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Amiloride vs Furosemide: side-by-side comparison

Amiloride (Potassium-sparing diuretic) and Furosemide (Loop diuretic) belong to different therapeutic classes and are rarely substitutes for each other. The comparison is useful when a single patient is weighing both options for adjacent or overlapping needs.

Property Amiloride Furosemide
Therapeutic class Potassium-sparing diuretic Loop diuretic
CAS 2609-46-3 54-31-9
ATC C03DB01 C03CA01
Molecular weight 229.63 g/mol 330.7 g/mol
Brands with this active ingredient 1 1

What they share

Amiloride and Furosemide share the common regulatory framework for prescription active ingredients, bioequivalence standards for generics, and pharmacist oversight. Beyond that, points in common are limited.

Key differences

Amiloride acts by a different mechanism than Furosemide, with indications that barely overlap. Comparing the two is useful when a clinician has mentioned both in the same context or the patient wants to understand why one was prescribed instead of the other.

Mechanisms compared

Amiloride: Amiloride blocks the epithelial sodium channel (ENaC) in the distal convoluted tubule and collecting duct of the kidney, reducing sodium reabsorption and indirectly decreasing potassium and hydrogen ion excretion. Furosemide: Furosemide acts on the thick ascending limb of the loop of Henle in the kidney, where it inhibits the Na+/K+/2Cl- co-transporter (NKCC2).

Indications compared

Amiloride: Amiloride is approved for hypertension (typically in combination with thiazides), oedema in heart failure or hepatic cirrhosis (in combination), and primary hyperaldosteronism (Liddle syndrome and pseudohyperaldosteronis… Furosemide: Furosemide is approved for the treatment of fluid overload due to heart failure, chronic kidney disease and liver cirrhosis (with or without ascites), as well as for acute pulmonary oedema.

Safety profile

Amiloride: Common adverse effects include hyperkalaemia (the main risk), hyponatraemia, dehydration and gastrointestinal upset. Furosemide: Common adverse effects include electrolyte imbalances (low potassium, magnesium, sodium, calcium), volume depletion, dizziness on standing, and increased serum uric acid (with potential gout flares).

Frequently asked questions

Is Amiloride better than Furosemide?

Amiloride and Furosemide are not "better or worse" — they treat different things. The sensible question is which fits your specific need.

Can Amiloride and Furosemide be combined?

Whether they can be combined depends on the indications and the interaction profile of each. If both are in a single prescription, the prescriber has weighed it; in self-medication they should never be combined.

Do they have the same side-effect profile?

No — they belong to different classes and have distinct side-effect profiles. Each has its own prescribing information.

Products with Amiloride

Products with Furosemide

The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.