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2.2.4
Potassium-sparing
diuretics with other
diuretics
Although it is preferable to prescribe thiazides (section
2.2.1)
and potassium-sparing diuretics (section 2.2.3)
separately,
the use of
fixed combinations may be justi-
fied if compliance is a problem. Potassium-sparing diur-
etics are not usually necessary in the routine treatment
of
hypertension,
unless
hypokalaemia develops.
For
interactions,
see Appendix 1 (diuretics).
Amiloride with thiazides
Co-amilozide
(Non-proprietary) A
Tablets
,
co-amilozide 2.5/25 (amiloride hydro-
chloride 2.5 mg, hydrochlorothiazide 25 mg), net price
28-tab pack = £3.73
Brands include
Moduret 25
c
Dose
hypertension, initially 1 tablet daily, increased if necessary
to max.
2 tablets daily
Congestive heart failure,
initially 1 tablet daily,
increased if
necessary to max.
4 tablets daily
Oedema and ascites in cirrhosis of the liver, initially 2 tablets daily,
increased if necessary to max.
4 tablets daily;
reduce for main-
tenance if possible
Tablets
,
co-amilozide 5/50 (amiloride hydrochloride
5 mg,
hydrochlorothiazide 50 mg),
net price 28 =
£1.14
Brands include
Amil-Co
c
,
Moduretic
c
Dose
hypertension, initially ½ tablet daily, increased if necessary
to max.
1 tablet daily
Congestive heart failure,
initially ½ tablet daily,
increased if
necessary to max.
2 tablets daily
Oedema and ascites in cirrhosis of the liver, initially 1 tablet daily,
increased if necessary to max.
2 tablets daily;
reduce for main-
tenance if possible
Navispare
c
(Goldshield) A
Tablets
,
f/c,
orange,
amiloride hydrochloride 2.5 mg,
cyclopenthiazide 250 micrograms,
net price 28-tab
pack = £2.70
Excipients
include gluten
Dose
hypertension,
1–2 tablets in the morning
Amiloride with loop diuretics
Co-amilofruse
(Non-proprietary) A
Tablets
,
co-amilofruse 2.5/20 (amiloride hydro-
chloride 2.5 mg,
furosemide 20 mg),
net price 28-tab
pack = £1.18,
56-tab pack = £1.83
Brands include
Frumil LS
c
Dose
oedema,
1 tablet in the morning
Tablets
,
co-amilofruse 5/40 (amiloride hydrochloride
5 mg,
furosemide 40 mg),
net price 28-tab pack =
£1.17,
56-tab pack = £1.42
Brands include
Frumil
c
Dose
oedema,
1–2 tablets in the morning
Tablets
,
co-amilofruse 10/80 (amiloride hydro-
chloride 10 mg,
furosemide 80 mg),
net price 28-tab
pack = £11.51
Dose
oedema,
1 tablet in the morning
Amiloride with bumetanide
(Non-proprietary) A
Tablets
,
amiloride hydrochloride 5 mg,
bumetanide
1 mg,
net price 28-tab pack = £29.60
Dose
oedema,
1–2 tablets daily
Triamterene with thiazides
Counselling
Urine may look slightly blue in some lights
Co-triamterzide
(Non-proprietary) A
Tablets
,
co-triamterzide 50/25 (triamterene 50 mg,
hydrochlorothiazide 25 mg),
net price 30-tab pack =
95p.
Label:
14, (see above), 21
Dose
hypertension,
1 tablet daily after breakfast,
increased if
necessary,
max.
4 daily
Oedema,
2 tablets daily (1 after breakfast and 1 after midday
meal) increased to 3 daily if necessary (2 after breakfast and 1
after midday meal); usual maintenance in oedema, 1 daily or 2 on
alternate days; max.
4 daily
Brands include
Triam-Co
c
Dyazide
c
(Goldshield) A
Tablets
,
peach,
scored,
co-triamterzide 50/25
(triamterene 50 mg,
hydrochlorothiazide 25 mg),
net
price 30-tab pack = 95p.
Label:
14, (see above), 21
Dose
hypertension,
1 tablet daily after breakfast,
increased if
necessary,
max.
4 daily
Oedema,
2 tablets daily (1 after breakfast and 1 after midday
meal) increased to 3 daily if necessary (2 after breakfast and 1
after midday meal); usual maintenance in oedema, 1 daily or 2 on
alternate days; max.
4 daily
Kalspare
c
(DHP Healthcare) A
Tablets
,
orange,
f/c,
scored,
triamterene 50 mg,
chlortalidone 50 mg,
net price 28-tab pack = £9.90.
Label:
14,
(see above),
21
Dose
hypertension,
oedema,
1–2 tablets in the morning
Triamterene with loop diuretics
Counselling
Urine may look slightly blue in some lights
Frusene
c
(Orion) A
Tablets
,
yellow,
scored,
triamterene 50 mg,
furose-
mide 40 mg, net price 56-tab pack = £4.34. Label: 14,
(see above)
Dose
oedema,
½–2 tablets daily in the morning
Spironolactone with thiazides
Co-flumactone
(Non-proprietary) A U
Tablets
,
co-flumactone 25/25 (hydroflumethiazide
25 mg, spironolactone 25 mg), net price 100-tab pack
= £20.23
Brands include
Aldactide 25
c
Dose
congestive heart failure, initially 4 tablets daily;
range 1–8
tablets daily (but not recommended because spironolactone
generally given in lower dose)
Tablets
,
co-flumactone 50/50 (hydroflumethiazide
50 mg, spironolactone 50 mg), net price 28-tab pack =
£10.70
Brands include
Aldactide 50
c
Dose
congestive heart failure, initially 2 tablets daily;
range 1–4
tablets daily (but not recommended because spironolactone
generally given in lower dose)
Spironolactone with loop diuretics
Lasilactone
c
(Sanofi-Aventis) A
Capsules
,
blue/white,
spironolactone 50 mg,
furose-
mide 20 mg,
net price 28-cap pack = £7.97
Dose
resistant oedema,
1–4 capsules daily
2.2.5
Osmotic diuretics
Mannitol is an osmotic diuretic that can be used to treat
cerebral oedema and raised intra-ocular pressure.
BNF 61
2.2.4 Potassium-sparing diuretics with other diuretics
89
2
Cardiovascular system