbness, prickling, pins and needles, or tingling feelings
  • troubled breathing
  • bloody urine
  • blistering, peeling, or loosening of the skin
  • arm, back, or jaw pain
  • wrinkled skin

It is also possible to overdose on this medication, so it is imperative to go to the emergency room immediately if you begin to experience any of these symptoms:

  • drowsiness
  • mood changes
  • pain or weakness in the hands or feet
  • trembling
  • irritability
  • weak pulse

This drug can also cause certain side effects that will generally go away on their own without any medical treatment. The more common of these include weight loss and rash. Less common are stomach pain and leg ache. Rarely, people experience these side effects that go away on their own:

  • bad taste
  • unable to sleep
  • bloated, full feeling
  • trouble sleeping
  • changes in appetite
  • swelling of the breasts or breast soreness in both females and males
  • discouragement
  • sleeplessness
  • double vision
  • the sensation of spinning
  • the feeling of constant movement of self or surroundings
  • redness of the face, neck, arms, and occasionally upper chest
  • feeling sad or empty
  • the overbright appearance of lights
  • hair loss or thinning of hair
  • muscle spasm
  • inability to have or keep an erection
  • loss of bladder control
  • increased urge to urinate during the night
  • the loss in sexual ability, desire, drive, or performance
  • indigestion
  • loss of interest or pleasure
  • increased sweating
  • night blindness
  • hiccups
  • the passing of gas
  • a general feeling of discomfort or illness
  • seeing halos around lights
  • a feeling of warmth
  • sleepiness
  • excess air or gas in the stomach or intestines
  • stomach fullness or discomfort from a stuffy nose
  • disturbed color perception
  • trouble concentrating
  • tunnel vision
  • blurred or loss of vision
  • waking to urinate at night

While this is a list of many side effects that have been reported when taking Amiloride and Hydrochlorothiazide, it is in no way comprehensive, as it is always possible that you may experience different side effects. If you notice any adverse reaction to your medication that does not dissipate on its own, it is always a good idea to discuss the situation with your doctor.

Dosage

This drug combination is prescribed at the appropriate level for each patient, with instructions to take a tablet either once or twice per day. With this drug, it is important to take at the same time each day, and many patients report that it is necessary to take at least four hours prior to bedtime to reduce the need to get up during the night to urinate. Do not take a double dose of this medicine; if you miss a dose and it is close to your next scheduled time to take the medication, it is best to wait and take the regular dosage at that time.

Patients who also take a high cholesterol medication need to wait for at least four to six hours between administering each medication. Follow your physician's advice as fully as possible and take each medication as near to the same time every day. As high blood pressure often has no symptoms, it is imperative to continue taking the medication even if you do not feel ill or unwell. Inform your doctor immediately if your blood pressure continues to be high or becomes elevated while taking the hypertension medication.

Major drug interactions

Your doctor will need to have a comprehensive knowledge of all of the medicines, both prescription and over the counter, that you are taking before they prescribe Amiloride and Hydrochlorothiazide. Even when there can be a possibility of a drug interaction, your doctor may prescribe this diuretic in a different dose or other variance. However, if you are taking Dofetilide, Triamterene or Eplerenone, it is strongly recommended that you not also take Amiloride and Hydrochlorothiazide at the same time.

Again, your doctor will review your specific case and determine which course of treatment is best for you. They may opt to change one of the above prescriptions for one that is more suitable for use with Amiloride and Hydrochlorothiazide, or prescribe a different type of hypertension medicine.

The group of drugs listed below can present difficulties when used with Amiloride and Hydrochlorothiazide, but your physician may prescribe both under their supervision.

  • Aceclofenac
  • Valdecoxib
  • Acemetacin
  • Trandolapril
  • Alacepril
  • Tolfenamic Acid
  • Amtolmetin Guacil
  • Tenoxicam
  • Arsenic Trioxide
  • Sulindac
  • Benazepril
  • Sotalol
  • Bufexamac
  • Salsalate
  • Captopril
  • Rofecoxib
  • Choline Salicylate
  • Quinapril
  • Clonixin
  • Proquazone
  • Delapril
  • Proglumetacin
  • Dexibuprofen
  • Potassium
  • Diclofenac
  • Piketoprofen
  • Digitalis
  • Perindopril
  • Digoxin
  • Parecoxib
  • Dofetilide
  • Oxaprozin
  • Droxicam
  • Nimesulide Beta Cyclodextrin
  • Enalapril Maleate
  • Niflumic Acid
  • Etofenamate
  • Naproxen
  • Felbinac
  • Morniflumate
  • Fepradinol
  • Metildigoxin
  • Flecainide
  • Meloxicam
  • Flufenamic Acid
  • Meclofenamate
  • Fosinopril
  • Loxoprofen
  • Imidapril
  • Lithium
  • Ketanserin
  • Levomethadyl
  • Ketorolac
  • Lisinopril
  • Ketoprofen
  • Lornoxicam
  • Indomethacin
  • Lumiracoxib
  • Ibuprofen
  • Mefenamic Acid
  • Flurbiprofen
  • Methotrexate
  • Floctafenine
  • Moexipril
  • Feprazone
  • Nabumetone
  • Fenoprofen
  • Nepafenac
  • Etoricoxib
  • Nimesulide
  • Etodolac
  • Ouabain
  • Enalaprilat
  • Oxyphenbutazone
  • Droperidol
  • Pentopril
  • Dipyrone
  • Phenylbutazone
  • Digitoxin
  • Piroxicam
  • Diflunisal
  • Pranoprofen
  • Dexketoprofen
  • Propyphenazone
  • Deslanoside
  • Proscillaridin
  • Cyclophosphamide
  • Ramipril
  • Cilazapril
  • Salicylic Acid
  • Celecoxib
  • Sodium Salicylate
  • Bupropion
  • Spirapril
  • Bromfenac
  • Temocapril
  • Aspirin
  • Tiaprofenic Acid
  • Arginine
  • Tolmetin
  • Amphetamine
  • Trimethoprim
  • Acetyldigoxin
  • Zofenopril

Again, if you are going to use one of the above drugs with this hypertension drug, your doctor may alter the dosage amount of one or both of the medications.

The use of the diuretic with the short list below may increase the likelihood of unwanted side effects, but it may also provide the best treatment for your condition.

  • Bepridil
  • Gossypol
  • Quinidine
  • Carbenoxolone
  • Ginkgo
  • Cholestyramine
  • Licorice
  • Carbamazepine
  • Cholestyramine
  • Topiramate

Be sure to always follow the exact dosage instructions that your physician provides, and keep them informed of any changes in any of the medications, both prescribed and over the counter, at all times.

Warnings

Do not take this drug with foods that are high in potassium, such as bananas, and check with your doctor to learn more about any beneficial changes that you can make to your eating habits while taking this drug. Advise your physician on your alcohol and tobacco intake, and always make them aware of any changes to your diet and lifestyle habits. Patients with high blood pressure often benefit from a low sodium diet, weight loss, and increased exercise.

This drug is known to cause dizziness, as well as lightheadedness. Be sure that you are fully aware of how the drug affects you prior to driving, operating heavy machinery, or performing any other task that requires full alertness. When first adjusting to the medication, it is a good idea to rise from a sitting position in a slow manner, to avoid the onset of dizziness and lightheadedness. Be sure to maintain a proper level of hydration while taking this medication, as it will help to reduce the possibility of dizziness.

Amiloride and Hydrochlorothiazide may also increase your sensitivity to sunlight. Be sure to limit your exposure to the sun and do not engage in visiting tanning booths while on this medication.

This medication has been known to interfere with the blood sugar levels of diabetes patients, and it is important that you communicate fully with your doctor about any other conditions and medications that are part of your overall medical treatment.

As with all medications, be sure to comprehensively discuss the use of Amiloride and Hydrochlorothiazide with your medical care provider if you are pregnant, breastfeeding, or plan to become pregnant in the near future. While there have been no conclusive negative results in the study of this drug in the use of animals that are pregnant, it is best to thoroughly consult with your doctor whenever there is a major change in your overall health, such as pregnancy. While these animal studies do not show any significant risk to pregnancy, no comprehensive clinical studies have been conducted in pregnant women.

Likewise, there are no comprehensive clinical studies of the effects of this drug on women who are breastfeeding their children. It is important to remember that every situation is different and your doctor, who best understands your total health profile, will determine if this drug is appropriate for your use during pregnancy and breastfeeding.

Studies have not shown any side effects or medical reasons that Amiloride and Hydrochlorothiazide is not effective for use in pediatric and geriatric patients.

Use of this drug while consuming alcohol is not recommended. If you are concerned about your current level of alcohol consumption, it is a good idea to discuss this with your physician. Decreasing the use of alcohol and tobacco, especially in patients with high blood pressure, can improve the overall health and well-being of the patient.

High blood pressure and edema, the two conditions that this drug treats, can be improved with simple adjustments to the patients' diet and activity level. This drug helps to maintain a blood pressure level that will not cause harm and damage to the heart and arteries which can lead to further health complications. When the use of Amiloride and Hydrochlorothiazide is coupled with a diet that is low in sodium, and a moderate amount of regular exercise, there are many positive benefits.

Storage

Whenever possible, keep all medication in the container it originally came in. Avoid exposure to extreme hot and cold temperatures, moisture, and direct sunlight, and try to keep it at room temperature - between 59 and 86 degrees Fahrenheit. It is important that this medication not be stored in the bathroom, due to the high level of moisture that is often in that area of the home.

As with all other medications, be sure to keep Amiloride and Hydrochlorothiazide out of the reach of children and store the medication in a child-proof container. It is never good practice to flush unused medication down the toilet, nor should it be disposed of in the trash where it can be taken by someone else. Ask your doctor or pharmacist about the best and safest ways to dispose of outdated and unused medication.

Summary

Amiloride and Hydrochlorothiazide are two drugs that are often combined to treat both hypertension as well as edema (water retention) in patients that suffer from chronic heart failure. Available only via prescription, this drug is essentially a water pill, and removes excess water and salt from the body, which is an effective way to keep high blood pressure under control. The main risk with this drug is an increased level of potassium in the system, and overdose is also possible.

The increased flow of urine helps to reduce blood pressure, and Amiloride protects the body from losing too much potassium as more fluid is discharged from the body. There are several major drugs that do not interact well with this medicine, and it is important to always discuss all of the medications that you are taking with your doctor in a comprehensive manner.

Diabetes patients must be aware of the effects that this drug can have on their blood sugar and discuss effective strategies for managing this effect with their doctor. Your doctor should be aware of all medicines that you are currently taking, whether they be prescription, over the counter, herbal, or a vitamin or mineral supplement. Be sure to advise your physician of all of your health conditions and concerns prior to beginning treatment of your hypertension or edema with Amiloride and Hydrochlorothiazide.

Patients that suffer from high blood pressure often have the condition without any major symptoms. As a result of this, some patients will cease taking the medication because they feel fine, which can cause a decrease in their overall health and increase the likelihood of further complications from hypertension. If you are prescribed this drug, be sure to take it as directed, even if you don't think that your symptoms warrant this action. High blood pressure is never fully cured, and this medication only helps to maintain a healthier blood pressure level. Consult with your doctor prior to making any changes to how you take this or any other of your medications.

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Last Reviewed:
December 10, 2017
Last Updated:
April 05, 2018
Content Source: