Drug reference

Triamterene

Potassium-Sparing Diuretic · Diuretic

Potassium-Sparing DiureticDiuretic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

FDA category + note

Top interactionssee all 12 →

BucindololSevereTextbookKDT 7e
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EsmololSevereTextbookKDT 7e

Mechanism

Triamterene is a weak diuretic that causes retention of potassium. It is typically given with thiazide or loop diuretics to enhance diuresis and serve as a more effective alternative to potassium supplements.

Indications

Prevention of hypokalemia when co-administered with thiazide or loop diureticsOedema (in combination with other diuretics)Liddle syndromecombination with other diuretics (to augment diuresis and offset kaliuretic effects)Combination with thiazides to antagonize urinary K+ loss and risk of ventricular arrhythmiasIn conjunction with thiazide type or high ceiling diuretic (to prevent hypokalaemia, augment natriuretic response)Supplement antihypertensive action of thiazidesHypertensionCounteract hypokalemic effect of diuretics

Dosing

Adult: Start 25 mg, common daily dose 100 mg (with RAS blocker); Start 50 mg, common daily dose 200 mg (without RAS blocker).
Renal adjustment: Avoid in severe impairment. Monitor plasma-potassium concentration due to high risk of hyperkalaemia.
Hepatic adjustment: Manufacturer advises caution; avoid in severe hepatic failure or hepatic coma. Initial dose reduction advised.

Pharmacokinetics

Duration

6–8 hours

Half-life

Bioavailability

~50%

Protein binding

partly bound to plasma proteins

Metabolism

metabolized in the liver to an active metabolite (4-hydroxytriamterene sulfate) which is excreted in urine

Excretion

excreted in urine

Contraindications

Anuria
Dehydration
Hyperkalaemia
Hypovolaemia
Renal failure
Severe hypokalaemia
Severe hyponatraemia
Concomitant use with potassium supplements
Concomitant use with ACE inhibitors
Concomitant use with angiotensin-II receptor antagonists
hyperkalemia
patients at increased risk of developing hyperkalemia (e.g., renal failure, patients receiving other K+-sparing diuretics, patients taking angiotensin-converting enzyme inhibitors, patients taking K+ supplements)
renal insufficiency with creatinine clearance <30 mL/min
should not be combined with ACEIs and MRAs
K+ supplements
Toxaemia of pregnancy

Side effects

Common

Blue fluorescence of urinenauseavomitingleg crampsdizzinessreduced glucose tolerancephotosensitizationCNS adverse effectsGI adverse effectsmusculoskeletal adverse effectsdermatological adverse effectshematological adverse effectshyperkalemiaMuscle crampsRise in blood ureaImpaired glucose tolerancePhotosensitivityAcidosisHyperkalaemiaHyperkalemia, especially in CKD or with other agents that favor potassium retention

Serious