Urinary Electrolyte Profiles after Amiloride, Hydrochlorthiazide and the Combination

Acute effects of amiloride (5 mg) (A), hydrochlorthiazide (50 mg) (H) and the combination (50 + 5 mg) (HA) on urinary electrolyte excretion and pH of ten healthy volunteers – taking placebo five times and twice randomly A and HA and once H – were studied during one day.Amiloride showed a natriuretic effect, which in combination was additive to that of hydrochlorthiazide, but the excretion of water did not increase significantly after A. The urinary excretion of potassium decreased with amiloride below normal levels and was at the level of placebo after the combination (HA). There was a striking linear correlation between urinary sodium and potassium with all the drugs, although showing with A a higher potassium retention during high sodium excretion. Urinary pH rose after A and HA during the first 8 hours, but this effect was not seen, however, after H.No significant differences in the effect of the two brands of A (Medamor® and Puritrid®) on the urinary electrolyte excretion and pH, nor in those of the two brands of HA (Moduretic® and Amitrid®) were found. Similarly, the plasma concentrations of hydrochlorthiazide, determined gas chromatographically, were equal after Moduretic® and Amitrid® tablets. The systemic availability of H was faster in the combination of HA than alone. In the AUC value of H, however, there was no significant difference between HA and H tablets.