There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. 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. Teratogenicity studies with amiloride HCl in rabbits and mice given 20 and 25 times the maximum human dose, respectively, revealed no evidence of harm to the fetus, although studies showed that the drug crossed the placenta in modest amounts. Reproduction studies in rats at 20 times the expected maximum daily dose for humans showed no evidence of impaired fertility. At approximately 5 or more times the expected maximum daily dose for humans, some toxicity was seen in adult rats and rabbits and a decrease in rat pup growth and survival occurred. umud.info doxylamine
AB1, AB2, AB3, etc. Titrate dosage carefully and monitor serum electrolytes closely because of increased risk of hyperkalemia with monotherapy. Use appropriate replacement therapy in those who are sodium depleted. a Use water restriction rather than replacement of sodium chloride in edematous patients with dilutional hyponatremia during hot weather, except in rare instances when hyponatremia is life-threatening. For diarrhea in malnourished or zinc-deficient children: 10-40 mg elemental zinc daily. Administer orally with food.
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. Has been used to correct the metabolic alkalosis produced by thiazides and other kaliuretic diuretics. 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. Warning signs of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, and shock.
Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; dry mouth; excessive thirst; slowed heart rate; unusual muscle weakness; unusual tiredness; vomiting. This medicine may increase the amount of potassium in your blood. Midamor usually begins to act within 2 hours after an oral dose. Its effect on electrolyte excretion reaches a peak between 6 and 10 hours and lasts about 24 hours. Peak plasma levels are obtained in 3 to 4 hours and the plasma half-life varies from 6 to 9 hours. 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. naprosyn
ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension ESH and of the European Society of Cardiology ESC. J Hypertens. 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. 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. Substantially eliminated by kidneys; assess renal function periodically since geriatric patients are more likely to have decreased renal function. The presence of other medical problems may affect the use of this medicine. MIDAMOR should be administered with food. Distributed into milk in animals; not known whether distributed into human milk. It is not known whether the drug is dialyzable. Exerts potassium-sparing effect by decreasing sodium reabsorption in the distal tubule and reducing both potassium and hydrogen secretion and subsequent excretion. Some experts state that inclusion in combination drug regimens may be considered in patients with resistant hypertension. Do not stop taking any medications without consulting your healthcare provider. Inc. Moduretic amiloride HCl-hydrochlorothiazide tablets prescribing information. Whitehouse Station, NJ; 2002 Nov.
Schiffl H, Schollmeyer P "Clinical efficacy and safety of long-term diuretic treatment in renal parenchymal hypertension. Maximum 20 mg daily recommended by some experts. 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. For the eating disorder anorexia nervosa: 100 mg of zinc gluconate daily. ST segment also may occur. a b ECG changes do not usually occur in patients who develop mild hyperkalemia during amiloride therapy. irbesartan
C; a protect from moisture, freezing, and excessive heat. Hummel SL, Konerman MC. Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt? National high blood pressure education program working group on hypertension control in children and adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. For treating attention deficit-hyperactivity disorder ADHD in children: doses of zinc sulfate 55 mg 15 mg elemental zinc to 150 mg 40 mg elemental zinc daily. Take Midamor by mouth with food. Metabolic side effects are the most common. Amiloride may cause hyperkalemia in up to 10% of patients, although the risk is decreased to about 1% to 2% when thiazide or loop diuretics are coadministered. Patients with diabetes or who are on other potassium-sparing therapy, ACE inhibitors, or potassium supplementation are predisposed to amiloride-induced hyperkalemia. 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. 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. For treating stomach ulcers: zinc sulfate 200 mg three times daily.
Inc. Midamor amiloride HCl tablets prescribing information. Whitehouse Station, NJ; 2002 Nov. Use with caution in patients with cardiopulmonary disease or uncontrolled diabetes mellitus because of risk of developing metabolic or respiratory acidosis, which may result in rapid increases in serum potassium concentration. a b Monitor acid-base balance frequently in such patients. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses. Long-term maintenance therapy for patients deemed unsuitable for surgery or those with idiopathic hyperaldosteronism. Anuria, acute or chronic renal insufficiency, and evidence of diabetic nephropathy are contraindications to the use of Midamor. Effect on urinary electrolyte excretion persists for about 24 hours. Midamor should be discontinued at least three days before glucose tolerance testing. cheapest price for cyclosporin
Drinking alcohol with this medicine can cause side effects. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. About 50% of an oral dose is absorbed. Hypochloremia usually does not require specific treatment except in patients with severe hepatic or renal disease. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. For sickle cell disease: zinc sulfate 220 mg three times daily. Reactions occurring in 3% to 8% of patients treated with Midamor. Those reactions occurring in less than 3% of the patients are unmarked. Midamor is to be used only by the patient for whom it is prescribed. Do not share it with other people. 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. Genitourinary problems include rare complaints of impotence. Polyuria and urinary frequency are reported in less than 1% of patients. 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. 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. 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.
Safety and efficacy have not been established in patients younger than 18 years. Unlike thiazide diuretics, does not consistently inhibit the excretion of uric acid; has variable effects on serum uric acid concentration. Yancy CW. The Uncertainty of Sodium Restriction in Heart Failure: We Can Do Better Than This. JACC Heart Fail. 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. 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. L may occur with all potassium-sparing agents, including amiloride. a b c See Boxed Warning. Crosses the placenta in animals; not known whether crosses placenta in humans. According to some clinicians, maximum effective daily dosage may be as high as 40 mg daily. 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. Sherman LG, Liang CS, Baumgardner S et al. Piretanide, a potent diuretic with potassium-sparing properties, for the treatment of congestive heart failure. Clin Pharmacol Ther. Monitor serum electrolyte and BUN concentrations closely in patients with hepatic cirrhosis with ascites and metabolic alkalosis receiving amiloride in combination with other diuretics. 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. 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. 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. The use of potassium-conserving agents is often unnecessary in patients receiving diuretics for uncomplicated essential hypertension when such patients have a normal diet. Midamor has little additive diuretic or antihypertensive effect when added to a thiazide diuretic. Tablets Midamor, 5 mg, are yellow, diamond-shaped, compressed tablets, coded MSD 92 on one side and Midamor on the other. cheapest tacrolimus purchase online pharmacy
Increase dosage as necessary up to a maximum of 20 mg once daily. Excreted in urine 50% as unchanged drug and in feces 40% possibly as unabsorbed drug. 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. Initially, 5 mg daily; increase dosage as necessary to 10 mg daily. Patients with persistent hyperkalemia may require dialysis. Initially, 5 mg daily; a b 524 increase dosage as necessary to 10 mg daily. Talk with your health provider. Maintenance dose: 100 to 400 mg orally per day until surgery; may be used long-term at the lowest effective dose in patients deemed unsuitable for surgery. Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of amiloride in the elderly. Do not take other medicines unless they have been discussed with your doctor. Moderate Be cautious with this combination. 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. III to IV when used in addition to standard therapy. Has been used to control hypertension and correct electrolyte abnormalities associated with primary hyperaldosteronism. 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. This information should not be used to decide whether or not to take Midamor or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Midamor. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Midamor. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Midamor.
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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. Midamor should be administered with food. 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. cheapest place to buy mectizan
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. According to some clinicians, amiloride hydrochloride dosage should be reduced to the lowest effective level in any disease state, following initial diuresis with a kaliuretic diuretic. Treatment of patients with hypokalemia when other measures are considered inappropriate or inadequate. Treatment or prevention of hypokalemia induced by thiazide or other kaliuretic diuretics in patients with heart failure or hypertension.
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. 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. order generic clarithromycin payment usa
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. Known hypersensitivity to amiloride or any ingredient in the formulation. No data are available in regard to overdosage in humans.