Uses: Duiretic
Quantity: 100 tabs
Chemical Name: Amilorid, Hydrochlorothiazide
Therapeutic indications
The information provided in Therapeutic indications of Adco-Retic is based on data of another medicine with exactly the same composition as the Adco-Retic. . Be careful and be sure to specify the information on the section Therapeutic indications in the instructions to the drug Adco-Retic directly from the package or from the pharmacist at the pharmacy.
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Adco-ReticIC (amiloride and hydrochlorothiazide) is indicated in those patients with hypertension or with congestive heart failure who develop hypokalemia when thiazides or other kaliuretic diuretics are used alone, or in whom maintenance of normal serum potassium levels is considered to be clinically important, e.g., digitalized patients, or patients with significant cardiac arrhythmias.
The use of potassium-conserving agents is often unnecessary in patients receiving diuretics for uncomplicated essential hypertension when such patients have a normal diet.
Adco-ReticIC (amiloride and hydrochlorothiazide) may be used alone or as an adjunct to other antihypertensive drugs, such as methyldopa or beta blockers. Since Adco-ReticIC (amiloride and hydrochlorothiazide) enhances the action of these agents, dosage adjustments may be necessary to avoid an excessive fall in blood pressure and other unwanted side effects.
This fixed combination drug is not indicated for the initial therapy of edema or hypertension except in individuals in whom the development of hypokalemia cannot be risked.
Dosage (Posology) and method of administration
The information provided in Dosage (Posology) and method of administration of Adco-Retic is based on data of another medicine with exactly the same composition as the Adco-Retic. . Be careful and be sure to specify the information on the section Dosage (Posology) and method of administration in the instructions to the drug Adco-Retic directly from the package or from the pharmacist at the pharmacy.
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Adco-ReticIC (amiloride and hydrochlorothiazide) should be administered with food.
The usual starting dosage is 1 tablet a day. The dosage may be increased to 2 tablets a day, if necessary. More than 2 tablets of Adco-ReticIC (amiloride and hydrochlorothiazide) daily usually are not needed and there is no controlled experience with such doses. Hydrochlorothiazide can be given at doses of 12.5 to 50 mg per day when used alone. Patients usually do not require doses of hydrochlorothiazide in excess of 50 mg daily when combined with other antihypertensive agents.
The daily dose is usually given as a single dose but may be given in divided doses. Once an initial diuresis has been achieved, dosage adjustment may be necessary. Maintenance therapy may be on an intermittent basis.
Contraindications
The information provided in Contraindications of Adco-Retic is based on data of another medicine with exactly the same composition as the Adco-Retic. . Be careful and be sure to specify the information on the section Contraindications in the instructions to the drug Adco-Retic directly from the package or from the pharmacist at the pharmacy.
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Hyperkalemia
Adco-ReticIC (amiloride and hydrochlorothiazide) should not be used in the presence of elevated serum potassium levels (greater than 5.5 mEq per liter).
Antikaliuretic Therapy or Potassium Supplementation
Adco-ReticIC (amiloride and hydrochlorothiazide) should not be given to patients receiving other potassium-conserving agents, such as spironolactone or triamterene. Potassium supplementation in the form of medication, potassium-containing salt substitutes or a potassium-rich diet should not be used with Adco-ReticIC (amiloride and hydrochlorothiazide) except in severe and/or refractory cases of hypokalemia. Such concomitant therapy can be associated with rapid increases in serum potassium levels. If potassium supplementation is used, careful monitoring of the serum potassium level is necessary.
Impaired Renal Function
Anuria, acute or chronic renal insufficiency, and evidence of diabetic nephropathy are contraindications to the use of Adco-ReticIC (amiloride and hydrochlorothiazide). Patients with evidence of renal functional impairment (blood urea nitrogen [BUN] levels over 30 mg per 100 mL or serum creatinine levels over 1.5 mg per 100 mL) or diabetes mellitus should not receive the drug without careful, frequent and continuing monitoring of serum electrolytes, creatinine, and BUN levels. Potassium retention associated with the use of an antikaliuretic agent is accentuated in the presence of renal impairment and may result in the rapid development of hyperkalemia.
Hypersensitivity
Adco-ReticIC (amiloride and hydrochlorothiazide) is contraindicated in patients who are hypersensitive to this product, or to other sulfonamide-derived drugs.
Special warnings and precautions for use
The information provided in Special warnings and precautions for use of Adco-Retic is based on data of another medicine with exactly the same composition as the Adco-Retic. . Be careful and be sure to specify the information on the section Special warnings and precautions for use in the instructions to the drug Adco-Retic directly from the package or from the pharmacist at the pharmacy.
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WARNINGS
Hyperkalemia
Like other potassium-conserving diuretic combinations, Adco-ReticIC (amiloride and hydrochlorothiazide) may cause hyperkalemia (serum potassium levels greater than 5.5 mEq per liter). In patients without renal impairment or diabetes mellitus, the risk of hyperkalemia with Adco-ReticIC (amiloride and hydrochlorothiazide) is about 1-2 percent. This risk is higher in patients with renal impairment or diabetes mellitus (even without recognized diabetic nephropathy). Since hyperkalemia, if uncorrected, is potentially fatal, it is essential to monitor serum potassium levels carefully in any patient receiving Adco-ReticIC (amiloride and hydrochlorothiazide) , particularly when it is first introduced, at the time of dosage adjustments, and during any illness that could affect renal function.
The risk of hyperkalemia may be increased when potassium-conserving agents, including Adco-ReticIC (amiloride and hydrochlorothiazide) , are administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, cyclosporine or tacrolimus. (See PRECAUTIONS: DRUG INTERACTIONS.) Warning signs or symptoms of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, shock, and ECG abnormalities. Monitoring of the serum potassium level is essential because mild hyperkalemia is not usually associated with an abnormal ECG.
When abnormal, the ECG in hyperkalemia is characterized primarily by tall, peaked T waves or elevations from previous tracings. There may also be lowering of the R wave and increased depth of the S wave, widening and even disappearance of the P wave, progressive widening of the QRS complex, prolongation of the PR interval, and ST depression.
Treatment of hyperkalemia: If hyperkalemia occurs in patients taking Adco-ReticIC (amiloride and hydrochlorothiazide) , the drug should be discontinued immediately. If the serum potassium level exceeds 6.5 mEq per liter, active measures should be taken to reduce it. Such measures include the intravenous administration of sodium bicarbonate solution or oral or parenteral glucose with a rapid-acting insulin preparation. If needed, a cation exchange resin such as sodium polystyrene sulfonate may be given orally or by enema. Patients with persistent hyperkalemia may require dialysis.
