amiloride hydrochloride + furosemide: clinical use

Prescribing considerations

• Confirm a condition requiring prompt diuresis and a clinical reason to conserve potassium.
• Correct hypovolaemia, hypotension and significant electrolyte or acid-base disturbance before treatment.
• Ensure urinary output; monitor closely where urinary outflow may be obstructed.
• Use particular caution with renal or hepatic impairment, diabetes, gout, hypoproteinaemia, systemic lupus erythematosus and in older adults.
• Review concomitant medicines for effects on potassium, renal function, blood pressure, lithium concentrations and ototoxicity.

Contraindications and cautions

• Hypersensitivity to amiloride, furosemide, sulfonamides, sulfonamide derivatives or product excipients
• Hypovolaemia or dehydration
• Severely impaired renal function as defined in the selected SmPC, anuria or specified forms of renal failure
• Hyperkalaemia, severe hypokalaemia or severe hyponatraemia
• Concomitant potassium supplements or potassium-sparing diuretics
• Precomatose states associated with cirrhosis or Addison's disease
• Breastfeeding
• Children and adolescents younger than 18 years

Monitoring

• Volume status, blood pressure and urinary output
• Serum sodium, potassium, creatinine, urea and glucose
• Closer potassium monitoring with impaired renal function or medicines that increase potassium
• Clinical response and signs of dehydration, hypotension, electrolyte disturbance, gout or worsening glucose control
• Fetal growth if use during pregnancy is considered medically essential

Clinical pharmacology

Furosemide is a potent loop diuretic that increases sodium, chloride and water excretion. Amiloride blocks distal tubular sodium uptake and reduces potassium secretion, adding natriuresis while limiting furosemide-related potassium loss. Both are substantially eliminated unchanged in urine.

Formulation and product differences

• The selected presentation is an oral tablet.
• It contains lactose and Sunset Yellow FCF (E110), which may cause allergic reactions.
• Its sodium content is considered essentially sodium-free.

Tablet

Route: Oral

Strengths: 5 mg + 40 mg