Schiffl H, Schollmeyer P "Clinical efficacy and safety of long-term diuretic treatment in renal parenchymal hypertension. BUN levels. Potassium retention associated with the use of an antikaliuretic agent is accentuated in the presence of renal impairment and may result in the rapid development of hyperkalemia. For muscle cramps in zinc deficient people with liver disease: zinc sulfate 220 mg twice daily. Some medical conditions may interact with Midamor. cheap pyrantel buy shopping usa
Potassium-sparing effect of amiloride generally persists during prolonged therapy with the drug, but may diminish with time in some patients. NDC 0574-0291-01 bottles of 100. 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.
Diuretic activity usually occurs within 2 hours. Some MEDICINES MAY INTERACT with Midamor. 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.
Inc. Midamor amiloride HCl tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. 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. 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.
Use Midamor with caution in the ELDERLY; they may be more sensitive to its effects. 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. 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. 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. If you have any questions about Midamor, please talk with your doctor, pharmacist, or other health care provider. Anon. Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Part II. Management of heart failure: approaches to the prevention of heart failure. Am J Cardiol. Renal clearance may be reduced in patients with renal impairment. L may occur with all potassium-sparing agents, including amiloride. a b c See Boxed Warning. 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. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. 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. 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. 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. Midamor is not an aldosterone antagonist and its effects are seen even in the absence of aldosterone. Midamor Amiloride HCl is available for oral use as tablets containing 5 mg of anhydrous amiloride HCl. 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.
Not metabolized in the liver. Effect on urinary electrolyte excretion persists for about 24 hours. Patients with persistent hyperkalemia may require dialysis. 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. 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. zestoretic
If hyperkalemia occurs in patients taking Midamor, the drug should be discontinued immediately. 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. Amiloride is known to cause significant elevations in serum aldosterone, renin, and angiotensin II levels. When amiloride is used in fixed combination with hydrochlorothiazide, consider the cautions, precautions, and contraindications associated with hydrochlorothiazide. Consult WARNINGS section for additional precautions. 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. For treating the common cold: one zinc gluconate or acetate lozenge, providing 9-24 mg elemental zinc, dissolved in the mouth every two hours while awake when cold symptoms are present. Amiloride should rarely be used alone, because such use may result in increased risk of hyperkalemia. a b Use alone only when persistent hypokalemia has been documented. 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. 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. Maximum 40 mg daily. Different salt forms provide different amounts of elemental zinc. Zinc sulfate contains 23% elemental zinc; 220 mg zinc sulfate contains 50 mg zinc. buy cheapest celebrex visa europe celebrex
Management of edema associated with heart failure, cirrhosis of the liver, or secondary hyperaldosteronism. Patient advice: Advise patients to avoid potassium supplements and foods containing high levels of potassium, including salt substitutes. 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. ST segment also may occur. a b ECG changes do not usually occur in patients who develop mild hyperkalemia during amiloride therapy. Importance of informing patients of other important precautionary information. a See Cautions. 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. 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. Duration of therapy: Treatment should be continued for at least 2 weeks to achieve a maximum response. Subsequently, the dose may be adjusted according to patient response. C; a protect from moisture, freezing, and excessive heat. Maximum 20 mg once daily. 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. 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. cyclophosphamide price in canada
Increased BUN concentration may occur, most frequently during forced diuresis in debilitated patients with hepatic cirrhosis with ascites and metabolic alkalosis or in those with resistant edema. a b In such patients, monitor BUN concentration carefully when amiloride is used with other diuretics. Store Midamor at room temperature, between 59 and 86 degrees F 15 and 30 degrees C in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Midamor out of the reach of children and away from pets. 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. 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 should be discontinued at least three days before glucose tolerance testing. 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. However, some clinicians state maximum effective dosage may be as high as 40 mg daily. Anuria, acute or chronic renal insufficiency, diabetic nephropathy. Safety and efficacy of amiloride alone or in fixed combination with hydrochlorothiazide not established; a b c however, some experts have suggested an amiloride dosage for hypertension based on limited clinical experience. a See Pediatric Patients under Dosage and Administration. 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. About 50% of an oral dose is absorbed. 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. 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.
Take Midamor by mouth with food. American Heart Association Task Force on practice guidelines. Circulation. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. 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. 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. buy legit cozaar
Monitor serum electrolyte and BUN concentrations closely in patients with hepatic cirrhosis with ascites and metabolic alkalosis receiving amiloride in combination with other diuretics. Importance of taking drug with food to help avoid stomach upset. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Use with caution in patients with severe, preexisting hepatic insufficiency because of risk of hepatic encephalopathy; monitor such patients carefully for signs and symptoms of hepatic encephalopathy. Potassium-sparing effect of amiloride is additive with that of spironolactone. a May be effective in some patients unresponsive to spironolactone; unlike spironolactone, diuretic effect of amiloride is independent of aldosterone concentrations. Major Do not take this combination. mail order now antivert australia antivert
May increase urinary aldosterone and plasma renin concentrations, probably as a compensatory feedback mechanism caused by potassium retention and natriuresis. If hypokalemia persists after an adequate trial of 10 mg daily, may increase dosage to 15 and then 20 mg daily. Warning signs of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, and shock. 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. Amiloride Midamor is used as a "water pill" to help remove excess water from the body. Another effect of amiloride Midamor is that it can increase the amount of zinc in the body. Taking zinc supplements with amiloride Midamor might cause you to have too much zinc in your body. Dosing considerations for Zinc. Zinc might decrease blood sugar in people with type 2 diabetes. Diabetes medications are also used to lower blood sugar. Taking zinc along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed. 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. Duration of therapy: When given as the sole diuretic, continue the initial dose for at least 5 days, after which the initial dose may be adjusted to an optimal maintenance dose. For the eating disorder anorexia nervosa: 100 mg of zinc gluconate daily. Increases urinary excretion of sodium, calcium, and bicarbonate with little, if any, increase in chloride excretion. The information contained in the Truven Health Micromedex products as delivered by Drugs. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA. According to some clinicians, maximum effective daily dosage may be as high as 40 mg daily. Clinical studies of Midamor did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy. Ask your healthcare professional how you should dispose of any medicine you do not use. fexofenadine
Safety and efficacy have not been established in patients younger than 18 years. Davidson C, Burkinshaw L, Morgan DB "The effects of potassium supplements, spironolactone or amiloride on the potassium status of patients with heart failure. The dose of this drug should remain unchanged if a second diuretic is added. Store at room temperature away from moisture, heat, or freezing temperatures. What happens if I miss a dose? 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. Hummel SL, Konerman MC. Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt? Amiloride is a type of diuretic water pill that helps prevent your body from losing too much potassium.
The presence of other medical problems may affect the use of this medicine. Some experts state that inclusion in combination drug regimens may be considered in patients with resistant hypertension. 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. In some patients, it may be beneficial to administer the usual 5- to 10-mg daily dosage in 2 divided doses daily. Prophylaxis of hypokalemia in patients taking digitalis when other measures are considered inadequate or inappropriate. 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. No data are available in regard to overdosage in humans. purchase cheapest cipro online australia
For treating stomach ulcers: zinc sulfate 200 mg three times daily. Initially, 5 mg daily; increase dosage as necessary to 10 mg 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. Long-term maintenance therapy for patients deemed unsuitable for surgery or those with idiopathic hyperaldosteronism. Do not stop taking any medications without consulting your healthcare provider. 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. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. 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. Genitourinary problems include rare complaints of impotence. Polyuria and urinary frequency are reported in less than 1% of patients. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC 7. Bethesda, MD: National Institutes of Health; 2004 Aug. NIH publication No. 04-5230. dref.info zithromax
Administer orally, preferably with food to decrease GI adverse effects. Wilson JR, Reichek N, Dunkman WB et al. Effect of diuresis on the performance of the failing left ventricle in man. Am J Med. Minor adverse reactions were reported relatively frequently about 20% but the relationship of many of the reports to amiloride HCl is uncertain and the overall frequency was similar in hydrochlorothiazide treated groups. For hypogeusia sense of taste is abnormal: 25-100 mg zinc. Excreted in urine 50% as unchanged drug and in feces 40% possibly as unabsorbed drug. Midamor may cause drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Midamor with caution. Midamor should be administered with food. Inc. Moduretic amiloride HCl-hydrochlorothiazide tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. Potassium-sparing diuretic; pyrazinecarbonyl guanidine derivative. Yancy CW. The Uncertainty of Sodium Restriction in Heart Failure: We Can Do Better Than This. JACC Heart Fail. See Specific Drugs, Foods, and Laboratory Tests under Interactions. 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. Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of amiloride in the elderly. Ask your health care provider any questions you may have about how to use Midamor. 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. sumatriptan
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Exhibits potassium-sparing effect when used with kaliuretic diuretics. Lynn KL, Bailey RR, Swainson CP, Sainsbury R, Low WI "Renal failure with potassium-sparing diuretics. For treating acne: 30-135 mg elemental zinc daily. 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 adverse reactions for Midamor listed in the following table have been arranged into two groups: 1 incidence greater than one percent; and 2 incidence one percent or less. The incidence for group 1 was determined from clinical studies conducted in the United States 837 patients treated with Midamor. The adverse effects listed in group 2 include reports from the same clinical studies and voluntary reports since marketing. The probability of a causal relationship exists between Midamor and these adverse reactions, some of which have been reported only rarely. Has been used in combination with hydrochlorothiazide in patients with recurrent calcium nephrolithiasis.
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. Yellow 10, iron oxide, lactose, magnesium stearate and starch. Registered trademark of Paddock Laboratories, Inc. 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.
Other reactions have been reported but occurred under circumstances where a causal relationship could not be established. However, in these rarely reported events, that possibility cannot be excluded. Therefore, these observations are listed to serve as alerting information to physicians. Disclaimer: Every effort has been made to ensure that the information provided by Multum, Truven Health Analytics, Inc. Minor Be cautious with this combination. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Nervous system side effects occur in less than 3% of patients, and include headache, weakness, and fatigue. Encephalopathy may be induced by amiloride-associated metabolic changes in some patients with severe liver disease.