Amiloride + hydrochlorothiazide

Should be taken with food.

Hyperkalaemia; anuria; acute renal failure, severe progressive renal disease; severe hepatic failure, precoma associated with hepatic cirrhosis; Addison's disease; hypercalcaemia; diabetic neuropathy; DM. Child <18 yr. Lactation.

Renal impairment; BUN >10 mmol/L, serum creatinine >130 mmol/L. Monitor serum electrolytes and blood urea levels in seriously ill patients e.g. those with hepatic cirrhosis with ascites and metabolic alkalosis, or those with resistant oedema. Pre-existing severe liver disease. May affect parathyroid function. Hyperuricaemia or gout may occur. Cholesterol and triglyceride levels may be increased. Thiazides may impair glucose tolerance. DM may be precipitated or aggravated. May activate or exacerbate SLE. Elderly. Hyponatraemia. Pregnancy.

Electrolyte imbalance e.g. hyponatraemia, hypochloraemic alkalosis, hypokalaemia and hypomagnesaemia. Anaphylaxis, back pain, chest pain, fatigue, fever, headache, malaise, neck/shoulder ache, pain in extremities, syncope, weakness; angina, arrhythmias, digitalis toxicity, orthostatic hypotension, necrotising angiitis, palpitation and tachycardia; GI disturbances; agranulocytosis, aplastic anaemia, haemolytic anaemia, leucopenia, neutropenia, purpura and thrombocytopenia; alopecia, diaphoresis, dry mouth, flushing, photosensitivity, pruritis, rash, sialadenitis and urticaria; glycosuria, gout, hyperglycaemia and hyperuricaemia; joint pain, leg ache and muscle cramps; dizziness, encephalopathy, paraesthesia, stupor, tremors, vertigo; decreased libido, depression, insomnia, mental confusion, nervousness, restlessness, sleepiness and somnolence; cough, dyspnoea and respiratory distress; bad taste, increased intraocular pressure, nasal congestion, tinnitus, visual disturbance and xanthopsia; bladder spasm, dysuria, impotence, incontinence, interstitial nephritis, nocturia, polyuria, renal dysfunction.

Additive effects with other antihypertensives. May increase the responsiveness to tubocurarine. May reduce arterial responsiveness to pressor amines e.g. norepinephrine. Orthostatic hypotension may occur with alcohol, barbiturates and narcotics. Discontinue diuretics 2-3 days before initiation of an ACE inhibitor to reduce the likelihood of 1st dose hypotension. Increased hypokalaemia with corticosteroids or ACTH. Attenuation of diuretic, natriuretic and antihypertensive effects of diuretics with NSAIDs. Increased hyponatraemia with chlorpropamide. Increased hyperkalaemia with ciclosporin, tacrolimus, indometacin and angiotensin II receptor antagonists.

Diuretics

C03DB01 - amiloride ; Belongs to the class of other potassium-sparing agents. Used as diuretics.
C03AA03 - hydrochlorothiazide ; Belongs to the class of low-ceiling thiazide diuretics.