Triamterene

Generic name: triamterene (try AM teh reen)
Brand name: Dyrenium
Drug class: Potassium-sparing diuretics

Triamterene is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

Triamterene is used to treat fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney condition called nephrotic syndrome.

Triamterene is also used to treat edema caused by using steroid medicine or having too much aldosterone in your body. Aldosterone is a hormone produced by the adrenal glands to help regulate the salt and water balance in your body.

Warnings

You should not use triamterene if you have severe kidney or liver disease, urination problems, or high levels of potassium in your blood. You should not take triamterene if you also take potassium supplements, or other diuretics such as amiloride or spironolactone.

Call your doctor right away if you have signs of hyperkalemia (high potassium), such as nausea, irregular heartbeats, weakness, or loss of movement. High potassium may be more likely in older adults, or in people with kidney disease, diabetes, or severe illness.

You should not take triamterene if you also take potassium supplements, or other diuretics such as amiloride or spironolactone.

Call your doctor right away if you have signs of hyperkalemia (high potassium), such as nausea, slow or unusual heart rate, weakness, or loss of movement. You may be more likely to have high potassium if you have kidney disease, diabetes, a severe illness, or if you an older adult.

Avoid drinking alcohol, which can increase some of the side effects of triamterene.

Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.

Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking triamterene.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Triamterene can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Before taking this medicine

You should not use triamterene if you are allergic to it, or if you have:

• severe kidney disease, or if you are unable to urinate;
• severe liver disease;
• high potassium levels (hyperkalemia); or
• if you take potassium supplements, or another potassium-sparing diuretic such as amiloride, eplerenone, or spironolactone.

To make sure triamterene is safe for you, tell your doctor if you have ever had:

• diabetes;
• heart disease;
• kidney disease;
• liver disease;
• gout; or
• kidney stones.

Using triamterene may increase your risk of developing hyperkalemia (high levels of potassium in your blood). High potassium may be more likely in older adults, or in people with kidney disease, diabetes, or severe illness.

Tell your doctor if you are pregnant or if you become pregnant. Triamterene may harm an unborn baby. However, the benefit of treating edema during pregnancy may outweigh the risk to the baby.

You should not breastfeed while using this medicine.

Triamterene is not approved for use by anyone younger than 18 years old.

How should I take triamterene?

Take triamterene exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take triamterene after eating a meal to avoid stomach upset.

Taking a diuretic can make you urinate more often, which could disrupt your sleep. If you take triamterene only once per day, take it in the morning to reduce the chance of night-time urination.

You may need frequent medical tests. Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG).

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using triamterene.

If you need surgery, tell the surgeon ahead of time that you are using this mediciner.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Dosing information

Usual Adult Dose for Ascites:

Initial dose: 100 mg orally 2 times a day after meals
Maximum dose: 300 mg/day

Comments:
-The dosage should be titrated to the needs of the individual patient.
-The maximum therapeutic effect may not be seen for several days.
-When this drug is used concomitantly with another diuretic or antihypertensive agent, the total daily dose of each agent should be lowered initially and then adjusted according to patient need.

Use: To reduce edema in cardiac failure, cirrhosis of the liver or nephrotic syndrome, and in that associated with corticosteroid treatment

Usual Adult Dose for Edema:

Initial dose: 100 mg orally 2 times a day after meals
Maximum dose: 300 mg/day

Comments:
-The dosage should be titrated to the needs of the individual patient.
-The maximum therapeutic effect may not be seen for several days.
-When this drug is used concomitantly with another diuretic or antihypertensive agent, the total daily dose of each agent should be lowered initially and then adjusted according to patient need.

Use: To reduce edema in cardiac failure, cirrhosis of the liver or nephrotic syndrome, and in that associated with corticosteroid treatment

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include increased nausea, vomiting, unusual heart rate, muscle weakness, or loss of movement.

What to avoid

Avoid driving or hazardous activity until you know how triamterene will affect you. Your reactions could be impaired.

Drinking alcohol with this medicine can cause side effects.

Triamterene could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Triamterene side effects

Get emergency medical help if you have signs of an allergic reaction to triamterene: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

• pale skin, easy bruising or bleeding;
• slow, fast, or uneven heartbeat;
• jaundice (yellowing of the skin or eyes);
• little or no urinating;
• signs of a kidney stone - sudden pain in your back or side, vomiting, fever, chills, painful urination, and urine that looks, red, pink, brown, or cloudy; or
• high potassium level - nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common triamterene side effects include:

• nausea, diarrhea;
• dizziness, headache;
• dry mouth; or
• feeling weak or tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect triamterene?

Tell your doctor about all your other medicines, especially:

• any other diuretic;
• lithium;
• insulin or oral diabetes medicine;
• heart or blood pressure medicine; or
• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with triamterene, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.