Response of thiazide-induced hypokalemia to amiloride

JAMA. 1983 Jan 14;249(2):237-41.

Abstract

The effects of amiloride hydrochloride on thiazide-induced hypokalemia were evaluated. In metabolic balance studies, amiloride reversed thiazide-induced urinary potassium loss, restored plasma bicarbonate concentration and pH to pretreatment levels, and produced further increases in aldosterone secretion. Effects of long-term administration of hydrochlorothiazide and an amiloride-hydrochlorothiazide combination were compared in outpatients who had experienced thiazide-induced hypokalemia while receiving oral potassium supplements. After eight weeks, those given hydrochlorothiazide alone had an average serum potassium level of 3.01 +/- 0.08 mEq/L). Those given the amiloride-hydrochlorothiazide combination had an average serum potassium level of 3.75 +/- 0.008 mEq/L, not significantly different from the control value (3.82 +/- 0.08 mEq/L). Both groups had increased plasma aldosterone concentrations and plasma renin activity. The potassium-conserving effect of amiloride persisted with extended therapy.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aldosterone / blood
  • Amiloride / administration & dosage*
  • Amiloride / pharmacology
  • Bicarbonates / blood
  • Drug Therapy, Combination
  • Humans
  • Hydrochlorothiazide / administration & dosage
  • Hydrochlorothiazide / adverse effects*
  • Hypertension / drug therapy*
  • Hypokalemia / chemically induced
  • Hypokalemia / prevention & control*
  • Potassium / urine
  • Pyrazines / administration & dosage*

Substances

  • Bicarbonates
  • Pyrazines
  • Hydrochlorothiazide
  • Aldosterone
  • Amiloride
  • Potassium