Naturetic Tablet
Amiloride Hydrochloride + Hydrochlorothiazide
5 mg + 50 mg
Drug International Ltd.
| Pack size | |
|---|---|
| Unite Price | 0.64 BDT |
Indications
Naturetic Tablet is used for:
Hypertension, Congestive heart failure, Hepatic cirrhosis with ascites and oedema
Adult Dose
Oral
Hypertension
Adult: Per tab contains amiloride hydrochloride 2.5 mg and hydrochlorothiazide 25 mg: Initially 1 tab daily, increased up to a max of 2 tabs daily as a single or divided dose. Per tab contains amiloride hydrochloride 5 mg and hydrochlorothiazide 50 mg: Initially 1/2 tab daily, increased up to a max of 1 tab daily as a single or divided dose.
Congestive heart failure
Adult: Per tab contains amiloride hydrochloride 2.5 mg and hydrochlorothiazide 25 mg: Initially 1 tab daily, increased up to a max of 4 tabs daily. Per tab contains amiloride hydrochloride 5 mg and hydrochlorothiazide 50 mg: Initially 1/2 tab daily, increased up to a max of 2 tabs daily. Reduce maintenance dose if possible.
Hepatic cirrhosis with ascites and oedema
Adult: Per tab contains amiloride hydrochloride 2.5 mg and hydrochlorothiazide 25 mg: Initially 2 tabs daily, increased up to a max of 4 tabs daily. Per tab contains amiloride hydrochloride 5 mg and hydrochlorothiazide 50 mg: Initially 1 tab daily, increased up to a max of 2 tabs daily. Reduce maintenance dose if possible.
Child Dose
Renal Dose
Administration
Should be taken with food.
Contra Indications
Hyperkalaemia; anuria; acute renal failure, severe progressive renal disease; severe hepatic failure, precoma associated with hepatic cirrhosis; Addison's disease; hypercalcaemia; diabetic neuropathy; DM. Child <18 yr. Lactation.
Precautions
Renal impairment; BUN >10 mmol/L, serum creatinine >130 mmol/L. Monitor serum electrolytes and blood urea levels in seriously ill patients e.g. those with hepatic cirrhosis with ascites and metabolic alkalosis, or those with resistant oedema. Pre-existing severe liver disease. May affect parathyroid function. Hyperuricaemia or gout may occur. Cholesterol and triglyceride levels may be increased. Thiazides may impair glucose tolerance. DM may be precipitated or aggravated. May activate or exacerbate SLE. Elderly. Hyponatraemia. Pregnancy.
Lactation: Excretion in breast milk is unknown. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pregnancy-Lactation
Pregnancy Category: B
Lactation: Excretion in breast milk is unknown. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Interactions
Additive effects with other antihypertensives. May increase the responsiveness to tubocurarine. May reduce arterial responsiveness to pressor amines e.g. norepinephrine. Orthostatic hypotension may occur with alcohol, barbiturates and narcotics. Discontinue diuretics 2-3 days before initiation of an ACE inhibitor to reduce the likelihood of 1st dose hypotension. Increased hypokalaemia with corticosteroids or ACTH. Attenuation of diuretic, natriuretic and antihypertensive effects of diuretics with NSAIDs. Increased hyponatraemia with chlorpropamide. Increased hyperkalaemia with ciclosporin, tacrolimus, indometacin and angiotensin II receptor antagonists.
Potentially Fatal: Increases risk of hyperkalaemia with other potassium-sparing diuretics (spironolactone or triamterene). Increases risk of lithium toxicity.
Side Effects
Side effects of Amiloride Hydrochloride + Hydrochlorothiazide :
1-10%
Amiloride
Hyperkalemia (10%), Anorexia (3-8%), Diarrhea (3-8%), Headache (3-8%), Nausea (3-8%), Vomiting (3-8%), Abdominal pain (<3%), Appetite changes (<3%), Constipation (<3%), Cough (<3%),
Dizziness (<3%), Dyspnea (<3%), Encephalopathy (<3%), Fatigue (<3%), Gas pain (<3%), Impotence (<3%), Muscle cramps (<3%), Weakness (<3%)
Hydrochlorothiazide
Hypotension, Anorexia, Epigastric distress, Hypokalemia, Phototoxicity
Mode of Action
Amiloride is an antikaliuretic with weak natriuretic, diuretic and antihypertensive effects. Some clinical studies found these effects to be partially additive to the effects of thiazide diuretics. Amiloride exerts its potassium-sparing effect by inhibiting Na reabsorption at the distal renal tubules; this decreases the net -ve potential of the tubular lumen and reduces both K and hydrogen secretion and their subsequent excretion.
Hydrochlorothiazide is a diuretic and antihypertensive. It reduces electrolyte reabsorption from the renal tubules. Hydrochlorothiazide increases excretion of Na and chloride in approx equiv amounts. Natriuresis may be accompanied by some loss of K and bicarbonate. It exerts its hypotensive effect partly by reducing peripheral resistance.
Note
Naturetic 5 mg + 50 mg Tablet generic name is Amiloride Hydrochloride + Hydrochlorothiazide. Naturetic 5 mg + 50 mg Tablet is manufactured by Drug International Ltd.Naturetic is availble in all over Bangladesh.
Mes BD drug index information on Naturetic Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.