Triamterene

Brand names

• Apo-Triazide [CD]
• Dyazide [CD]
• Dyrenium
• Maxzide [CD]
• Maxzide-25 [CD]
• Novo-Triamzide [CD]
• Nu-Triazide

Usage

Used as an adjunctive, supplementary treatment with other diuretics to conserve potassium while promoting the excretion of sodium and water. In conjunction with thiazide or loop diuretics, triamterene reduces the overall fluid volume in the body and so helps to control symptoms of heart disease, kidney disease, and liver disease.

How it works

Triamterene promotes the excretion of sodium and excess water by altering kidney enzymes that control urine production. Unlike most other types of diuretics, triamterene promotes fluid and salt loss but does not deplete normal levels of potassium.

Side effects

Serious

Skin rash, hives, lightheadedness, unusual bleeding.

Common

Dry mouth, stomach irritation.

Less common

Dizziness, nausea, vomiting, stomach cramps, diarrhea, headache, increased sensitivity of skin to sunlight.

Possible interactions

Other medicaments:

Triamterene may increase the effects of:

• amantadine (Symmetrel).
• digoxin (Lanoxin).
• metformin (Glucophage).
• methotrexate (Mexate), leading to bone marrow toxicity.
• valsartan (Diovan), leading to potassium toxicity.

Triamterene taken concurrently with:

• captopril (Capoten) or other ACE inhibitors may cause excessively high blood potassium levels.
• cyclosporine (Sandimmune).
• dofetilide (Tikosyn) may lead to excessive dofetilide levels. Careful patient monitoring and more frequent dofetilide levels are indicated if these medicines are combined.
• folic acid may reduce folic acid benefits.
• histamine (H2) blockers may decrease triamterene absorption and its therapeutic effects.
• indomethacin (Indocin) may increase the risk of kidney damage.
• lithium may cause accumulation of lithium to toxic levels.
• NSAIDs may blunt the blood-pressure-lowering effect of triamterene.
• potassium preparations may cause excessively high blood pressure. Tacrolimus (Prograf) may lead to excessively high blood potassium levels.

Foods:

Diets high in high-potassium foods may cause problems.

Herbal medicines or minerals:

Ginseng may increase blood pressure, blunting the benefits of these medicines. Hawthorn, saw palmetto, ma huang, goldenseal, yohimbe and licorice may also increase blood pressure. Calcium and garlic may help lower blood pressure. Use caution and work with your doctor to make sure blood pressure is not lowered too much. Eleuthero root and ephedra should be avoided by people living with hypertension.

Alcohol:

Alcohol may enhance drowsiness and the blood-pressure-lowering effect of this medicament.

Exposure to sun:

Use caution-this medicament may cause photosensitivity.

Discontinuation:

With high-dose or prolonged use, it is best to slowly withdraw this medicament. Stopping it suddenly may cause rebound potassium removal and potassium deficiency.

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