1 What is Midamor?

Brand: Midamor

Generic: Amiloride Hydrochloride

Midamor is usually prescribed to treat or restore the potassium level in blood in those patients who are suffering from low potassium level along with hypertension or congestive heart failure (CHF).

It is used alone or in combination with other medicines in order to treat high blood pressure i.e. hypertension. Amiloride is categorized into potassium-sparing diuretics.

Potassium-sparing diuretics are either aldosterone antagonist or directly inhibit Na+ channels in DT and CD cells of renal tubules to indirectly conserve K+.

Monitoring of serum electrolytes, especially serum K+ level along with renal function tests is recommended while patients undergoing amiloride therapy. 

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2 What To Know Before Using

If you are about to start Midamor, speak with your doctor about what you need to know. This is a decision that your doctor will make with your active participation. For this medicine, certain factors such as present and past illness, drug interactions, metabolic impairments, hypersensitivity reactions, pregnancy, lactation etc. may alter the drug action. 

Inhibitors of renal epithelial Na+ channel (e.g. amiloride) are non-steroidal organic bases with identical actions. Their most important effect is to decrease K+ excretion, particularly when it is high due to large K+ intake or use of a diuretic that enhances K+ loss. This is accompanied by a small increase in Na+ excretion.

The excess urinary Na+ is matched by Clˉ and variable amounts of HCO₃ˉ resulting in slightly alkalinized urine. The luminal membrane of late DT and CD cells expresses a distinct ‘amiloride-sensitive’ or ‘renal epithelial’ Na+ channel through which Na+ enters the cell down its electrochemical gradient.

Amiloride is used in conjunction with thiazide-type or high ceiling diuretics to prevent hypokalemia and slightly augment the natriuretic and antihypertensive response. The risk of hyperkalemia is the most important adverse effect of amiloride.

Thus, it should not be given with K+ supplements to avoid dangerous hyperkalemia. Hyperkalemia is also more likely in patients receiving ACE inhibitors /ARBs, beta-blockers, NSAIDs and in those with renal impairment.

Amiloride is 10 times more potent than triamterene and at higher doses, it also inhibits Na+ reabsorption in PT, but this is clinically insignificant. It decreases Ca2+ excretion and increases urate excretion. Only 1/4of an oral dose is absorbed. It is not bound to plasma proteins and not metabolized.

3 Proper Usage

To use Midamor properly, you must follow all instructions given by your doctor. The dose of this medicine will vary according to patient’s condition or requirements. You should follow the doctor's directions and advice.

The amount of medicine that you take should not exceed the maximum therapeutic dose. Also, the frequency of your daily drug administration and the duration of drug therapy depend on the particular medical problem for which you are taking the medicine.

Therapeutic administration of Midamor is described below:

  • In order to treat hypertension (HTN): amiloride is used with thiazide diuretics in order to restore normal serum K+ levels. At the initial stage, 5 mg amiloride is usually added to kaliuretic diuretics. The maximum dose of amiloride should not exceed 10 mg/day.
  • In order to treat congestive heart failure (CHF): amiloride is used here in combination with a thiazide or other kaliuretic diuretics. This combination helps to prevent hypokalemia by restoring normal potassium level. 5 mg amiloride is given orally along with thiazide therapy. This dose can be increased up to 10 mg/day.
  • In order to treat hypokalemia: amiloride is also used alone. The therapeutic dose may vary but it is advised to start with 5 mg.

Always try to take your medicine in time. If you miss any dose of this medicine, you should take it as soon as possible. But when it is time for your next dose, then skip the missed dose and go back to your regular dosing schedule.

You should store the medicine in a closed container at room temperature away from heat, moisture, and direct light. 

4 Precautions To Take

Before using Midamor, there are some precautions you must take. Regular visits are recommended to make sure this medicine is working properly or not while you are undergoing amiloride therapy. Some important measures should be taken if you feel any discomfort following this drug therapy.

Firstly, you should stop using the drug and then consult with your physician immediately. Amiloride may be responsible for some side effects of its own so it should be used according to a doctor’s prescription.

Certain drugs should not be used concurrently with such medications. It is always recommended to consult with your doctor if you are in need of some drugs for another health problem.

Sometimes it is must avoid some particular medicines during this drug therapy in order to get rid of serious drug reactions. Before starting amiloride therapy, you should tell your doctor about any other drugs including herbal remedies or vitamins you are receiving.

This medicine is not advised for those who have had allergic reactions to such type of drugs or its constituents.

5 Potential Side Effects

Make sure you meet with your doctor in using Midamor to avoid unwanted potential side effects. There are some unwanted side-effects associated with each drug that usually do not need medical attention.

These side-effects usually go away during the treatment episode as your body adjusts to the medicine. Additionally, your health care professional may advise you about the ways how to prevent or reduce those unwanted side-effects.

Sometimes you may need to consult with the doctor if you feel any serious discomfort. The usual side effects like: