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. Different salt forms provide different amounts of elemental zinc. Zinc sulfate contains 23% elemental zinc; 220 mg zinc sulfate contains 50 mg zinc. May be particularly useful for preventing diuretic-induced hypokalemia in patients in whom the clinical consequences of hypokalemia represent an important risk, such as patients receiving cardiac glycosides or those with cardiac arrhythmias. fludrocortisone
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. Do not stop taking any medications without consulting your healthcare provider. The fixed-combination preparation with hydrochlorothiazide should be used for initial antihypertensive therapy only in selected patients in whom the potential development of thiazide-induced hypokalemia cannot be risked. a c See General under Dosage and Administration.
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses. Gupta D, Georgiopoulou VV, Kalogeropoulos AP et al. Dietary sodium intake in heart failure. Circulation. Midamor should not be given to patients receiving other potassium-conserving agents, such as spironolactone or triamterene. In diabetic patients, hyperkalemia has been reported with the use of all potassium-conserving diuretics, including Midamor, even in patients without evidence of diabetic nephropathy. Therefore, Midamor should be avoided, if possible, in diabetic patients and, if it is used, serum electrolytes and renal function must be monitored frequently.
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. 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. To increase growth and weight gain in children with sickle cell disease who have not reached puberty: 10 mg elemental zinc per day.
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking amiloride. MIDAMOR, one 5 mg tablet daily, should be added to the usual antihypertensive or diuretic dosage of a kaliuretic diuretic. The dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets of MIDAMOR daily usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. 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. Importance of taking drug with food to help avoid stomach upset. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.
NDC 0574-0291-01 bottles of 100. Protect from moisture, freezing and excessive heat. For the long test, correction of hypokalemia and hypertension provides presumptive evidence of primary hyperaldosteronism. Amiloride alone has mild hypotensive activity. Has been used to control hypertension and correct electrolyte abnormalities associated with primary hyperaldosteronism. Store at room temperature away from moisture, heat, or freezing temperatures. What happens if I miss a dose? azulfidine
In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. 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. Inc. Midamor amiloride HCl tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. Hypochloremia usually does not require specific treatment except in patients with severe hepatic or renal disease. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. buy genuine vermox vermox
The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA. Ask your healthcare professional how you should dispose of any medicine you do not use. If hyperkalemia occurs, discontinue amiloride immediately. Safety and efficacy have not been established in patients younger than 18 years. Talk with your health provider. where to purchase zovirax pharmacy
Reactions occurring in 3% to 8% of patients treated with Midamor. Those reactions occurring in less than 3% of the patients are unmarked. Battle DC, von Riotte AB, Gaviria M et al. Amelioration of polyuria by amiloride in patients receiving long-term lithium therapy. N Engl J Med. Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco. Midamor is a potassium-conserving antikaliuretic drug that possesses weak compared with thiazide diuretics natriuretic, diuretic, and antihypertensive activity. These effects have been partially additive to the effects of thiazide diuretics in some clinical studies. When administered with a thiazide or loop diuretic, Midamor has been shown to decrease the enhanced urinary excretion of magnesium which occurs when a thiazide or loop diuretic is used alone. Midamor has potassium-conserving activity in patients receiving kaliuretic-diuretic agents. Initially, 5 mg daily; a b 524 increase dosage as necessary to 10 mg daily. III to IV when used in addition to standard therapy. Take amiloride with food. Potassium-sparing effect of amiloride generally persists during prolonged therapy with the drug, but may diminish with time in some patients. 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. Co. Midamor amiloride hydrochloride tablets prescribing information. West Point, PA; 1992 Apr. For treating age-related macular degeneration AMD: elemental zinc 80 mg plus vitamin C 500 mg, vitamin E 400 IU, and beta-carotene 15 mg daily. 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.
Diuretic activity usually occurs within 2 hours. If it is necessary to use MIDAMOR alone see the starting dosage should be one 5 mg tablet daily. This dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. Hyperkalemia has been associated with cardiac irregularities. a b ECG changes associated with hyperkalemia are mainly characterized by tall, peaked T waves or elevations since previous tracings. Prophylaxis of hypokalemia in patients taking digitalis when other measures are considered inadequate or inappropriate. 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. Safety and effectiveness in pediatric patients have not been established. Inc. Moduretic amiloride HCl-hydrochlorothiazide tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. Used concomitantly with a thiazide diuretic mainly to prevent or treat diuretic-induced hypokalemia. a b See Hypokalemia Induced by Kaliuretic Diuretics under Uses. Food decreases the extent of GI absorption to about 30%, but does not affect the rate of absorption. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Titrate dosage carefully and monitor serum electrolytes closely because of increased risk of hyperkalemia with monotherapy. fluconazole online lowest price
The risk of hyperkalemia may be increased when potassium-conserving agents, including Midamor, are administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, cyclosporine or tacrolimus. Potassium-sparing diuretic; pyrazinecarbonyl guanidine derivative. ST segment also may occur. a b ECG changes do not usually occur in patients who develop mild hyperkalemia during amiloride therapy. Not all side effects for Midamor may be reported. You should always consult a doctor or healthcare professional for medical advice. Appropriate studies have not been performed on the relationship of age to the effects of amiloride in the pediatric population. Three-character codes are assigned only in situations when more than one reference listed drug of the same strength has been designated under the same heading. Two or more reference listed drugs are generally selected only when there are at least two potential reference drug products which are not bioequivalent to each other. If a study is submitted that demonstrates bioequivalence to a specific listed drug product, the generic product will be given the same three-character code as the reference listed drug it was compared against. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. Diarrhea; headache; loss of appetite; nausea; weakness. ille.info mycelex
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Check with your pharmacist about how to dispose of unused medicine. Patients with persistent hyperkalemia may require dialysis. 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. AHFS Drug Information 2017. McEvoy GK, ed. Amiloride hydrochloride. 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. cyclosporin
Use Midamor with caution in the ELDERLY; they may be more sensitive to its effects. If it is necessary to use Midamor alone see the starting dosage should be one 5 mg tablet daily. This dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. 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. Renal clearance may be reduced in patients with renal impairment. Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake. 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. 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. Patterson JH, Adams KF Jr, Applefeld MM et al. Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Pharmacotherapy. If you have any questions about Midamor, please talk with your doctor, pharmacist, or other health care provider. Anuria, acute or chronic renal insufficiency, and evidence of diabetic nephropathy are contraindications to the use of Midamor. For sickle cell disease: zinc sulfate 220 mg three times daily. In some patients, it may be beneficial to administer the usual 5- to 10-mg daily dosage in 2 divided doses daily. Renal side effects including renal insufficiency is unusual after amiloride the active ingredient contained in Midamor monotherapy because it is only a weak diuretic. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC VI. Bethesda, MD: National Institutes of Health. NIH publication No. 98-4080. Take Midamor by mouth with food.
Tablets Midamor, 5 mg, are yellow, diamond-shaped, compressed tablets, coded MSD 92 on one side and Midamor on the other. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. 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. All medicines may cause side effects, but many people have no, or minor, side effects. Treatment or prevention of hypokalemia induced by thiazide or other kaliuretic diuretics in patients with heart failure or hypertension. Richardson A, Bayliss J, Scriven AJ et al. Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. Lancet. McNay JL, Oran E "Possible predisposition of diabetic patients to hyperkalemia following administration of potassium-retaining diuretic, amiloride MK 870. Millar JA, Fraser R, Mason P, Leckie B, Cumming AM, Robertson JI "Metabolic effects of high dose amiloride and spironolactone: a comparative study in normal subjects. For muscle cramps in zinc deficient people with liver disease: zinc sulfate 220 mg twice daily. buy methimazole amsterdam
Keep out of the reach of children. Gastrointestinal complaints of diarrhea, nausea, constipation, anorexia, and general abdominal pain occur less than 5% of patients. Penicillamine is used for Wilson's disease and rheumatoid arthritis. Zinc might decrease how much penicillamine your body absorbs and decrease the effectiveness of penicillamine. Take zinc and penicillamine at least 2 hours apart. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. Do not take other medicines unless they have been discussed with your doctor. Reevaluate need for amiloride therapy following initial diuresis with a kaliuretic diuretic, since potassium loss may decrease. a Subsequent dosage adjustment may be necessary, or amiloride may be used intermittently. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. 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 drugs you are taking, check with your doctor, nurse or pharmacist. 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. Zinc might decrease how much antibiotic the body absorbs. Taking zinc along with some antibiotics might decrease the effectiveness of some antibiotics. To avoid this interaction, take antibiotics at least 2 hours before or 4-6 hours after zinc supplements. cheapest naltrexone buy uk
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When abnormal, the ECG in hyperkalemia is characterized primarily by tall, peaked T waves or elevations from previous tracings. There may also be lowering of the R wave and increased depth of the S wave, widening and even disappearance of the P wave, progressive widening of the QRS complex, prolongation of the PR interval, and ST depression. 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. However, some clinicians state maximum effective dosage may be as high as 40 mg daily. While using amiloride, you will need frequent blood tests. Your heart function may need to be checked using an electrocardiograph or ECG sometimes called an EKG.
Amiloride HCl was devoid of mutagenic activity in various strains of Salmonella typhimurium with or without a mammalian liver microsomal activation system Ames test. 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. C; a protect from moisture, freezing, and excessive heat. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Midamor while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking Midamor.
In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Therefore, when Midamor and non-steroidal anti-inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of the diuretic is obtained. Since indomethacin and potassium-sparing diuretics, including Midamor, may each be associated with increased serum potassium levels, the potential effects on potassium kinetics and renal function should be considered when these agents are administered concurrently.
Disclaimer: Every effort has been made to ensure that the information provided by Multum, Truven Health Analytics, Inc. Midamor, one 5 mg tablet daily, should be added to the usual antihypertensive or diuretic dosage of a kaliuretic diuretic. The dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets of Midamor daily usually are not needed, and there is little controlled experience with such doses. If persistent hypokalemia is documented with 10 mg, the dose can be increased to 15 mg, then 20 mg, with careful monitoring of electrolytes. Maximum 20 mg once daily.