Furosemide and Amiloride

Diuretic · Loop diuretic/Potassium sparing diuretic

Indications

Prompt diuresis where potassium conservation is important.

Dosage

Adults: 1-2 tab in the morning. Elderly, adjust according to renal function, response and electrolyte levels. Children: Not recommended.

Adverse Effects

Amiloride: Rash, photo sensitivity, blood dyscrasias, gout, hyperkalaemia, GI upset, anorexia. Furosemide: Disorders of electrolyte balance, dehydration, allergic reactions, GI upset, hypotension, rash, hyperuricaemia, hyperglycaemia, raised serum creatinine.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Amiloride: Hyperkalaemia, anuria, severe renal impairment, Addison's disease, diabetic nephropathy. Furosemide: Renal failure with anuria, hypokalaemia, hyponatraemia, hypotension, hypersensitivity to sulphonamides, in pregnancy for short time and if strictly indicated. Comatose or precomatose states associated with liver cirrhosis or encephalopathy, hypovolaemia, dehydration. Addison's disease. Precautions: Amiloride: Diabetes. Acidosis. Gout. Renal or hepatic impairment. Monitor urea and electrolyte. Elderly. Furosemide: Furosemide may pass into breast milk and inhibit lactation, stop breast feeding. Prostatic hypertrophy or impaired micturition. Monitor fluid and electrolyte balance, renal function, and blood counts. Diabetes, gout, renal or hepatic impairment, hepatorenal syndrome,…

Interactions

Amiloride: K+ supplement, K+ sparing diuretics, digitalis, lithium, antihypertensives, ACE inhibitors, angiotensin II antagonist, cyclosporin, tacrolimus, NSAIDs, other drugs with hypotensive effect, TCADs, MAOIs, St John's wort, carbamazepine, antipsychotics, corticosteroids, atomoxetine, oestrogen, drospirenone, alcohol. Furosemide: Digitalis, lithium, aminoglycosides, cephalosporins, antihypertensives, NSAIDs, digoxin, vancomycin, carbamazepine, phenytoin, corticosteroids, theophylline, risperidone, K+ - sparing diuretics, K+ suppl.

Pharmacokinetics

FUROSEMIDE: Onset of action: Diuresis: Oral, sublingual: 30-60 mins. IM: 30 mins. IV: Approx. 5 min. Symptomatic treatment with acute pulmonary oedema: Within 15-20 mins, occurs prior to diuretic effect. Peak effect: Oral, sublingual: 1-2 hrs. Duration: Oral, sublingual: 6-8 hrs. IV: 2 hrs. Metabolism: Minimally hepatic. Bioavailability: Oral Tab: 47%-64%. Oral soln: 50%. Sublingual adm of oral tab: Approx. 60%. Half-life elimination: Normal renal func: 0.5-2 hrs. End-stage renal disease: 9 hrs. Excretion: Urine (Oral: 50%, IV: 80%). Faeces. AMILORIDE: Onset: 2 hrs. Duration: 24 hrs. Absorption: 50% absorbed from GI tract. Metabolism: Insignificant. Half-life elimination: 6-9 hrs. Time to peak: 6-10 hrs. Excretion: Urine (mainly).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.