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Triamterene information from DrugsUpdate  

See Available Brands of Triamterene in India

P - Caution when used during pregnancy
L - Contraindicated in lactation
LI - Lab *

Triamterene (trade name Dyrenium) is a potassium-sparing diuretic used in combination with thiazide diuretics for the treatment of hypertension and edema.

Pharmacodynamics

Pharmacokinetics

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 hours.

Duration
Diuresis: 7-9 hours.

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 hours.

Excretion
Mainly excreted in the urine as metabolites and unchanged triamterene.

Triamterene Indications / Triamterene Uses

Information Not Available

Triamterene Adverse Reactions / Triamterene Side Effects

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.

Precautions

Information Not Available

Special Precautions

Overdosage
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.

Other 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.

Other Interactions

Information Not Available

Dosage

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.

Food(before/after)

Should be taken with food. (Take after meals.)

List of Contraindications

Triamterene and Pregnancy

Caution when used during pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

If used in pregnancy-induced hypertension.

Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Triamterene and Lactation

Contraindicated in lactation

Triamterene and Children

Information Not Available

Triamterene and Geriatic

Information Not Available

Triamterene and Other Contraindications

Severe renal or hepatic impairment, preexisting or drug-induced hyperkalemia, patients at risk of respiratory or metabolic acidosis. Lactation.

Storage

Oral
Store between 15-30°C (59-86°F).

Lab interference

Oral
Store between 15-30°C (59-86°F).

Triamterene brands in India:

Ditide Frusemene

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