The effect of amiloride/hydrochlorothiazide combination vs furosemide plus potassium supplementation in the treatment of oedema of cardiac origin.

In this double-blind multicentre study efficacy and safety of amiloride/hydrochlorothiazide (A/HCTH) combination and furosemide plus potassium supplementation (FUR/P) was compared after four weeks basal period -- FUR/P period. 43 patients entered the double-blind period which lasted for ten weeks. Congestive heart failure was well controlled in both of those treatment groups. There was only one patient (FUR/P-group) whose daily dose had to be increased. According their own evaluation the patients tolerated the A/HCTH combination (48%) better than the FUR/P combination (30%). In the A/HCTH-group one clinically significant case of hypokalaemia was found which caused the therapy to be stopped. In the FUR/P-group two patients discontinued the treatment because of clinical side effects. In the long-term therapy of congestive heart failure hydrochlorothiazide together with potassium-sparing amiloride is a pleasant and effective therapy for patients with normal renal function, but the risk of hypokalaemia must be kept in mind also when using this combination.