Lometazid 5 mg + 10 mg tablets – methyclothiazide and amiloride for hypertension, heart failure and oedema

Lometazid is a medicine containing two active substances – methyclothiazide and amiloride hydrochloride – that acts as a diuretic, helping the body eliminate excess fluid in the urine. Methyclothiazide belongs to the thiazide diuretics and amiloride to the potassium-sparing diuretics. The medicine is registered as 5 mg + 10 mg tablets.

Together, these substances lower blood pressure and remove swelling of various origins. Lometazid is a prescription-only medicine, and the dose is determined by the doctor according to the patient's condition and other medicines.

What is Lometazid (methyclothiazide and amiloride) used for and how should it be taken?

Key facts about the medicine

What is Lometazid used for?

According to the official package leaflet, Lometazid is used to treat:

• high blood pressure (arterial hypertension);
• heart failure (congestive heart failure);
• swelling (oedema) of various origins.

How is it used and dosed?

The medicine is taken by mouth. Dosing is individual and depends on your condition and other medicines you take.

• Adults: the usual daily dose is ½ to 1 tablet a day, in the morning after breakfast.
• Do not change the dose yourself; if you feel the medicine works too weakly or too strongly, talk to your doctor or pharmacist.
• Avoid potassium-rich foods (e.g. milk, bananas, raisins, prunes) – your doctor will tell you which foods to avoid.

The dosing above is the general dosing from the leaflet and is not an individual recommendation.

Special patient groups

• Children: use is contraindicated because safety in children has not been established.
• Elderly people: may already have electrolyte imbalance, so the dose is carefully adjusted to kidney function and clinical response; they have a higher risk of hyperkalaemia.
• Impaired kidney function: the medicine must not be used in severe kidney disease or kidney failure, anuria or diabetic nephropathy; milder impairment requires caution and monitoring.
• Impaired liver function: the medicine must not be used in severe liver impairment or pre-coma associated with cirrhosis; severe liver disease requires medical advice.

Contraindications – when the medicine must not be used

Do not take Lometazid if:

• you are allergic to methyclothiazide, amiloride, sulphonamides (including thiazide diuretics and sulphonamide antibiotics such as sulfamethoxazole) or any of the excipients;
• you have high blood potassium (hyperkalaemia);
• you take medicines containing potassium or potassium as a dietary supplement;
• you take another potassium-sparing diuretic (e.g. spironolactone or triamterene);
• you have anuria (no urine production), severe kidney disease or kidney failure, or diabetic nephropathy;
• you have severe liver impairment or pre-coma associated with cirrhosis;
• you have Addison's disease;
• you have high blood levels of calcium, urea or creatinine;
• you take lithium;
• you are pregnant or breastfeeding.

Precautions and warnings

• Have your blood electrolytes checked regularly. Contact your doctor if you experience dry mouth, drowsiness, restlessness, confusion, muscle pain or cramps, muscle weakness, low blood pressure, fast heartbeat, reduced urination, nausea or vomiting.
• Hyperkalaemia is especially possible in elderly and hospitalised patients with liver cirrhosis or cardiac oedema and kidney impairment; fatal cases have been reported. If hyperkalaemia occurs, the medicine is stopped immediately.
• Thiazides can affect glucose tolerance and worsen diabetes; the doctor may adjust the dose of antidiabetic medicines or insulin. Cholesterol, triglycerides and uric acid (gout) may increase.
• Tell your doctor if you have lupus or gout, if you have had severe vomiting or diarrhoea, metabolic or respiratory acidosis, or if you take digoxin.
• Reduced vision or eye pain may be signs of fluid accumulation in the choroid (choroidal effusion) or increased eye pressure and may occur within hours to a week of taking the medicine; untreated, they can lead to permanent vision loss. The risk is higher in people who have had an allergy to penicillin or sulphonamides.
• Amiloride should be stopped at least 3 days before diabetes tests, as it may affect the results.
• The medicine contains lactose.

Interactions with other medicines, food and drink

It is important to tell your doctor or pharmacist if you take:

• lithium (contraindicated), potassium salts and potassium-containing medicines;
• diabetes medicines (e.g. chlorpropamide, insulin);
• ciclosporin or tacrolimus;
• other blood pressure medicines: ACE inhibitors (captopril, enalapril), angiotensin II antagonists (losartan, valsartan), beta-blockers (sotalol), calcium channel blockers (amlodipine, diltiazem), alpha-blockers (prazosin), clonidine, diazoxide, methyldopa, moxonidine, hydralazine, minoxidil, sodium nitroprusside;
• non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen);
• antidepressants (MAO inhibitors, tricyclic antidepressants) and St John's wort;
• carbamazepine, barbiturates, antipsychotics (amisulpride, pimozide, chlorpromazine), anxiolytics and hypnotics (diazepam), atomoxetine;
• corticosteroids, ACTH, levodopa, baclofen, tizanidine, nitrates, oestrogen and drospirenone, alprostadil, moxisylyte, aldesleukin, trilostane, anaesthetics;
• opioid analgesics (codeine, morphine and others), colestyramine and colestipol, adrenaline.

Avoid alcohol, as it may cause a large drop in blood pressure. Also avoid potassium-rich foods.

Pregnancy and breastfeeding

Lometazid must not be taken during pregnancy and breastfeeding. Routine use of diuretics in pregnancy is not indicated; thiazides cross the placenta and may cause jaundice, low platelets and bone marrow depression in the newborn. Thiazides pass into breast milk, so breastfeeding must be stopped if treatment is necessary.

Driving and using machines

Reduced mental alertness may impair the ability to drive and use machines. Do not drive until you know how the medicine affects you.

Possible side effects

Side effects are mainly related to diuresis, thiazide therapy and the underlying disease. Apart from hyperkalaemia, significant adverse reactions have rarely been reported; nausea, loss of appetite, abdominal pain, wind and mild rash are mainly caused by amiloride.

• Metabolism: hyperkalaemia, hyponatraemia, hypokalaemia, dehydration, raised blood sugar and uric acid, gout.
• Nervous system and mood: light-headedness, vertigo, pins and needles, tremor, insomnia, nervousness, confusion, depression, drowsiness.
• Eye and ear: transient blurred vision, increased eye pressure, yellow vision, ringing in the ears.
• Heart and blood vessels: drop in blood pressure on standing, arrhythmias, fast heartbeat, palpitations, angina.
• Digestion: dry mouth, nausea, vomiting, diarrhoea, constipation, abdominal pain, wind, thirst, hiccups, activation of a peptic ulcer, pancreatitis, gastrointestinal bleeding.
• Skin: rash, itching, sweating, sensitivity to light, hives, hair loss; rarely severe toxic epidermal necrolysis.
• Kidneys and urination: frequent and night-time urination, painful urination, impaired kidney function.
• Blood: reduced white blood cells and platelets, anaemia.
• Other: muscle cramps, joint pain, headache, weakness, reduced libido, impotence, fainting.

Report any suspected side effect to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose: symptoms include dehydration and changes in blood electrolyte levels. Contact a doctor or emergency service immediately, especially if a child has swallowed a tablet.
• Missed dose: do not take a double dose; continue with the recommended schedule.
• Stopping treatment: do not stop the medicine without consulting your doctor.

Related information

• How to lower high blood pressure without medicines

For additional care and support with high blood pressure and heart conditions (regular blood pressure checks), see also the Blood pressure monitors category – products in this category do not replace the medicine you have been prescribed.

Composition, packaging and manufacturer

• Active substances: 5 mg methyclothiazide and 10 mg amiloride hydrochloride (as amiloride hydrochloride dihydrate) per tablet.
• Excipients: crospovidone, lactose monohydrate, povidone K-25, microcrystalline cellulose, magnesium stearate.
• Appearance: round, biconvex, pale yellow tablets.
• Pack: PVC-Al/PVC blister with 15 tablets; 2 blisters per carton (30 tablets).
• Marketing authorisation holder and manufacturer: GALENIKA AD BEOGRAD, Batajnički drum b.b., Belgrade.

Storage

• Store below 25 °C in the original package to protect from light and moisture.
• Keep out of the sight and reach of children; do not use after the expiry date stated on the pack.
• Return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

Why must I not take potassium with Lometazid?

Amiloride is a potassium-sparing diuretic. Extra potassium from medicines, supplements or large amounts of potassium-rich food can lead to hyperkalaemia, which can be life-threatening. That is why combination with potassium is contraindicated.

When is the best time to take Lometazid?

According to the leaflet, the usual dose of ½ to 1 tablet is taken in the morning after breakfast.

Can I drink alcohol while taking Lometazid?

Alcohol should be avoided because it can cause a large drop in blood pressure.

Does Lometazid affect blood sugar?

Thiazides can affect glucose tolerance and worsen diabetes, so the doctor may adjust diabetes treatment. Before diabetes tests, amiloride should be stopped at least 3 days in advance, as agreed with the doctor.

Sources

• ALIMS – Package leaflet Lometazid®, 5 mg + 10 mg, tablet (May 2022, in Serbian)
• ALIMS – Summary of Product Characteristics Lometazid®, 5 mg + 10 mg, tablet (in Serbian)

Date sources were checked: 24.10.2026.