Usual Adult Dose for Congestive Heart Failure

Initial dose: Amiloride 5 mg-Hydrochlorothiazide 50 mg orally once a day or in divided doses
Maintenance dose: Amiloride 5 to 10 mg-Hydrochlorothiazide 50 to 100 mg orally once a day or in divided doses

Comments:

• Doses greater than amiloride 10 mg-hydrochlorothiazide 100 mg per day are usually not needed and there is no controlled data with such doses.
• Hydrochlorothiazide can be given at doses of 12.5 to 50 mg per day when used alone.
• Patients usually do not require more than hydrochlorothiazide 50 mg per day when combined with other antihypertensive agents.

Use: Treatment of patients with hypertension or congestive heart failure who develop hypokalemia when thiazides or other kaliuretic diuretics are used alone, or in whom maintenance of normal serum potassium levels is considered to be clinically important (e.g., digitalized patients or patients with significant cardiac arrhythmias).

Usual Adult Dose for Hypertension

Initial dose: Amiloride 5 mg-Hydrochlorothiazide 50 mg orally once a day or in divided doses
Maintenance dose: Amiloride 5 to 10 mg-Hydrochlorothiazide 50 to 100 mg orally once a day or in divided doses

Comments:

• Doses greater than amiloride 10 mg-hydrochlorothiazide 100 mg per day are usually not needed and there is no controlled data with such doses.
• Hydrochlorothiazide can be given at doses of 12.5 to 50 mg per day when used alone.
• Patients usually do not require more than hydrochlorothiazide 50 mg per day when combined with other antihypertensive agents.

Use: Treatment of patients with hypertension or congestive heart failure who develop hypokalemia when thiazides or other kaliuretic diuretics are used alone, or in whom maintenance of normal serum potassium levels is considered to be clinically important (e.g., digitalized patients or patients with significant cardiac arrhythmias).

Renal Dose Adjustments

Use with caution

If impairment becomes evident: Discontinue this drug.

Liver Dose Adjustments

Use with caution

Precautions

US BOXED WARNING:

• HYPERKALEMIA: Like other potassium-conserving diuretic combinations, amiloride and hydrochlorothiazide may cause hyperkalemia (serum potassium levels greater than 5.5 mEq/L). In patients without renal impairment or diabetes mellitus, the risk of hyperkalemia with this combination product is about 1% to 2%. This risk is higher in patients with renal impairment or diabetes mellitus (even without recognized diabetic nephropathy). Since hyperkalemia is potentially fatal if uncorrected, it is essential to monitor serum potassium levels carefully in any patient receiving amiloride hydrochloride and hydrochlorothiazide, particularly during treatment initiation, dose adjustments, and any illness that could affect renal function.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice: Should be taken with meals.

Storage requirements: Protect from light.

Monitoring:

• Metabolic: Serum electrolytes