A REVIEW ARTICLE ON TRIAMTERENE DRUG – DIURETIC

Triamterene is a potassium-sparing diuretic that has been in use since 1964. Triamterene is used by physicians who treat patients with fluid retention states secondary to conditions such as congestive heart failure, nephrotic kidney disease, liver cirrhosis, secondary hyperaldosteronism, or even merely idiopathic edema; all of which are FDA approved indications. When giving Triamterene in the combination dosage form with hydrochlorothiazide, other FDA-approved indications of use include the management of hypertension or the treatment of edema in patients who develop hypokalemia secondary to hydrochlorothiazide monotherapy. Of note, the use of Triamterene can also be indicated for overcoming diuretic resistance in patients on only one full dose of a diuretic; by combining two types of diuretics such as Triamterene with a loop diuretic, a diuretic synergism would successfully overcome the resistance and achieve the desired reduction in edema.

Triamterene (TA) is a mild ‘potassium-sparing’ diuretic usually employed in combination with other more potent diuretics in the treatment of hypertension. TA pharmacokinetics and pharmacodynamics in normal volunteers, elderly subjects and in patients with renal and hepatic dysfunction are reviewed. A variety of adverse renal effects, such as abnormalities in urinary sediment, nephrolithiasis, interstitial nephritis and acute renal failure, has been reported to occur and is also reviewed. Of particular concern with the increased availability of ‘over-the-counter’ nonsteroidal anti-inflammatory medications (NSAID) is the adverse interaction between TA and NSAID which may culminate in acute renal failure. Although a rare occurrence, the clinician should be aware of potential adverse reactions associated with the use of TA.