For sickle cell disease: zinc sulfate 220 mg three times daily. 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. Tarssanen L, Huikko M, Rossi M "Amiloride-induced hyponatremia. Patients with persistent hyperkalemia may require dialysis.
Hyperkalemia has been associated with cardiac irregularities. a b ECG changes associated with hyperkalemia are mainly characterized by tall, peaked T waves or elevations since previous tracings. Antikaliuretic therapy should be instituted only with caution in severely ill patients in whom respiratory or metabolic acidosis may occur, such as patients with cardiopulmonary disease or poorly controlled diabetes. If Midamor is given to these patients, frequent monitoring of acid-base balance is necessary. If hyperkalemia occurs in patients taking Midamor, the drug should be discontinued immediately. Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.
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. ST segment also may occur. a b ECG changes do not usually occur in patients who develop mild hyperkalemia during amiloride therapy.
In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. Has been used to correct the metabolic alkalosis produced by thiazides and other kaliuretic diuretics. Midamor should be discontinued at least three days before glucose tolerance testing.
Other reactions have been reported but occurred under circumstances where a causal relationship could not be established. However, in these rarely reported events, that possibility cannot be excluded. Therefore, these observations are listed to serve as alerting information to physicians. 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. 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. May increase urinary aldosterone and plasma renin concentrations, probably as a compensatory feedback mechanism caused by potassium retention and natriuresis. Safety and efficacy have not been established in patients younger than 18 years. 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. Keep out of the reach of children. 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. Monitor serum electrolyte, creatinine, and BUN periodically; some clinicians recommend weekly determinations during initiation of therapy. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.
Does not competitively inhibit aldosterone; activity is independent of aldosterone concentrations. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Vidt DG "Mechanism of action, pharmacokinetics, adverse effects, and therapeutic uses of amiloride hydrochloride, a new potassium-sparing diuretic. All medicines may cause side effects, but many people have no, or minor, side effects. Maximum 20 mg daily recommended by some experts. theophylline
Does not appear to be diabetogenic or to alter carbohydrate metabolism in humans. Some medical conditions may interact with Midamor. The presence of other medical problems may affect the use of this medicine. Increase dosage as necessary up to a maximum of 20 mg once daily. Zinc might decrease blood sugar in people with type 2 diabetes. Diabetes medications are also used to lower blood sugar. Taking zinc along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed. Amiloride is known to cause significant elevations in serum aldosterone, renin, and angiotensin II levels. If you miss a dose of Midamor, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. This may not be a complete list of all interactions that may occur. Ask your health care provider if Midamor may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Lynn KL, Bailey RR, Swainson CP, Sainsbury R, Low WI "Renal failure with potassium-sparing diuretics. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. If it is necessary to use Midamor alone see the starting dosage should be one 5 mg tablet daily. This dosage may be increased to 10 mg per day, if necessary. More than two 5 mg tablets 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. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. buy glimepiride stock direct glimepiride
The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Drugs. Davidson C, Burkinshaw L, Morgan DB "The effects of potassium supplements, spironolactone or amiloride on the potassium status of patients with heart failure. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Patient advice: Advise patients to avoid potassium supplements and foods containing high levels of potassium, including salt substitutes. Midamor may cause drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Midamor with caution. 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. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Management of edema associated with heart failure, cirrhosis of the liver, or secondary hyperaldosteronism. Do not keep outdated medicine or medicine no longer needed. Not all side effects for Midamor may be reported. You should always consult a doctor or healthcare professional for medical advice. Anuria, acute or chronic renal insufficiency, diabetic nephropathy. Warning signs or symptoms of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, shock, and ECG abnormalities. Monitoring of the serum potassium level is essential because mild hyperkalemia is not usually associated with an abnormal ECG. Initial diagnostic measure to provide presumptive evidence of primary hyperaldosteronism while patients are on normal diets. Some MEDICINES MAY INTERACT with Midamor. Used in fixed combination with hydrochlorothiazide for treatment of hypertension in patients who require a thiazide diuretic and in whom the development of hypokalemia cannot be risked and in patients who develop hypokalemia during hydrochlorothiazide monotherapy.
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. AMILoride and ethanol may have additive effects in lowering your blood pressure. Long-term maintenance therapy for patients deemed unsuitable for surgery or those with idiopathic hyperaldosteronism. Amiloride alone has mild hypotensive activity. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Midamor while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking Midamor. Initially, 5 mg daily; a b 524 increase dosage as necessary to 10 mg daily. American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. Significantly elevated serum uric acid, cholesterol, and triglyceride levels have been associated with combination hydrochlorothiazide-amiloride therapy. These metabolic abnormalities may not be due to amiloride since they are reported during hydrochlorothiazide monotherapy. Food decreases the extent of GI absorption to about 30%, but does not affect the rate of absorption. Patterson JH, Adams KF Jr, Applefeld MM et al. Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Pharmacotherapy. osel.info digoxin
Lithium generally should not be given with diuretics because they reduce its renal clearance and add a high risk of lithium toxicity. Read circulars for lithium preparations before use of such concomitant therapy. Reevaluate need for amiloride therapy following initial diuresis with a kaliuretic diuretic, since potassium loss may decrease. a Subsequent dosage adjustment may be necessary, or amiloride may be used intermittently. Renal side effects including renal insufficiency is unusual after amiloride the active ingredient contained in Midamor monotherapy because it is only a weak diuretic. The adverse reactions for Midamor listed in the following table have been arranged into two groups: 1 incidence greater than one percent; and 2 incidence one percent or less. The incidence for group 1 was determined from clinical studies conducted in the United States 837 patients treated with Midamor. The adverse effects listed in group 2 include reports from the same clinical studies and voluntary reports since marketing. The probability of a causal relationship exists between Midamor and these adverse reactions, some of which have been reported only rarely. Has been used in combination with hydrochlorothiazide in patients with recurrent calcium nephrolithiasis. 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. AB1, AB2, AB3, etc. Treatment of patients with hypokalemia when other measures are considered inappropriate or inadequate. 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. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Midamor should not be given to patients receiving other potassium-conserving agents, such as spironolactone or triamterene. Amiloride is a type of diuretic water pill that helps prevent your body from losing too much potassium. Safety and effectiveness in pediatric patients have not been established. Not metabolized in the liver. Minor Be cautious with this combination. The information contained in the Truven Health Micromedex products as delivered by Drugs. order serophene uk
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About 50% of an oral dose is absorbed. Titrate dosage carefully and monitor serum electrolytes closely because of increased risk of hyperkalemia with monotherapy. Administer orally, preferably with food to decrease GI adverse effects. generic etoricoxib good
Zinc can attach to tetracyclines in the stomach. This decreases the amount of tetracyclines that can be absorbed. Taking zinc with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction, take tetracyclines 2 hours before or 4-6 hours after taking zinc supplements. Evaluate BUN and serum potassium and creatinine concentrations regularly, especially in patients with suspected or confirmed renal insufficiency. a b Monitor serum potassium concentrations closely in geriatric and diabetic patients. a b Avoid use in diabetic patients, if possible, because of the risk of hyperkalemia.
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. Drinking alcohol with this medicine can cause side effects. Your doctor may recommend you eat certain foods or take supplements to keep your potassium from getting too low. Follow the diet and medication plan created for you by your doctor or nutrition counselor. podofilox
Treatment or prevention of hypokalemia induced by thiazide or other kaliuretic diuretics in patients with heart failure or hypertension. 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. Amiloride should rarely be used alone, because such use may result in increased risk of hyperkalemia. a b Use alone only when persistent hypokalemia has been documented. flonase