التداخل بين أميلوريد وتوراسيميد

Hyperkalemia occurs commonly (about 10%) when amiloride is used without a kaliuretic diuretic.

When amiloride HCl is used concomitantly with a thiazide diuretic in patients without these complications, the risk of hyperkalemia is reduced to about 1-2 percent.

It is thus essential to monitor serum potassium levels carefully in any patient receiving amiloride, particularly when it is first introduced, at the time of diuretic dosage adjustments, and during any illness that could affect renal function.

Diabetes Mellitus In diabetic patients, hyperkalemia has been reported with the use of all potassium-conserving diuretics, including amiloride HCl, even in patients without evidence of diabetic nephropathy.

(See WARNINGS .) Lithium generally should not be given with diuretics because they reduce its renal clearance and add a high risk of lithium toxicity.

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment.

Organic Anion Drugs: May decrease diuretic activity of torsemide.

The antihypertensive and diuretic effects of torsemide can be reduced by NSAIDs.

Monitor diuretic effect and blood pressure when used in combination with CYP2C9 inhibitor or inducer.