Triamterene

Indications
 Oral
Oedema
Adult: 150-250 mg/day in 2 divided doses, after breakfast and lunch. Maintenance: doses may be given on alternate days. Max: 300 mg/day.
Renal impairment: Use with caution. Severe: avoid.
Hepatic impairment: Severe: avoid.
Oral
Hypertension
Adult: In combination with other diuretics e.g. hydrochlorothiazide: Initially, 50 mg daily.
Renal impairment: Use with caution. Severe: avoid.
Hepatic impairment: Severe: avoid.
Contraindications
 severe renal or hepatic impairment, preexisting or drug-induced hyperkalemia, patients at risk of respiratory or metabolic acidosis. Lactation.
Warnings / Precautions
 Renal and hepatic impairment; cirrhosis; DM; hyponatraemia; hyperuricaemia; history of nephrolithiasis; depleted folic acid stores. Monitor electrolyte concentrations closely, especially potassium levels. Observe for signs of liver damage, blood dyscrasias or other idiosyncratic reactions. Discontinue treatment if urinary calculus is passed. Pregnancy and elderly.
Adverse Reactions
 Photosensitivity reactions; increase in uric acid concentrations; megaloblastic anaemia; thrombocytopenia; hyperkalaemia; nephrolithiasis; renal failure; GI disturbances such as nausea, vomiting, diarrhoea; dry mouth; fatigue; dizziness; skin rash, muscle cramps; headache; orthostatic hypotension; increased BUN concentrations, LFT abnormalities.
Overdose Reactions
 Symptoms: electrolyte imbalance, especially hyperkalemia. GI disturbances such as nausea, vomiting, weakness, hypotension. Management: Empty stomach by emesis or gastric lavage. Treatment is supportive and symptomatic. Monitor electrolyte pattern and fluid balance closely. Severe hypotension may be relieved by admin of pressor agents such as norepinephrine. Dialysis may be useful.
Drug Interactions
 Increased risk of hyperkalemia with potassium supplements, other potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, trilostane, potassium-containing medications (such as parenteral penicillin G potassium), eplerenone, tacrolimus, ciclosporin, LMWH. Increased risk of bone marrow suppression with methotrexate.
Potentially Fatal: Increased risk of nephrotoxicity with NSAIDs and ciclosporin. Increased risk of lithium toxicity.
See Below for More triamterene Drug Interactions
Lab Interactions
 May cause pale blue fluorescence in urine which may interfere with methods of enzyme assay that depend on fluorometry, e.g. determinations of lactic dehydrogenase activity. Interferes with fluorometric assay of quinidine due to similar fluorescence spectra.
Mechanism of Actions
 Triamterene is a potassium sparing diuretic which appears to act mainly on the distal renal tubules. It increases the excretion of Na and reduces the excretion of potassium. It adds to the natriuretic but reduces the kaliuretic effects of other diuretics. It is structurally similar to folate and has anti-folate activity.
Onset: Diuresis: 2-4 hr.
Duration: Diuresis: 7-9 hr.
Absorption: Rapid but variable absorption from GI tract. Bioavailability: 50%.
Distribution: Crosses the placenta; may be distributed into breast milk. Protein binding: 60%.
Metabolism: Extensively metabolised. Plasma half-life: 2 hr.
Excretion: Mainly excreted in the urine as metabolites and unchanged triamterene.
Administration
 Should be taken with food. (Take after meals.)
Storage Conditions
 Oral: Store between 15-30°C (59-86°F).
ATC Classification
 C03DB02 - triamterene ; Belongs to the class of other potassium-sparing agents. Used as diuretics.
Storage
 Oral: Store between 15-30°C (59-86°F).
Available As
  • Triamterene 50 mg

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