• Amiloride is a water pill or a diuretic that causes the body to get rid of extra salt and water, without causing excess loss of potassium or hypokalemia.

Amiloride is a potassium-sparing diuretic or water pill. It brings about fluid loss via the kidneys without causing potassium loss. It is used with other diuretics to treat high blood pressure (hypertension),  heart failure, or accumulation of extra fluid in the body (edema).

It prevents low blood potassium levels when used the other diuretics. Amiloride may be used alone to increase blood potassium levels with regular monitoring in those with persistent low levels.  

Amiloride is contraindicated in patients with

• Hyperkalemia (high potassium levels), kidney impairment, anuria (absence of urine formation), diabetic kidney disease .
• Allergy to the drug
• Intake of other potassium sparing drugs like spironolactone , and potassium supplements, as well as salt substitutes.

• The recommended dosage of amiloride is one tablet of 5 mg per day, which can be increased to 10 mg per day if necessary.

• In case the hypokalemia (low blood potassium) persists, the dose can be increased to 15mg, and then 20 mg, but with careful monitoring of the electrolyte levels.

If the drug is taken too close to bedtime, the patient will need to wake up to urinate thereby disturbing his/her sleep, so it is best to take medication at least 4 hours before bedtime.

• Liver enzymes should be monitored in patients with liver impairment on amiloride. Amiloride is not recommended for nursing mothers.

• Serum potassium levels should be monitored during treatment.

• Amiloride should be avoided in diabetes patients or patients at a high risk of acidosis. It may also interfere with the results of glucose tolerance test.

•  General: Rash, weakness
•  Gastrointestinal: Nausea, loss of appetite, pain in the abdomen, excess gas
•  Blood: Hyperkalemia, hyponatremia (low blood sodium levels), hypochloremia (low blood chloride levels)
•  Kidney: Increase in blood urea nitrogen
•  Nervous system: Headache, encephalopathy in patients with severe liver disease, dizziness
•  Respiratory system: Cough, breathlessness
•  Reproductive system: Impotence

• Check with your doctor right away if you experience numbness or tingling in the hands, feet, or lips, weakness or heaviness and paralysis of the legs, slow heart rate or extremely low blood pressure as these could be signs of hyperkalemia.

• Hyperkalemia may occur if amiloride is administered with potassium-sparing diuretics like spironolactone and triamterene, ACE inhibitors, potassium supplements, indomethacin, cyclosporine or tacrolimus
• Amiloride may increase lithium levels resulting in lithium toxicity
• NSAIDs can reduce the diuretic effect of amiloride

• Store tablets at controlled room temperature (20° to 25°C), protect from moisture, freezing, and excessive heat.