Triamterene
Mechanism :
It is a diuretic agent, which acts on the distal tubules and increases the sodium and water excretion from the kidneys. It is used in the treatment of edema associated with congestive cardiac failure, liver diseases and kidney diseases. It is usually given in combination with thiazide diuretics to prevent hypokalemia.
Indication :
- Edema associated with congestive heart failure
- Cirrhosis of the liver
- Nephrotic syndrome
- Steroid-induced edema, idiopathic edema and edema due to secondary hyperaldosteronism.
Contraindications :
Do not use triamterene if you have kidney disease, urination problems, severe liver disease, or high levels of potassium in your blood. Do not use potassium supplements or other diuretics while you are taking triamterene.
Dosing :
Safety & efficacy not established in children.
Doses of 2 to 4 mg/kg/day PO, given in 1 to 2 divided doses have been used in children. Maximum dosage is 6 mg/kg/day PO or 300 mg/day, whichever is less.
Adverse Effect :
Nausea, diarrhea, weakness, dry mouth and blood dyscrasias, edema, hypotension, CHF, dizziness, photosensitivity, fatigue, hyperuricemia, nephrotoxicity.
Interaction :
Captopril: Increased risk of hyperkalemia.
Indomethacin: Risk of acute renal impairment with this combination.
Potassium: Increased risk of hyperkalemia.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Avoid. |
| <10 | Avoid. |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unknown dialysability. Avoid |
| HD | Unknown dialysability. Avoid |
| HDF/High flux | Unknown dialysability. Avoid |
| CAV/VVHD | Unknown dialysability. Avoid |
Hepatic Dose :
Dose reduction may be need as cirrhosis is associated with a four-fold increase in half-life.
Mild to moderate hepatic impairment: Dose adjustment guidelines are not available, as dosing has not been studied. Use cautiously.
Severe impairment: The use of this drug is contraindicated.