Kaltide Tablet
Amiloride Hydrochloride + Hydrochlorothiazide
5mg + 50mg
ACI Limited
| Pack size | 30's Pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 2.02 AED |
Indications
Kaltide 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
Renal Impairment
Use cautioni in patients with diabetes mellitus or serum creatinine >1.5 mg/dL; contraindicated in anuria, acute or chronic renal insufficiency or signs of diabetic nephropathy
Administration
Should be taken with food.
Contra Indications
Hypersensitivity to amiloride, HCTZ or sulfonamides
Concomitant use with potassium-sparing agents (eg, spironolactone, triamterene)
Concomitant administration with any form of potassium supplementation
Acute renal failure or evidence of diabetic nephropathy
Anuria
Hyperkalemia (potassium levels >5.5 mEq/L)
Precautions
Avoid use in patients with diabetes; may require adjustments in insulin or oral hypoglycemic treatment; hyperglycemia may occur during administration
Electrolyte imbalance (hypokalemia, hypophosphatemia, hyperkalemia, hypercalcemia, hypomagnesemia, hyponatremia, or hypochloremic alkalosis) may occur
Triglyceride and cholesterol levels may increase
May experience an increase in serum urea nitrogen (BUN), or serum creatinine
Symptoms of lupus erythematosus may exacerbate
Hydrochlorothiazide may cause acute transient myopia and acute angle closure glaucoma within hours or weeks of initiating therapy
Gout symptoms may be precipitated
Hypersensitivity reactions may occur with or without history of allergy or bronchial asthma
Not for administration in patients with acute or chronic renal insufficiency (cumulative drug effects may be observed); diuretics may precipitate azotemia in renal disease
Use caution in patients in whom respiratory or metabolic acidosis may occur
Use caution in patients with hepatic impairment; minor alterations of fluid and electrolyte imbalance may precipitate hepatic coma
The risk of hydrochlorothiazide toxicity may be greater in renal impairment
Antihypertensive effects of this therapy may be enhanced in post-sympathectomy patients
Monitoring Parameters
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 edema.
Monitor serum potassium levels in patients receiving amiloride and hydrochlorothiazide especially when initiating therapy, adjusting the dose or with an illness that may cause renal dysfunction; hyperkalemia (potassium levels ≥ 5.5 mEq/L) if uncorrected is potentially fatal and may occur in patients without renal impairment or diabetes mellitus (risk of hyperkalemia is 1-2%)
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.
Contraindicated (0)
Serious - Use Alternative (20)
aminolevulinic acid oral
aminolevulinic acid topical
carbamazepine
cyclophosphamide
cyclosporine
dofetilide
drospirenone
eplerenone
isocarboxazid
lofexidine
methyl aminolevulinate
potassium acid phosphate
potassium chloride
potassium phosphates, IV
spironolactone
squill
tafenoquine
tretinoin
tretinoin topical
triamterene
Adverse 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
Mechanism 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
Kaltide 5mg + 50mg Tablet manufactured by ACI Limited. Its generic name is Amiloride Hydrochloride + Hydrochlorothiazide. Kaltide is availble in Bangladesh.
Farmaco BD drug index information on Kaltide Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.