Moduretic

Moduretic (Du Pont 1970) Navispare (Novartis)-comb. Moduretic (Merck Sharp Dohme 1975)-comb. Midamor (Merck Sharp Dohme 1981)... 

Medozide (Malesci)-comb. Moduretic (Merck Sharp Dohme)-comb. 

Proprietary Names. Arumil Midamor Modamide. It is an ingredient of Amilco, Frumil, Moducren, and Moduretic. 

Amiloride exerts an inhibitory action on sodium channels under the influence of aldosterone in the distal tubule. Its action is therefore complementary to that of the thiazides and, used with them, it augments sodium loss and but limits potassium loss. One such combination, co-amilozide, (Moduretic) (amiloride 2.5-5 mg plus hydrochlorothiazide 25-50 mg), is used for hypertension or oedema. The maximum effect of amiloride occurs about 6 h after an oral dose with a duration of action >24h 21 h). The oral dose is 5-20 mg daily. 

Sweden s National Adverse Reaction Monitoring System called the attention of physicians to a case in which a 73-year-old woman developed anaphylactic shock after taking only a single tablet of Moduretic (7). The National System had received three other reports on anaphylactic reactions to this combination, and by 1988 the WHO center in Uppsala had received eight others from other countries. Except for mild skin reactions, hypersensitivity reactions to hydrochlorothiazide alone are highly unusual and not of this type. 

Anonymous. Moduretic-anaphylactic shock. Uppsala WHO Collaborating Centre for Adverse Drug Reaction Monitoring, Adv React Newslett 1988 (3 ). 

The use of fixed combination of a thiazide and a potassium-sparing drug, often Moduretic (hydrochlorothiazide 50 mg with amiloride 5 mg), has been consistently implicated in diuretic-induced hyponatremia. Treatment with chlorpropamide (200-800 mg/day) along with Moduretic has precipitated hyponatremia in several cases (96). Simultaneous use of Moduretic with trimethoprim has also been reported to increase the risk (97). The mechanism appears to be impairment of the clearance of free water, resulting in dilutional hyponatremia. Whether... 

Indometacin reduces the effect of diuretics (69). Combination of indometacin with Moduretic (co-amilo-zide amiloride + hydrochlorothiazide) results in hyperkalemia (70). 

Mor R, Pitlik S, Rosenfeld JB, Mor R, Pitlik S, Rosenfeld JB. Indomethacin- and Moduretic-induced hyperkalemia. Israel Journal of Medical Sciences 1983 9 535-537. 

Amiloride/Hydrochtorothiazide, USP (Moduretic, Generic) Oral 5 mg amiloride hydrochloride/50 mg hydrochlorothiazide... 

Sulfonamides, penicillins, diclofenac, oxyphenbutazone, piroxicam, phenytoin, carbamazepine (Same as for erythema multiforme) penicillamine, captopril, piroxicam, penicillins, rifampicin Frusemide, penicillamine, penicillin, PUVA therapy Immunosuppressants, mexiletine, thioridazine, penicillamine, moduretic , atenolol, quinacrine... 

Trade names Amikal Kaluril Medamor Midamor (Merck) Midoride Modamide Moduretic (Merck) Nirulid Ride Indications Prevention of hypokalemia associated with kaliuretic diuretics, management of edema in hypertension Category Diuretic, potassium-sparing Half-life 6-9 hours... 

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