Last updated on: 14.11.2021

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Amiloride (like triamterene) belongs to the potassium-sparing diuretics and is approved for lowering blood pressure in arterial hypertension, relieving heart failure and treating edema. Amiloride is combined with other thiazide diuretics such as bemetizide, hydrochlorothiazide and xipamide or loop diuretics.

Spectrum of action
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Pharmacologically, amiloride (molecular formula: C6H8ClN70) is a pyrazine derivative. It continues to contain a guanidino group. Amiloride inhibits the aldosterone-dependent epithelial sodium channel in the late distal tubule of the nephron. In this part of the tubule system, sodium ions are passively reabsorbed from the urine. This occurs in exchange with potassium ions. If sodium reabsorption is inhibited by blocking the channel, the excretion of sodium ions via the kidneys increases. Secondarily, the excretion of potassium is reduced. At the same time, water is excreted along with the sodium and thus urine is increased (sodium binds water in a hydrate shell).

Amiloride and its metabolites are excreted 50% by the kidneys and 50% by the stool. The half-life is about 18 h.

Undesirable effects
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  • Exsiccosis
  • Sodium deficiency
  • Increase in blood urea levels,

Ophthalmological UAW:

  • Visual disturbances such as worsening of existing myopia.
  • Xerophthalmia
  • Glaucoma

Dermatological UAW:

  • Pruritus
  • Reddening of the skin
  • Exanthema
  • Urticaria
  • Photosensitivity
  • Lupus erythematosus
  • Increased sweating (hyperhidrosis)

Electrolyte disorders

Metabolic disorders

  • Increase in blood glucose
  • Glucosuria
  • Increase in blood lipids
  • Increase in uric acid concentration

Haematological UAW

  • Leukopenia
  • Anemia

Cardiac adverse events:

  • Cardiac arrhythmias
  • Hyperkalaemia (this risk is particularly present in patients with diabetes mellitus and impaired renal function or metabolic acidosis).
  • Patients with liver cirrhosis are at risk of megaloblastic anaemia.

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Combination with other antihypertensives increases antihypertensive effect

Non-steroidal anti-inflammatory drugs may inhibit the effect of amiloride

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hypersensitivity to the active substance

Potassium deficiency

Pregnancy and breastfeeding

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Moduretic®, Amiloretic®,

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Last updated on: 14.11.2021