Amiloride: Uses, Interactions and Safety

Uses

Amiloride is a potassium-conserving diuretic mainly added to a potassium-losing diuretic in hypertension or congestive heart failure. Its principal purpose is to correct or prevent low potassium in selected patients, including those at particular risk from hypokalaemia. It has relatively weak diuretic and blood-pressure effects by itself.

Administration

This summary concerns oral tablets. Take the prescribed formulation as directed. Amiloride is generally used with another diuretic, rather than routinely alone. Changes to other diuretics, potassium supplements and salt substitutes need prescriber review. A normal potassium result today does not remove the need for later checks.

Safety

High potassium can be fatal and may initially cause no symptoms. Testing is particularly important when starting treatment, changing medicines or developing an illness that affects kidney function. Seek urgent help for severe weakness, fainting or a slow or irregular heartbeat. Kidney disease and pre-existing high potassium are major restrictions. Do not combine potassium-sparing diuretics yourself.

Interactions

ACE inhibitors, ARBs, ciclosporin and tacrolimus increase the risk of high potassium. Finerenone should not be combined with amiloride. Lithium toxicity can occur, and NSAIDs can reduce the diuretic response or worsen renal/potassium problems.

Pregnancy and breastfeeding

Pregnancy safety data are insufficient; use requires a clear clinical need and individual assessment. Human milk data are limited or absent. The prescriber should decide whether breastfeeding or treatment should stop.

Adverse effects

Nausea, reduced appetite, abdominal discomfort, wind and mild rash have been reported. Potassium changes are the most important risk, so laboratory monitoring remains necessary even when gastrointestinal symptoms are mild.

Sources

• Amiloride prescribing information
• Turkish Hypertension Consensus Report 2025
• Kerendia: EMA product information

Additional verified references

• ATC/DDD Index: amiloride