Triamterene

Triamterene is a potassium sparing diuretic, independent of the presence or absence of aldosterone. Triamterene is antihypertensive agent. Chemically Triamterene is 2, 4, 7- triamino-6-phenylpteridine. It inhibits reabsorption of sodium ions in exchange for potassium and hydrogen ion at the site of distal tubules. Triamterene is also used in combination with thiazide diuretic in the management of oedema associated with congestive heart failure, cirrhosis and nephrotic syndrome.

Brands
DYAZIDE
Adult Dose
Dose: 75 to 125 mg
Single Dose: 100 (100)
Frequency: 12 hourly
Route: PO
Instructions: Initially for 1 Week
Neonatal
Dose: 1 to 2 mg/kg
Single Dose: 1.5 (1.5)
Frequency: 12 hourly
Route: Oral
Instructions: -
Paedriatic
Dose: 1 to 2 mg/kg
Single Dose: 1.5 (1.5)
Frequency: 12 hourly
Route: Oral
Instructions: -
Characteristics
. It is of Synthetic origin and belongs to Pteridine. It belongs to Na channel inhibitor (K-Sparing) pharmacological group on the basis of mechanism of action and also classified in Diuretics pharmacological group.The Molecular Weight of Triamterene is 253.30. Its pKa is 6.2.
Contraindications
Triamterene is contraindicated in conditions like Renal failure,Hyperkalaemia.
Effects
The severe or irreversible adverse effects of Triamterene, which give rise to further complications include Rashes, Thrombocytopenic purpura, Megaloblastic anemia, Renal stones, Nephrotic diabetes insipidus.Triamterene produces potentially life-threatening effects which include Hyperkalemia, Acute Renal Failure, Hypovolemia. which are responsible for the discontinuation of Triamterene therapy.The signs and symptoms that are produced after the acute overdosage of Triamterene include GI disturbances, Muscular weakness.The symptomatic adverse reactions produced by Triamterene are more or less tolerable and if they become severe, they can be treated symptomatically, these include Weakness, Headache, Diarrhea, Dry mouth, Nausea and vomiting.
Indications
Triamterene is primarily indicated in conditions like Edema, Heart failure, Hypertension, Oedema, Potassium conservation with thiazide/loop diuretics, and can also be given in adjunctive therapy as an alternative drug of choice in Liver cirrhosis, Nephrotic syndrome.
Interactions
Triamterene is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAmantadine (HCl)Triamteren reduces the clearance of amantadine result in increase plasma level thus increase toxicity such as ataxia,confusion and agitation.Minordose of amantadine should be reduced or discontinue the drug if necessary.an alternative diuretic may be subtituted.Canrenoate (K)Diclofenac (Na)traimterene deteriorate the renal function of diclofenacDiclofenac (Na)Concomitant use of these agents inhibit the renal synthesis of prostaglandin which help to maintain glomerular filtration and thus adversely affect the renal function result in hyperkalemia and elevation in blood pressure.ModerateClosely monitor renal function and blood pressure of patient. Avoid dehydration. Drugs should be discontinued ifhyperkalemia or renal insufficiency develop.DigoxinTriamterene may diminish the therapeutic effect of Digoxin. Specifically, the inotropic effects. ModerateMonitor for decreased therapeutic effects of Digoxin if Triamterene is initiated/dose increased, or increased effects if Triamterene is discontinued/dose decreased.IndomethacinIndomethacinMetformin (HCl)Triamterene reduces the excretion of metformin by competing for renal tubular transport results in increased level of metformin may lead to lactic acidosis.ModerateSlowly reduce the dose of metformin. Closely monitor the blood glucose level. Patient should notify to physician if experience signs of lactic acidosis.PerindoprilLikely interaction of TRIAMTERENE increasing the HYPERKALAEMIC effect of Perindopril Erbumine. MajorPotassium BicarbonateConcurrent use may cause high blood potassium levels and cause listlessness, confusion, abnormal skin sensations of the arms and legs, heaviness of limbs, slowed or irregular heartbeat, or stopping of the heart.Potassium CanrenoatePotassium CitrateSimultaneous administration of these agents can produce severe hyperkalemia.Concurrent use should be avoided.PramipexoleTriamterene decrease the clearance of pramipexole by ~20%.Rutin (Vitamin P)Rutin may have additive effects when used in combination with Triamterene.SpironolactoneTacrolimusThiamine HCl (Vitamin B1)Triamterene have been associated with decreased thiamin levels in the body by increasing urinary excretion and possibly by decreasing absorption and increasing metabolism. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Fluoroscent Measurement of Quinidine
Risks
Drug should not be given to Paediatrics, patients suffering from Kidney dysfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store in a well closed container, Below 40°C. Protect from Sunlight.
Warnings
Triamterene should be used with caution in patients with diabetes, liver, kidney problems or gout. Avoid prolonged sun exposure, use sunscreen and wear protective clothing. It should be used with caution during pregnancy and lactation.
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