Midamor

Generic Name: Amiloride hydrochloride
Product Name: Midamor

Indication

Kalurilâ??s main use is in combination with other diuretics to prevent potassium loss during vigorous diuresis or long-term therapy. This is particularly important in patients who are receiving cardiac glycoside therapy, during which hypokalaemia is especially dangerous. Alone, Kaluril has mild diuretic and antihypertensive activity.
Conditions in which Kaluril is useful include:
– oedema of cardiac origin
– hypertension
– hepatic cirrhosis with ascites and oedema

Action

Amiloride is a potassium sparing diuretic. This means that the hypokalaemia (potassium loss) seen with other diuretic agents does not occur. Amiloride works on the distal convoluted tubule of the kidney, where it interferes with the exchange of sodium and potassium. Sodium excretion is moderately increased, which means water excretion (ie: diuresis) increases as well. This effect is mild in comparison to loop or thiazide diuretics. The main use of Kaluril is not its diuretic effect, but is to conserve potassium in patients receiving diuretic agents that are likely to cause hypokalaemia. Chloride excretion (which is decreased with other diuretics) remains unchanged or even increases slightly with use of Kaluril, meaning that the risk of hyperchloraemic acidosis is decreased.

Dose advice

Usually a response is seen within a day, but maximal effect may not be seen for several days. Dose should be adjusted according to weight loss and serum electrolytes, satisfactory weight loss is 0.5-1kg/day.
Kaluril alone
– initial dose should be 10mg as a single dose or two doses of 5mg
– maximum daily dose is 20mg
– once diuresis has been achieved, reduce dose by 5mg increments
Kaluril + other diuretic
Oedema of cardiac origin
– 5-10mg daily with other diuretic agent
– if satisfactory result is not achieved, gradually increase dose of both agents
– do not exceed 20mg/day of Kaluril
– attempt dosage reduction of both agents once diuresis has been achieved
Hypertension
– 5-10mg daily with usual antihypertensive dose of thiazide diuretic
– not usually necessary to exceed 10mg/day, and must not exceed 20mg/day
Hepatic cirrhosis with ascites
– initial small dose of Kaluril, usually 5mg is sufficient
– increase doses of both until satisfactory response is achieved
– do not exceed daily dose of 20mg Kaluril
– maintenance doses may be lower than those required to initiate diuresis

Schedule

S4

Common side effects

– hyperkalaemia (too much potassium in the blood)
– decrease in serum sodium
– decrease in serum chloride
– weakness
– headache
– nausea
– vomiting
– constipation
– impotence
– dizziness
– muscle cramps

Uncommon side effects

– diarrhoea
– loss of appetite
– dry mouth
– abdominal pain
– flatulence
– increased frequency of urination
– postural hypotension (lightheadedness on standing)
– palpitations (due to hyperkalaemia)
– rash
– joint or muscle pain
– increased plasma creatinine (indicator of renal function)

 

For further information talk to your doctor.