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Moduretic (Amiloride hydrochlorothiazide)
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Moduretic

Moduretic is used for treating fluid retention (edema) and high blood pressure. It may be used alone or with other medicines.

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Also known as:  Amiloride hydrochlorothiazide.

Description

Moduretic is a diuretic (water pill) and a combination of a potassium-sparing diuretic (amiloride) and a thiazide diuretic (hydrochlorothiazide). It works by making the kidneys eliminate sodium (salt) and water from the body, which helps to lower blood pressure. The amiloride component helps minimize potassium loss.

Brand name of Moduretic is Moduretic.

Dosage

Take Moduretic by mouth with food.

Moduretic may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.

If you want to achieve most effective results do not stop taking Moduretic suddenly.

Overdose

If you overdose Moduretic and you don't feel good you should visit your doctor or health care provider immediately.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture, light and heat. Do not freeze. Keep container closed tightly. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Moduretic are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Moduretic if you are allergic to Moduretic components or to any ingredient in Moduretic or any other sulfonamide (eg, sulfamethoxazole).

Be careful with Moduretic if you're pregnant or you plan to have a baby, or you are a nursing mother.

Be careful with Moduretic if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.

Be careful with Moduretic if you have allergies to medicines, foods, or other substances.

Be careful with Moduretic if you have cirrhosis or liver problems, diabetes, gout, kidney problems or kidney stones, asthma, heart problems, or systemic lupus erythematosus.

Be careful with Moduretic if you have elevated blood acid, low folic acid levels, or electrolyte problems, or are dehydrated.

Be careful with Moduretic if you take potassium-sparing diuretics (eg, spironolactone), potassium supplements, or salt substitutes containing potassium because high blood potassium levels may occur and cause listlessness, confusion, abnormal skin sensations of the arms and legs, heaviness of limbs, slowed heart rate, irregular heart rhythm, or stopping of the heart; cholestyramine or colestipol because they may decrease Moduretic 's effectiveness; nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, indomethacin) because they may decrease Moduretic 's effectiveness and risk of kidney problems may be increased; barbiturates (eg, phenobarbital), certain chemotherapy medicines, corticosteroids (eg, prednisone), digoxin, dofetilide, ketanserin, narcotic pain medicines (eg, codeine), or medicines for high blood pressure because the risk of their side effects may be increased by Moduretic; diazoxide, lithium, or nondepolarizing neuromuscular blockers (eg, pancuronium) because their actions and the risk of their side effects may be increased by Moduretic; angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril) because the risk of high blood potassium and kidney problems may be increased by Moduretic; diabetes medicines (eg, glipizide) or insulin because their effectiveness may be decreased by Moduretic.

Do not stop taking Moduretic suddenly.

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The efficacy and biochemical effects of two low-dose thiazide plus potassium-sparing diuretic preparations were compared in the treatment of elderly patients with stable, mild to moderate congestive heart failure. Sixty patients (mean age 80 years) were randomly allocated to treatment with 1 tablet daily of either 25 mg hydrochlorothiazide/2.5 mg amiloride or 25 mg hydrochlorothiazide/50 mg triamterene. The dose was increased to 2 tablets daily if necessary, after 2 weeks, for a further 6 weeks. Patients' response to treatment was assessed at 2, 4 and 8 weeks using a simple clinical scoring system for signs and symptoms of their condition, and routine biochemical analysis was carried out at baseline and the end of treatment. One patient was withdrawn from the study due to a rash which was probably related to hydrochlorothiazide/amiloride treatment. A further 11 patients were excluded from the analysis because of intercurrent illness or inadequate records. Analysis of the results from 48 patients showed that both treatments resulted in an improvement in clinical score and weight reduction, with more than three-quarters of the patients responding to treatment. No serious biochemical disturbances occurred; in particular, no new cases of hyponatraemia (serum sodium less than 130 mmol/l) developed. Both preparations, therefore, were effective and tolerated forms of treatment for mild to moderate congestive heart failure in the elderly and there were no significant differences between them.

moduretic medication

A cross-over study comparing the effects of doxazosin, moduretic and amlodipine on fasting blood glucose and blood pressure levels in 9 adult hypertensive Nigerians is presented. The results showed that doxazosin, moduretic and amlodipine were effective in reducing diastolic blood pressure and thus confirmed our previous observation of blood pressure reduction during the monotherapies of these antihypertensive agents. The study further indicated the effectiveness of doxazosin in the management of severe essential hypertension in Nigerian patients. Fasting blood glucose level significantly decreased during doxazosin treatment phase and increased during moduretic phase, while amlodipine treatment did not have any effect on blood glucose level. In conclusion, the cross-over study seem to confirm the effectiveness of doxazosin therapy and its antidiabetic effect in hypertensive patients. The effectiveness of amlodipine therapy in controlling blood pressure was also observed, but no effect on blood glucose level, while moduretic therapy has hyperglycemic effect despite its effectiveness in blood pressure control in African patients.

moduretic dose

A cross-sectional retrospective drug use review was conducted between June 1st and August 31st 2002 using randomly selected 200 case notes of patients attending the Hypertension Clinic at a 900-bed tertiary care facility in southwestern Nigeria. 11 case notes were not used due to incompleteness.

moduretic 50 mg

Nephrogenic diabetes insipidus (NDI) is characterized by the kidney's inability to concentrate urine, which causes intense polyuria that may lead to urinary tract dilation. We report the morphological findings of the urinary tract in ten boys with NDI specifically addressing the presence and changes of urinary tract dilation during treatment.

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The purpose of this study was to identify the frequency of cardiac dysrhythmias in two similar groups of hypertensive middle-aged males (age 45-66). They had previously been randomized either to a diuretic treatment (n = 42), or a beta-blocking agent (n = 41). A 24-hour ambulatory Holter monitoring, and serum potassium, was obtained in all patients, serum magnesium was measured in 35 patients. The mean number of ventricular premature beats (VPBs) and the frequency of complex arrhythmias (19 vs. 5) was significantly higher in the diuretic group (p less than 0.01). The serum potassium was significantly lower (p less than 0.001) in the diuretic group, and there was a significant (p less than 0.005) inverse correlation between the number of VPBs and the serum potassium in all treated patients. The patients with complex arrhythmias were older (p less than 0.01) than the remainder of the patients. No correlation between serum magnesium and VPBs or complex arrhythmias was found. This study demonstrates increased frequency of VPBs in older hypertensive males, treated with diuretics, and that hypokalaemia predisposes to increased cardiac arrhythmias. We conclude that in older mildly hypertensive men hypokalaemia should be avoided.

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Acute effects of amiloride (5 mg) (A), hydrochlorthiazide (50 mg) (H) and the combination (50 + 5 mg) (HA) on urinary electrolyte excretion and pH of ten healthy volunteers--taking placebo five times and twice randomly A and HA and once H--were studied during one day. Amiloride showed a natriuretic effect, which in combination was additive to that of hydrochlorthiazide, but the excretion of water did not increase significantly after A. The urinary excretion of potassium decreased with amiloride below normal levels and was at the level of placebo after the combination (HA). There was a striking linear correlation between urinary sodium and potassium with all the drugs, although showing with A a higher potassium retention during high sodium excretion. Urinary pH rose after A and HA during the first 8 hours, but this effect was not seen, however, after H. No significant differences in the effect of the two brands of A (Medamor and Puritrid) on the urinary electrolyte excretion and pH, nor in those of the two brands of HA (Moduretic and Amitrid) were found. Similarly, the plasma concentrations of hydrochlorthiazide, determined gas chromatographically, were equal after Moduretic and Amitrid tablets. The systemic availability of H was faster in the combination of HA than alone. In the AUC value of H, however, there was no significant difference between HA and H tablets.

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An open parallel study was carried out in general practice on 70 patients with uncomplicated mild to moderate hypertension to compare the hypotensive efficacy of hydrochlorothiazide/amiloride with that of cyclopenthiazide/potassium. After a 2-week baseline period on placebo, patients were allocated at random to receive treatment with one or other of the diuretics starting with 1 tablet per day and increasing up to a maximum of 4 tablets per day or until their supine diastolic blood pressure was 90 mmHg or less. They were then continued at their optimum dose for a further 4 weeks. Analysis of the results from 62 patients showed that the hydrochlorothiazide/amiloride preparation produced both a greater decrease and better control of blood pressure in a greater percentage of patients that did the comparison diuretic. In addition, the beneficial effects were attained with fewer tablets, of importance for patient compliance.

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Patients were diagnosed at a median age of 1.6 years (range, 0.16-6.33 years) and treated with a low osmotic diet, hydrochlorothiazide-amiloride and indomethacin, which decreased the diuresis from a median of 10.5 ml/kg/h to 4.4 ml/kg/h (p < 0.001). Three patients showed normal renal ultrasound before treatment until last control, while the remaining seven showed urinary tract dilation. In this second group, dilation was reduced with treatment in four patients and disappeared in the remaining three. Children without dilation or in whom the dilation disappeared were diagnosed and treated earlier than those with persistent dilation (median 1.66 versus 4.45 years, respectively). After a median of 10.4 (range, 2.3-20.3) years of follow-up, no patients showed urological complications.

moduretic tablets dosage

A randomized double-blind, crossover trial was carried out in twenty hypertensive patients to evaluate the hypotensive efficacy and safety of indapamide. Indapamide in doses of 2.5 mg per day in combination with other antihypertensive agents was as effective in reducing the blood pressure in hypertensive patients as one tablet of Moduretic (50 mg hydrochlorothiazide and 5 mg amiloride). Indapamide induced no changes in serum potassium or uric acid levels and there were no major side effects.

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Old people are commonly receiving diuretics on admission to hospital. Diuretics are recognized as a risk factor for electrolyte disturbances; controversy exists about the relative risks of different combinations (in particular, co-amilozide [Moduretic]). We recorded the drug history and serum electrolytes in 1000 consecutive admissions to a geriatric hospital, and examined the relative prescribing rates of various diuretics in the community. Full results were obtained in 929 patients. A history of diuretic prescription was present in 353 (38%) of the patients; the mean serum sodium in this group (95% CI 136.0-137.1 mmol/l) was lower than in the 586 not prescribed diuretics (137.1-137.9 mmol/l). The difference was small but statistically significant (95% CI difference = 0.3-1.6 mmol/l; P less than 0.01). Hyponatraemia (serum sodium less than 130 mmol/l) was not significantly commoner in the 41 patients prescribed co-amilozide than in patients prescribed other diuretics. In general patients prescribed potassium-retaining diuretics had a lower serum sodium than the others. There was a significant positive correlation between the serum potassium and the log [serum urea] (r = 0.26, P less than 0.001) and a weak negative correlation existed between sodium and potassium (r = -0.14; P less than 0.001). There was an association between the prescription of potassium-retaining diuretics and a higher serum potassium; also an association between the prescription of a loop or thiazide diuretic and a lower serum potassium. These interactions were shown by multiple regression analysis to be independent and additive.(ABSTRACT TRUNCATED AT 250 WORDS)

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To study the effect of a combination of amiloride, 5 mg, and hydrochlorothiazide, 50 mg (Moduretic), on plasma and skeletal muscle electrolytes in patients on long-term diuretic therapy (greater than 1 year) for arterial hypertension and/or congestive heart failure, 58 patients were recruited. Fifty-five patients completed the study, 27 controls and 28 in the treatment group. The Moduretic group demonstrated a significant increase in skeletal muscle potassium and magnesium values and a significant decrease in systolic blood pressure after 6 months on therapy. There was no significant change in these parameters in the control group. It is concluded that this combination of amiloride and hydrochlorothiazide is capable of preserving the internal and external balance of potassium and magnesium on a long-term basis in the patient categories studied.

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moduretic generic name 2015-09-23

Medical treatment of the disease improved the dilation in all cases, preventing its potential complications. Lopressor Name Brand Regardless of the good outcome of our patients, periodic urologic follow-up is recommended in NDI patients.

moduretic maximum dose 2015-02-03

An open parallel study was carried out in general practice on 70 patients with uncomplicated mild to moderate hypertension to compare the hypotensive efficacy of hydrochlorothiazide/amiloride with that of cyclopenthiazide/potassium. After a 2-week baseline period on placebo, patients were allocated at random to receive treatment with one or other of the diuretics starting with 1 tablet per day and increasing up to a maximum of 4 Paracetamol 665 Mg tablets per day or until their supine diastolic blood pressure was 90 mmHg or less. They were then continued at their optimum dose for a further 4 weeks. Analysis of the results from 62 patients showed that the hydrochlorothiazide/amiloride preparation produced both a greater decrease and better control of blood pressure in a greater percentage of patients that did the comparison diuretic. In addition, the beneficial effects were attained with fewer tablets, of importance for patient compliance.

moduretic drug interactions 2015-02-20

Diurexan (xipamide) 40 mg daily was substituted for Navidrex-K (cyclopenthiazide 0.25 mg plus potassium 600 mg) or Moduretic (amiloride hydrochloride 5 mg plus hydrochlorthiazide 50 mg) in nineteen patients with oedema of cardiac origin. Comparative efficacy Diovan 40 Mg Generic and patient acceptability were examined over a 4-week treatment period. In six patients their oedema was resolved and in a further seven their oedema was markedly reduced (six patients had no overt oedema pre-trial). The body-weight of nine patients decreased by an average of 1.4 kg whilst in seven patients it remained static and in three patients it increased by an average of 1.8 kg. Thirteen of the patients preferred Diurexan at the end of the 4-week trial period, four patients had no preference and two patients preferred their previous treatment.

moduretic overdose 2015-11-02

This study tested the effects on cardiovascular outcomes of treatments based on nifedipine gastrointestinal therapeutic system (GITS) compared with the diuretic combination co-amilozide in a pre-specified subset of patients with isolated systolic hypertension (ISH) enrolled in the International Nifedipine Avelox Y El Alcohol GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study.

moduretic cost 2015-08-22

Plasma potassium and sodium concentrations were measured in a group of elderly patients taking maintenance thiazide diuretic therapy alone, with a potassium supplement or in combination with a potassium sparing diuretic. Fixed dose combinations of a thiazide and potassium sparing diuretic did not significantly reduce the prevalence of hypokalaemia and the combination of amiloride-hydrochlorothiazide was associated Indocin Gout Medicine with a disproportionate number of cases of hyponatraemia. The desirability of the current widespread use of fixed dose combination diuretics over less expensive single agents is questioned.

moduretic 5 mg posologia 2015-01-16

In a randomized double-blind study to compare the effect of atenolol vs. hydrochlorothiazide and amiloride (Moduretic) on left ventricular dimensions and systolic function, 100 When Did Zocor Go Generic hypertensive men were followed up during 1 year of treatment, 50 subjects being randomized to each drug. Echocardiography was performed at baseline, and after 3 and 12 months of treatment. A significant reduction in left ventricular mass with atenolol was paralleled by a decrease in left ventricular wall thickness and an increase in stroke volume. A similar reduction of left ventricular mass with Moduretic without a change in relative wall thickness and a decrease in stroke volume was observed. Cardiac output decreased in both groups.

moduretic dosage and administration 2017-12-15

There were significant reductions in SBP at some periods of the intervention in the exercise group (p=0.000 to 0.002) and control group (p=0.001 to 0.002), and significant difference in DBP at some periods of the intervention in exercise group (p=0.000 to 0.003) and control group ( Cost Valtrex Without Insurance Canada p=0.000 to 0.001). SBP (p=0.066) and DBP (p=0.100) did not differ between the two groups post-12-week intervention. The BP control rates were similar between the exercises (56.7%) and control (35.5%) groups (p=0.075). Similarly, between-group difference in the number of drugs was not significant (p=0.511).

moduretic fluid tablets 2017-04-20

A double-blind study was carried out in 24 hypertensive patients with thiazide-induced hypokalaemia (serum potassium less than 3.2 mmol/l) to compare the effects of treatment with an amiloride/hydrochlorothiazide combination or hydrochlorothiazide alone. The study was divided into three phases: (i) potassium repletion (Weeks 0 to 4) with oral potassium chloride (40 mmol/day), (ii) stabilization (Weeks 4 to 6) of normokalaemia, and (iii) active Amoxil 250mg 5ml Suspension drug treatment (Weeks 6 to 14), patients being allocated at random to receive one or other of the two treatments. Dosage was 2 tablets per day of the 5 mg amiloride plus 50 mg hydrochlorothiazide combination or of 50 mg hydrochlorothiazide alone. The results showed that blood pressure control was comparable in both treatment groups but hydrochlorothiazide alone caused a statistically significant reduction in serum potassium levels compared to the drug combination. Apart from 1 patient who developed hypokalaemia on hydrochlorothiazide alone, no other side-effects of treatment were reported.

moduretic drug information 2017-11-28

In a double-blind parallel-group study 133 patients with mild to moderate essential hypertension were randomised to felodipine 5mg twice daily or Moduretic mite every morning after a run-in placebo period of 1 to 2 weeks. All previous antihypertensive therapy was withdrawn at the start of the run-in period. After 4 weeks the dose of felodipine was increased to 10mg twice daily, and Moduretic mite was replaced by Moduretic in patients with a diastolic blood Himalaya Diabecon Ds Tablets pressure of greater than 80mm Hg. On the low dose, the supine blood pressure on felodipine was reduced by 24/14mm Hg from 174/105mm Hg, and on Moduretic mite by 19/11mm Hg from 171/103mm Hg. After the increase in dosage blood pressure was lowered further. There was no statistically significant difference in blood pressure reduction between the 2 groups. Severe adverse drug experiences (ADEs) were few and equally distributed. However, more felodipine patients were withdrawn because of ADEs. Potassium levels decreased and uric acid levels increased significantly in the Moduretic group.

moduretic 40 mg 2015-02-24

Hypertensive patients who are at high risk of developing cardiovascular (CV) complications have become the focus of modern treatment guidelines. The choice of antihypertensive therapies in these patients should be evidence-based: in particular, there should be evidence of a beneficial impact on CV events in addition to blood pressure-lowering effects. The International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT) is the first, large, randomized, double-blind study undertaken exclusively in high-risk hypertensive patients, with CV events as a prospectively defined primary end-point. The choice of a diuretic (co-amilozide) as a comparator reflects the fact that this group of antihypertensive drugs has been shown to reduce CV events in high-risk hypertensive patients. Nifedipine, administered in a long-acting gastrointestinal-transport-system (GITS) formulation, and Zantac Generic Name Uk co amilozide were equally effective in preventing overall CV or cerebrovascular complications. This finding extended to the subgroup of patients with diabetes at baseline. Substudies to INSIGHT showed that, compared with coamilozide, nifedipine GITS was significantly more effective at preventing an increase in intima-media thickness in the carotid artery and significantly slowed the progression of coronary calcification. The results from INSIGHT support incorporating nifedipine GITS in the management of high-risk hypertensive patients to prevent atherosclerosis-related illness and death.