amiloride/hydrochlorothiazide / Generic mfg. - LARVOL DELTA

Comparative Effectiveness of Chlorthalidone Versus Hydrochlorothiazide and Dose-Response of Amiloride on Blood Pressure and Biochemical Parameters. (PubMed, J Am Heart Assoc) - P3 | "Chlorthalidone and hydrochlorothiazide, administered at a 1:2 dosing ratio, show similar effects on BP and laboratory parameters. Amiloride 5 and 10 mg show similar effects on BP and most metabolic parameters, with no clear dose-response relationship, suggesting that any independent BP-lowering effect of amiloride is, at best, weak."

Clinical • HEOR • Journal • Cardiovascular • Hypertension • Hypotension

Renal TRPM6 but not Kv1.1 is required for magnesium homeostasis in mice. (PubMed, Am J Physiol Renal Physiol) - "GFR, lithium clearance, and natriuretic responses to furosemide, hydrochlorothiazide, or amiloride did not differ in tubule-Kv1.1 KO mice. In summary, renal TRPM6 plays a critical role in magnesium homeostasis under baseline conditions. Kv1.1 is not expressed along DCT and is not required for magnesium homeostasis or normal renal function at baseline."

Journal • Preclinical • Nephrology • Renal Disease • DCT

Vertebrobasilar Dolichoectasia Treatment With Amiloride (clinicaltrials.gov) - P2 | N=6 | Not yet recruiting | Sponsor: Huashan Hospital

New P2 trial

The Fine Line Between Salt Loss and Water Retention: A Case Report of Dynamic Sodium Disorders Following Traumatic Brain Injury (NKF-SCM 2026) - "Therapy with desmopressin, indomethacin, hydrochlorothiazide, and amiloride achieved stable eunatremia. The patient's sequential transition from central DI to CSW and later to nephrogenic DI highlights the interplay of neuroendocrine injury, ADH dysregulation, renal sodium handling, and medication effects. CONCLUSION Continuous reassessment of volume status, urinary studies, and sodium trends is essential, as prompt recognition of evolving electrolyte disorders allows timely therapy adjustments and optimizes neurological and systemic outcomes."

Case report • Clinical • Cardiovascular • CNS Disorders • Heart Failure • Hematological Disorders • Metabolic Disorders • Vascular Neurology

Congenital Nephrogenic Diabetes Insipidus Presenting as Neonatal Hypernatremia and Polyuria (NKF-SCM 2026) - "A desmopressin challenge showed no increase in urine osmolality, and copeptin was markedly elevated at 91.2 pmol/L, confirming NDI...Management included cautious hypotonic fluids, urine output replacement, PM 60/40 formula and breast milk, hydrochlorothiazide (DOL 8), and amiloride (DOL 15–21)...CONCLUSION Congenital NDI should be suspected in neonates with persistent hypernatremia and polyuria despite normal imaging and negative infectious workup. Copeptin-guided diagnosis provides early clarity, avoids unsafe fluid restriction, and supports timely initiation of targeted therapy."

Hypoglycemia • Infectious Disease • Metabolic Disorders • Septic Shock

The urine metabolomic signature of distal diuretics and diuretic-induced hyponatremia in patients with chronic kidney disease. (PubMed, Am J Physiol Renal Physiol) - "Therefore, we analyzed plasma and 24-hour urine samples from a previously completed randomized controlled trial including individuals with CKD (mean eGFR 39 ± 13 ml/min/1.73 m²) treated with amiloride/hydrochlorothiazide (5 mg/50 mg daily) for two weeks. These findings suggest that distal diuretics not only act locally in the distal convoluted tubule but also influence proximal tubular metabolism. In conclusion, our results highlight that distal diuretics induce significant metabolic changes in CKD, with urine metabolomics offering valuable insights into the physiological pathways and mechanisms underlying both therapeutic effects and adverse responses."

Journal • Cardiovascular • Chronic Kidney Disease • Heart Failure • Hypertension • Metabolic Disorders • Nephrology • Renal Disease

Contribution of murine strain background to Na + reabsorption in the kidney. (PubMed, bioRxiv) - "We found that the kidney expression of NHE3, NKCC2, and NCC are strain dependent. Additionally, murine strain significantly contributes to the diuretic responses induced by hydrochlorothiazide, amiloride, and furosemide."

Journal • Preclinical

Detection of Diuretics Contamination in Whey Protein-Based Dietary Supplements. (PubMed, ACS Omega) - "This study aimed to develop a reliable method using high-performance liquid chromatography with UV detection (HPLC-UV) to simultaneously detect the presence of the diuretics chlorothiazide, hydrochlorothiazide, furosemide, amiloride, and chlorthalidone in WPDS. Furosemide was the most frequently detected diuretic found in 28.8% (0.20-1.82 mg/g of WPDS) of all analyzed samples, followed by hydrochlorothiazide, detected in 19.0% (0.25-1.40 mg/g of WPDS). These results highlight the importance of screening for adulterants in WPDS before consumption to ensure proper quality control, protect consumer safety, and prevent unintentional doping cases."

Journal

Severe lithium-induced nephrogenic diabetes insipidus: The diuresis paradox. (PubMed, S Afr Med J) - "Amiloride with hydrochlorothiazide adequately reduced the polyuria. Management of lithium-induced NDI remains complex, and includes diuretics, which paradoxically reduce polyuria in this setting. Failure to follow up critical results led to profound morbidity, and is a crucial learning point in this case."

Journal • Bipolar Disorder • CNS Disorders • Critical care • Metabolic Disorders • Mood Disorders • Psychiatry • Renal Disease

Drug-associated hypertensive crisis: a disproportionality analysis of the FAERS database. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "Ramipril (282 cases) and valsartan (192 cases) ranked as the second and third medications, respectively. The top 5 drugs associated with the risk of hypertensive crisis under the ROR algorithm were amlodipine perindopril (ROR = 136.64), methyl aminolevulinate (ROR = 122.78), tranylcypromine (ROR = 105.15), rifapentine (ROR = 39.46), and amiloride hydrochlorothiazide (ROR = 39.36)...Our study showed that numerous medications carry potential risks for drug-associated hypertensive crisis. Further investigation is required to establish causality and inform clinical decision-making."

Journal

Systematic Review on the Efficacy of Atenolol in Antihypertensive Treatment: Recommendation from the Brazilian Society of Cardiology. (PubMed, Arq Bras Cardiol) - "Despite the limitations of available evidence, atenolol showed comparable efficacy in BP reduction, with small differences in cardiovascular outcomes favoring other antihypertensive classes. Its use may be considered among the options for combination therapy in the treatment of primary HTN in adults. Other beta-blockers were not evaluated in this systematic review."

Clinical • Journal • Review • Cardiovascular • Hypertension • Myocardial Infarction

Nephrogenic Diabetes Insipidus: Three Decades of Clinical Reality. (PubMed, Cureus) - "All desmopressin tests were negative...All patients were treated with hydrochlorothiazide and amiloride; indomethacin was added in 5 (62.5%)...The diagnosis should be considered in infants with failure to thrive, especially when accompanied by polyuria and polydipsia. Early recognition and intervention, even if non-specific, may improve long-term outcomes."

Journal • Autism Spectrum Disorder • CNS Disorders • Constipation • Developmental Disorders • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Mental Retardation • Metabolic Disorders • Nephrology • Pediatrics • Psychiatry

A Case of Severe Polyuria: Diagnostic Challenges and Management of Nephrogenic Diabetes Insipidus (ENDO 2025) - "Background:Arginine vasopressin V2 resistance (AVP-R), commonly known as nephrogenic diabetes insipidus (NDI), is an uncommon disorder in which the kidneys fail to respond to AVP, causing significant polyuria. Hereditary AVP-R, as seen in this patient, is a rare condition characterized by varying degrees of resistance to AVP. Approximately 90% of hereditary cases are linked to X-linked AVPR2 mutations (2,3), underscoring the importance of genetic testing. This case shows the difficulties in distinguishing AVP-R (NDI) from other causes of polyuria and demonstrates the pivotal role of desmopressin testing in confirming the diagnosis."

Clinical • Cardiovascular • Endocrine Disorders • Hypertension • Infectious Disease • Metabolic Disorders • Pneumonia • Respiratory Diseases

Congenital nephrotic syndrome due to MAGI2 mutation in two Brazilian siblings, one with concomitant galactosemia (GALT-1): A case report (IPNA 2025) - "Eventually, intravenous albumin was tapered to weekly infusions and then discontinued, with edema managed enterally using captopril, furosemide, amiloride, hydrochlorothiazide, and dietary optimization. Conclusions Genetic testing was crucial in diagnosing the older sister, and it enabled a swift suspicion in the case of the younger brother. Conducting WGS facilitated the diagnosis of another concurrent comorbidity, which wouldn't have been possible with a genetic panel."

Case report • Clinical • Cardiovascular • Cholestasis • Dyslipidemia • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Hepatology • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Renal Disease • Septic Shock

Combination of Diuretics in States of Resistant Nephrotic Edema: a Case Presentation. (PubMed, Maedica (Bucur)) - "We report the case of a 36-year-old man presenting with nephrotic edema managed with a combination of furosemide and human albumin...On the third day, a regimen comprising amiloride (5 mg/day) and hydrochlorothiazide (50 mg/day) was initiated, resulting in complete resolution of edema after 11 days. No hyperkalemia was observed, with only a slight elevation in serum creatinine levels. Although clinical trials are limited, mounting evidence from human and animal studies supports the concept of nephrotic syndrome as an overfill phenomenon and underscores the potential benefits of ENaC blockers in the management of nephrotic edema."

Journal • Glomerulonephritis • Nephrology • Renal Disease

Involvement of Cholinergic and Cyclooxygenase Pathways in the Diuretic Effects of Rosmarinic Acid. (PubMed, Chem Biodivers) - "To investigate this, we examined the diuretic activity of RA alone and in combination with hydrochlorothiazide (HCTZ), amiloride (AML), atropine (ATR), and indomethacin (INDO) to see if any of these drugs could interfere with RA's activity in an 8-hour acute diuresis animal model. ATR and INDO prevented RA from increasing urine excretion, suggesting a potential interaction with muscarinic receptors or a role in promoting prostaglandin production. Additionally, molecular docking analysis indicated possible interactions with key receptors involved in increased diuresis or free-electrolyte water excretion."

Journal • Acute Myelogenous Leukemia

5/6 Nephrectomy Impairs Acute Kaliuretic Responses and Predisposes to Postprandial Hyperkalemia. (PubMed, Am J Physiol Renal Physiol) - "The natriuretic and kaliuretic responses to furosemide, hydrochlorothiazide, and amiloride were largely similar between 5/6Nx and sham rats except for a significantly reduced kaliuretic response to hydrochlorothiazide in 5/6Nx rats. In contrast, the acute K+ load decreased the Na+/hydrogen exchanger 3 (NHE3) and increased serum- and glucocorticoid-regulated kinase 1 (SGK1) and the α-subunit of the epithelial sodium channel (ENaC) only in sham rats. Together, our data show that 5/6Nx impairs the natriuretic and kaliuretic response to an acute dietary K+ load which is further characterized by a loss of ENaC adaptation and the development of postprandial hyperkalemia."

Journal • Chronic Kidney Disease • Nephrology • Renal Disease

THE PREVENTION OF STROKE IN HIGH-RISK HYPERTENSIVE PATIENTS (ESOC 2024) - " In a prospective, randomized, open-label, blinded-endpoint trial, 13542 hypertensive patients at high risk for cardiovascular events were assigned to receive treatment with either amlodipine plus amiloride/hydrochlorothiazide (n = 6776) or telmisartan (n = 6766). The diuretics-based combination treatment was more efficacious in preventing stroke than telmisartan-based therapy in hypertensive patients with high cardiovascular risk, independent of blood pressure reduction."

Clinical • Cardiovascular • Ischemic stroke

A Rare Case of Congenital Nephrogenic Diabetes Insipidus Associated with Aquaporin 2 Gene Mutation and Subsequent Acute Lymphoblastic Leukemia: Impact of Steroids on Kidney Function. (PubMed, Am J Case Rep) - "He was treated with hydrochlorothiazide and amiloride. CONCLUSIONS We report a rare case of NDI caused by a missense mutation in the aquaporin 2 gene. One year later, the child developed ALL, and treatment with dexamethasone led to an uncompensated state of polydipsia and polyuria."

Journal • Acute Lymphocytic Leukemia • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Leukemia • Metabolic Disorders • Nephrology • Oncology • Renal Disease • T Acute Lymphoblastic Leukemia

Evaluation of the translation of multiple cardiovascular regulatory mechanisms in the anesthetized dog. (PubMed, J Pharmacol Toxicol Methods) - "The hemodynamic effects of 11 drugs (atropine, itraconazole, atenolol, ivabradine, milrinone, enalaprilat, fasudil, amlodipine, prazosin, amiloride, and hydrochlorothiazide) were profiled in an anesthetized dog cardiovascular model. Interestingly but not unexpected, 1 of 11 failed to display their predicted CV pattern which is likely due to a delay in pharmacodynamic effect that is beyond the duration of the experimental model (hydrochlorothiazide). The analysis from the current study supports the strategic use of the anesthetized dog model early in the drug discovery process for a comprehensive cardiovascular evaluation with good translation to human."

Journal • Anesthesia • Cardiovascular

Oral Furosemide and Hydrochlorothiazide/Amiloride versus Intravenous Furosemide for the Treatment of Resistant Nephrotic Syndrome. (PubMed, J Clin Med) - "A combination of oral diuretics based on furosemide, amiloride and hydrochlorothiazide is non-inferior to i.v. furosemide in weight control of patients with RNE and a similar safety profile."

Journal • Acute Kidney Injury • Glomerulonephritis • Hypotension • Nephrology • Renal Disease

COMBINED ORAL DIURETICS: A BETTER ALTERNATIVE FOR NEPHROTIC EDEMA THAN INTRAVENOUS FUROSEMIDE? (ERA-EDTA 2023) - "Combined oral diuretics with furosemide, amiloride and hydrochlorothiazide is more effective and safer than intravenous furosemide for the treatment of refractory nephrotic edema. These results make amiloride a promising diuretic and further trials with larger sample sizes and longer follow-up are needed in this regard."

Acute Kidney Injury • CNS Disorders • Glomerulonephritis • Hypotension • Immunology • Inflammatory Arthritis • Insomnia • Lupus • Lupus Nephritis • Nephrology • Renal Disease • Sleep Disorder

Mineralocorticoid Excess Syndrome with Abiraterone (ENDO 2023) - "Here we discuss a case of MES and strategies we implemented on treatment.Clinical Case: An 82-year-old patient with prostate cancer was treated with leuprolide, abiraterone, and prednisone. The patient later started furosemide for edema and hypertension...His prednisone was changed to dexamethasone to avoid any additional mineralocorticoid receptor agonist effect. To treat his MES, spironolactone and eplerenone were avoided to prevent potential androgen receptor agonism in the setting of his prostate cancer...Amiloride and hydrochlorothiazide were stopped... There is minimal literature on abiraterone induced endocrine side effects. This case will increase awareness of these and help endocrinologists individualize management of adverse effects experienced by prostate cancer patients on abiraterone."

Cardiovascular • Genito-urinary Cancer • Hypertension • Oncology • Prostate Cancer • Solid Tumor • AR

Diuretic and Natriuretic Effects of Hesperidin, a Flavanone Glycoside, in Female and Male Hypertensive Rats. (PubMed, Plants (Basel)) - "When given HSP in combination with hydrochlorothiazide (HCTZ) or amiloride (AMLR), urine volume and Na elimination were significantly increased compared to the group that received only HSP...Pre-treatment with a non-selective cholinergic receptor antagonist, atropine, partially prevented HSP-induced diuresis and natriuresis in male SHR, but this effect was not demonstrated with the non-selective inhibitor of the enzyme cyclooxygenase, indomethacin. This study shows the diuretic action of HSP in hypertensive rats, an activity probably associated with the cholinergic pathway. Although various biological actions have already been defined for HSP, this pioneering research reveals its potential as a diuretic medicine."

Journal • Preclinical

KCC3a, a Pathway for Potassium Loss in Alkalemia (KIDNEY WEEK 2022) - "We further show that treatment of wild-type mice with hydrochlorothiazide, amiloride, or fed a K + deficient diet up-regulated KCC3a levels, suggesting that volume depletion increases KCC3a abundance. In addition, KCC3a abundance increased significantly alongside pendrin abundance in bicarbonate-treated alkalotic mice, providing a credible mechanism for K + loss in metabolic alkalosis. Conclusion We showed that KCC3a is expressed in pendrin-expressing intercalated cells and propose a possible mechanism for K + loss in metabolic alkalemia."

Cardiovascular • Hypertension • Metabolic Disorders • Pain • CALB1 • SLC26A4 • TERC