Drug General Information (ID: DDICRU3HWJ)
  Drug Name Amiloride Drug Info Potassium acetate Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Diuretics Minerals And Electrolytes
  Structure

 Mechanism of Amiloride-Potassium acetate Interaction (Severity Level: Major)
     Increased risk of hyperkalemia Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Amiloride Potassium acetate
      Mechanism Hyperkalemia Hyperkalemia
      Key Mechanism Factor 1
Factor Name Hyperkalemia
Factor Description Hyperkalemia is a condition in which the level of potassium in the blood is higher than normal. While mild cases may not produce symptoms, severe hyperkalemia can lead to fatal arrhythmias if left untreated.
      Mechanism Description
  • Increased risk of hyperkalemia by the combination of Amiloride and Potassium acetate 

Recommended Action
      Management The use of potassium preparations in patients treated with potassium-sparing diuretics is generally not recommended. Caution is advised if coadministration is required, particularly in patients with renal impairment, diabetes, old age, worsening heart failure, and/or a risk for dehydration. Serum potassium and renal function should be checked regularly, and oral potassium supplementation should be avoided in patients with severe congestive heart failure who have serum potassium levels above 3.5 mEq/L. Patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as weakness, listlessness, confusion, tingling of the extremities, and irregular heartbeat.

References
1 McNay JL, Oran E "Possible predisposition of diabetic patients to hyperkalemia following administration of potassium-retaining diuretic, amiloride (MK 870)." Metabolism 19 (1970): 58-70. [PMID: 5410663]
2 Jarman PR, Kehely AM, Mather HM "Hyperkalaemia in diabetes: prevalence and associations." Postgrad Med J 71 (1995): 551-2. [PMID: 7479468]
3 Marcy TR, Ripley TL "Aldosterone antagonists in the treatment of heart failure." Am J Health Syst Pharm 63 (2006): 49-58. [PMID: 16373465]
4 Berry C, McMurray JJ "Serious adverse events experienced by patients with chronic heart failure taking spironolactone." Heart 85 (2001): E8. [PMID: 11250985]
5 Bozkurt B, Agoston I, Knowlton AA "Complications of inappropriate use of spironolactone in heart failure: when an old medicine spirals out of new guidelines." J Am Coll Cardiol 41 (2003): 211-4. [PMID: 12535810]
6 Shapiro S, Slone D, Lewis GP, Jick H "Fatal drug reactions among medical inpatients." JAMA 216 (1971): 467-72. [PMID: 5107928]
7 Product Information. Aldactone (spironolactone). Searle, Skokie, IL.
8 Masoudi FA, Gross CP, Wang Y, et al. "Adoption of spironolactone therapy for older patients with heart failure and left ventricular systolic dysfunction in the United States, 1998-2001." Circulation 112 (2005): 39-47. [PMID: 15983243]
9 Lawson DH, O'Connor PC, Jick H "Drug attributed alterations in potassium handling in congestive cardiac failure." Eur J Clin Pharmacol 23 (1982): 21-5. [PMID: 7128669]
10 Lawson DH "Adverse reactions to potassium chloride." Q J Med 43 (1974): 433-40. [PMID: 4424028]
11 O'Reilly MV, Murnaghan DP, Williams MB "Transvenous pacemaker failure induced by hyperkalemia." JAMA 228 (1974): 336-7. [PMID: 4406078]
12 Greenblatt DJ, Koch-Weser J "Adverse reactions to spironolactone: a report from the Boston Collaborative Drug Surveillance Program." JAMA 225 (1973): 40-3. [PMID: 4740303]
13 Product Information. K-Dur (potassium chloride). Schering Laboratories, Kenilworth, NJ.
14 Walker BR, Hoppe RC, Alexander F "Effect of triamterene on the renal clearance of calcium, magnesium, phosphate, and uric acid in man." Clin Pharmacol Ther 13 (1972): 245-50. [PMID: 4552822]
15 Jarman PR, Mather HM "Diabetes may be independent risk factor for hyperkalaemia." BMJ 327 (2003): 812. [PMID: 14525902]
16 Ponce SP, Jennings AE, Madias NE, Harrington JT "Drug-induced hyperkalemia." Medicine (Baltimore) 64 (1985): 357-70. [PMID: 2865667]
17 Walmsley RN, White GH, Cain M, McCarthy PJ, Booth J "Hyperkalemia in the elderly." Clin Chem 30 (1984): 1409-12. [PMID: 6744599]
18 Svensson M, Gustafsson F, Galatius S, Hildebrandt PR, Atar D "Hyperkalaemia and impaired renal function in patients taking spironolactone for congestive heart failure: retrospective study." BMJ 327 (2003): 1141-2. [PMID: 14615339]
19 Perazella MA "Drug-induced hyperkalemia: old culprits and new offenders." Am J Med 109 (2000): 307-14. [PMID: 10996582]
20 Mashford ML, Robertson MB "Spironolactone and ammonium and potassium chloride." Br Med J 4 (1972): 298-9. [PMID: 5083905]
21 Perazella MA, Mahnensmith RL "Hyperkalemia in the elderly: drugs exacerbate impaired potassium homeostasis." J Gen Intern Med 12 (1997): 646-56. [PMID: 9346463]
22 Martin J, Mourton S, Nicholls G "Severe hyperkalaemia with prescription of potassium-retaining agents in an elderly patient." N Z Med J 116 (2003): U542. [PMID: 14513088]