Amiloride and Torsemide interaction

Amiloride and Torsemide: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Amiloride (amiloride hydrochloride) label · effective 2023-05-05

Major

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

Boxed warningby drug classView label on DailyMed
Major

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.

Boxed warningby drug classView label on DailyMed
Major

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.

Boxed warningby drug classView label on DailyMed
Moderate

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.

Warningsby drug classView label on DailyMed
Moderate

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

Drug interactionsby drug classView label on DailyMed

From the Torsemide label · effective 2026-07-21

Moderate

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

Warnings and precautionsby drug classView label on DailyMed
Moderate

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

Drug interactionsby drug classView label on DailyMed
Moderate

Organic Anion Drugs: May decrease diuretic activity of torsemide.

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Moderate

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

Drug interactionsby drug classView label on DailyMed
Moderate

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

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.