This medicine may cause you to have an unusual feeling of tiredness when you begin to take it. You may also notice an increase in the amount of urine or in your frequency of urination. After you have taken the medicine for a while, these effects should lessen. In general, to keep the increase in urine from affecting your sleep:

• If you are to take a single dose a day, take it in the morning after breakfast.
• If you are to take more than one dose a day, take the last dose no later than 6 p.m., unless otherwise directed by your doctor.

However, it is best to plan your dose or doses according to a schedule that will least affect your personal activities and sleep. Ask your health care professional to help you plan the best time to take this medicine.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

If this medicine upsets your stomach, it may be taken with meals or milk. If stomach upset (nausea, vomiting, stomach pain or cramps) continues, check with your doctor.

For patients taking this medicine for high blood pressure :

• In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.
• Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
• Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing

The dose of potassium-sparing diuretics will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of potassium-sparing diuretics. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking potassium-sparing diuretics .

For amiloride
• For oral dosage form (tablets):
  • For high blood pressure or to lower the amount of water in the body:
    • Adults 5 to 10 milligrams (mg) once a day.
    • Children Dose must be determined by your doctor.

For spironolactone
• For oral dosage form (tablets):
  • To lower the amount of water in the body:
    • Adults At first, 25 to 200 milligrams (mg) a day. This is divided into two to four doses. Your doctor may increase your dose as needed.
    • Children Dose is based on body weight and must be determined by your doctor. The usual dose is 1 to 3 mg per kilogram (kg) (0.45 to 1.36 mg per pound) of body weight a day. The dose may be taken as a single dose or divided into two to four doses. Your doctor may increase your dose as needed.
  • For high blood pressure:
    • Adults At first, 50 to 100 milligrams (mg) a day. This may be taken as a single dose or divided into two to four doses. Your doctor may gradually increase your dose up to 200 mg a day.
    • Children Dose is based on body weight and must be determined by your doctor. The usual dose is 1 to 3 mg per kg (0.45 to 1.36 mg per pound) of body weight a day. The dose may be taken as a single dose or divided into two to four doses. Your doctor may increase your dose as needed.
  • To treat high aldosterone levels in the body:
    • Adults 100 to 400 mg a day. This is divided into two to four doses and taken until you have surgery. If you are not having surgery, your doses may be smaller.
  • For detecting high aldosterone levels in the body:
    • Adults 400 mg a day, taken in two to four divided doses. Your doctor may want you to take this dose for as little as four days or as long as three to four weeks. Follow your doctor's instructions.
  • To treat low potassium levels in the blood:
    • Adults 25 to 100 mg a day. This may be taken as a single dose or divided into two to four doses.

For triamterene
• For oral dosage form (capsules or tablets):
  • To lower the amount of water in the body:
    • Adults 100 mg twice a day. Your doctor may gradually increase your dose.
    • Children Dose is based on body weight and must be determined by your doctor. To start, the usual dose is 2 to 4 mg per kilogram (kg) (0.9 to 1.82 mg per pound) of body weight a day or every other day. This is divided into smaller doses. Your doctor may increase your dose as needed.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For potassium-sparing diuretics, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to amiloride, spironolactone, or triamterene. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Studies have not been done in pregnant women. However, this medicine has not been shown to cause birth defects or other problems in animals.

In general, diuretics are not useful for normal swelling of feet and hands that occurs during pregnancy. Diuretics should not be taken during pregnancy unless recommended by your doctor.

Breast-feeding Although amiloride, spironolactone, and triamterene may pass into breast milk, these medicines have not been reported to cause problems in nursing babies.

Children This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems in children than it does in adults.

Older adults Signs and symptoms of too much potassium are more likely to occur in the elderly, who are more sensitive than younger adults to the effects of this medicine.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking potassium-sparing diuretics, it is especially important that your health care professional know if you are taking any of the following:

• Angiotensin-converting enzyme (ACE) inhibitors (benazepril [e.g., Lotensin], captopril [e.g., Capoten], enalapril [e.g., Vasotec], fosinopril [e.g., Monopril], lisinopril [e.g., Prinivil, Zestril], quinapril [e.g., Accupril], ramipril [e.g., Altace]) or
• Cyclosporine (e.g., Sandimmune) or
• Potassium-containing medicines or supplements Use with potassium-sparing diuretics may cause high blood levels of potassium, which may increase the chance of side effects

• Digoxin Use with spironolactone may cause high blood levels of digoxin, which may increase the chance of side effects

• Lithium (e.g., Lithane) Use with potassium-sparing diuretics may cause high blood levels of lithium, which may increase the chance of side effects

• Diabetes mellitus (sugar diabetes) or
• Kidney disease or
• Liver disease Higher blood levels of potassium may occur, which may increase the chance of side effects

• Gout or
• Kidney stones (history of) Triamterene may make these conditions worse

• Menstrual problems or breast enlargement Spironolactone may make these conditions worse