Triamteres

Last updated on: 18.12.2020

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Definition
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Triamterene (like amiloride) belongs to the potassium-sparing diuretics and is approved for lowering blood pressure in arterial hypertension, relieving heart failure and treating edema. Triamterene is combined with other thiazide diuretics such as bemetizide, hydrochlorothiazide and xipamide or loop diuretics.

Spectrum of action
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Pharmacologically, triamterene (molecular formula: C12H11N7) is an organic chemical with a pteridine backbone and a dinuclear nitrogen-containing aromatic. Triamterene inhibits the aldosterone-dependent epithelial sodium channel in the late distal tubule of the nephron. In this part of the tubule system, sodium ions are passively reabsorbed from the urine. This occurs in exchange with potassium ions. If sodium reabsorption is inhibited by blocking the channel, the excretion of sodium ions via the kidneys increases. Secondarily, the excretion of potassium is reduced. At the same time, water is excreted along with the sodium and thus urine is increased (sodium binds water in a hydrate shell). Triamterene and its metabolites are excreted by the kidneys. The half-life is 2-4 h.

Dosage and method of use
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The daily dose is usually 100mg-200mg/day.

Undesirable effects
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General, UAW:

  • Exsiccosis
  • Sodium deficiency
  • Increase in blood urea levels,

Ophthalmological UAW:

  • visual disturbances such as worsening of existing myopia
  • Xerophthalmia
  • Glaucoma

Dermatological UAW:

  • Pruritus
  • Reddening of the skin
  • Exanthema
  • Urticaria
  • Photosensitivity
  • Lupus erythematosus
  • Increased sweating (hyperhidrosis)

Electrolyte disorders

  • Exsiccosis
  • Hypokalemia
  • Hyperkalaemia (this risk exists especially in patients with diabetes mellitus and impaired kidney function or metabolic acidosis)
  • Hyponatremia
  • Magnesium deficiency
  • Chlorine deficiency
  • Hypercalcaemia

Metabolic disorders

  • Increase in blood glucose
  • Glucosuria
  • Increase in blood lipids
  • Increase in uric acid concentration

Haematological UAW

  • Leukopenia
  • Anemia

Cardiac adverse events:

  • Cardiac arrhythmias

Patients with liver cirrhosis are at risk of megaloblastic anemia

Interactions
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Combination with other antihypertensives increases the antihypertensive effect

Non-steroidal anti-inflammatory drugs may inhibit the effect of triamterene

Contraindication
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hypersensitivity to the active substance

Potassium deficiency

Pregnancy and breastfeeding

Preparations
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Dytide®, Triampurund®; various other generics

+Bemeticide: Dehydro-Sanol®.

+hydrochlorothiazide: Verla®, Venostasin®, Triampur comp®, etc.

+hydrochlorothiazide +propanol: Beta-Turfa®

+Xipamide: Neotri®

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Diuretics;

Last updated on: 18.12.2020