From the Guidelines
Amiloride is not typically associated with causing hypomagnesemia (low magnesium levels). In fact, amiloride is a potassium-sparing diuretic, which means it can help increase potassium levels by reducing its excretion in the urine, and it is not commonly linked with hypomagnesemia 1.
Key Points to Consider
- The primary concern with amiloride is hyperkalaemia (high potassium levels), especially when combined with other medications like ACE inhibitors or in patients with renal impairment 1.
- Monitoring of electrolyte levels, including potassium and magnesium, is essential when taking amiloride, especially in patients with pre-existing electrolyte imbalances 1.
- If hypomagnesemia occurs, it is more likely due to other factors or medications, such as proton pump inhibitors 1, rather than amiloride itself.
- The usual dose of amiloride is 5-10 mg per day, and it's crucial to follow the prescribed dosage and monitoring schedule to minimize the risk of electrolyte disturbances 1.
Important Considerations
- Patients on diuretics, including amiloride, should be monitored for electrolyte imbalances, and potassium supplements may be necessary in some cases 1.
- Amiloride should be used with caution in patients with renal impairment or those taking other medications that can affect electrolyte levels 1.
From the FDA Drug Label
When administered with a thiazide or loop diuretic, amiloride HCl has been shown to decrease the enhanced urinary excretion of magnesium which occurs when a thiazide or loop diuretic is used alone.
No, Amiloride does not cause hypomagnesemia. In fact, it decreases the enhanced urinary excretion of magnesium that occurs with thiazide or loop diuretics 2.
From the Research
Amiloride and Hypomagnesemia
- There is no direct evidence to suggest that Amiloride causes hypomagnesemia. In fact, studies have shown that Amiloride may have magnesium-sparing effects 3.
- A study published in 1984 found that Amiloride reduced urinary magnesium and potassium, increased plasma magnesium and potassium, and also increased lymphocyte magnesium and potassium in congestive heart failure patients being treated with furosemide 3.
- Another study published in 1981 discussed the mechanism of action, pharmacokinetics, adverse effects, and therapeutic uses of Amiloride hydrochloride, but did not mention hypomagnesemia as a potential side effect 4.
- Other studies have focused on the use of Amiloride in treating hypokalemia associated with primary and secondary hyperaldosteronism 5, and in Bartter's syndrome 6, but have not reported hypomagnesemia as a side effect.
- In contrast, thiazide diuretics have been associated with an increased risk of hypomagnesemia 7, but combining thiazide diuretics with a potassium-sparing agent like Amiloride may not be associated with lower serum magnesium levels or hypomagnesemia 7.