Acebutolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Drug reference
Amiloride
Potassium-sparing diuretic (ENaC blocker) · Antihypertensive
Also known as Amiloride hydrochloride
START
5 mg PO once daily
TYPICAL MAX
20 mg/day
STOP IF
K >5.5 mmol/L, rising creatinine, or hyponatraemia
WATCH
Serum potassium, sodium, renal function
CDSCO approvedSchedule HATC C03DB01
KDIGO 2024 + manufacturer label
- ONSET
- 2h · onset
- PEAK
- 8h · peak effect
- t½
- 7h · t½
- DURATION
- 1d · once-daily
EXCRETION
Renal ~50% unchanged; faecal remainder
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Use only if clearly needed; limited data.
FDA category + note
Top interactionssee all 12 →
- AcebutololSevereTextbookKDT 7e
- AtenololSevereTextbookKDT 7e
- BetaxololSevereTextbookKDT 7e
- BisoprololSevereTextbookKDT 7e
Available in India
1 branded formulation. Look up specific brands in the Drugs workspace.
Mechanism
Blocks epithelial sodium channels (ENaC) in the distal tubule/collecting duct, producing mild natriuresis while reducing potassium and hydrogen secretion — a potassium-sparing diuretic.
Indications
Adjunct to thiazide/loop diuretics to conserve potassiumOedema (heart failure, cirrhosis with caution)Lithium-induced nephrogenic diabetes insipidus
Dosing
- Adult
- 5 mg PO once daily; usual 5–10 mg/day; max 20 mg/day. Often combined with hydrochlorothiazide.
- Pediatric
- 0.4–0.625 mg/kg/day (specialist).
- Renal adjustment
- Avoid if eGFR <30 / serum creatinine elevated (hyperkalaemia risk).
- Hepatic adjustment
- Caution in hepatic impairment (electrolyte shifts).
- Geriatric
- Start 5 mg; higher hyperkalaemia/AKI risk.
- Max dose
- 20 mg/day
Pharmacokinetics
Onset
~2 h
Peak effect
~6–10 h
Duration
~24 h
Half-life
~6–9 h (longer in renal impairment)
Bioavailability
~50%
Protein binding
Low (~23%)
Metabolism
Not metabolised
Excretion
Renal (~50% unchanged); faecal remainder
Contraindications
- Hyperkalaemia (K >5.5 mmol/L)
- Severe renal impairment / anuria
- Concomitant potassium supplements or other K-sparing diuretics
- Addison disease
Side effects
Common
HyperkalaemiaNauseaHeadacheDizzinessFatigue
Serious
- Severe hyperkalaemia / arrhythmia
- Hyponatraemia
- Acute kidney injury (volume depletion)
Pregnancy & lactation
Pregnancy
Use only if clearly needed; limited data.
Lactation
Limited data; caution.
Drug interactions
Atenolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Betaxolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Bisoprolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Bucindolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Carteolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Carvedilol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Celiprolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Esmolol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Esmolol Hydrochloride
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Imidapril
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Labetalol
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Related guidelines
Ask House about Amiloride
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, BNF·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20