Hydrochlorothiazide vs Amiloride: side-by-side comparison
Hydrochlorothiazide (Thiazide diuretic) and Amiloride (Potassium-sparing 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 | Hydrochlorothiazide | Amiloride |
|---|---|---|
| Therapeutic class | Thiazide diuretic | Potassium-sparing diuretic |
| CAS | 58-93-5 | 2609-46-3 |
| ATC | C03AA03 | C03DB01 |
| Molecular weight | 297.74 g/mol | 229.63 g/mol |
| Brands with this active ingredient | 1 | 1 |
What they share
Hydrochlorothiazide and Amiloride 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
Hydrochlorothiazide acts by a different mechanism than Amiloride, 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
Hydrochlorothiazide: Hydrochlorothiazide blocks the sodium-chloride symporter in the distal convoluted tubule of the kidney, reducing sodium reabsorption and producing modest diuresis. 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.
Indications compared
Hydrochlorothiazide: Hydrochlorothiazide is approved for hypertension (alone or in combination), oedema in heart failure, hepatic cirrhosis or nephrotic syndrome, and certain renal conditions. 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…
Safety profile
Hydrochlorothiazide: Common adverse effects include hypokalaemia, hyponatraemia, hyperuricaemia (with gout flares), hyperglycaemia, dyslipidaemia and orthostatic hypotension. Amiloride: Common adverse effects include hyperkalaemia (the main risk), hyponatraemia, dehydration and gastrointestinal upset.
Frequently asked questions
Is Hydrochlorothiazide better than Amiloride? ▾
Hydrochlorothiazide and Amiloride are not "better or worse" — they treat different things. The sensible question is which fits your specific need.
Can Hydrochlorothiazide and Amiloride 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 Hydrochlorothiazide
Products with Amiloride
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.