triamterene

Adult Dosing

Peripheral edema

Starting dose: 100 mg PO bid
Dosage should be titrated to meet the needs of the individual patient
Max: 300 mg/day

Notes:

Administer after meal
Do not coadminister potassium supplement

Pediatric Dosing

Safety and effectiveness in pediatric patients have not been established

[Outline]

Adult Dosing
Pediatric Dosing

Indications ⬆ ⬇

Treatment of peripheral edema

Contraindications ⬆ ⬇

Hypersensitivity to any of the ingredients of the product
Anuria
Severe or progressive kidney disease or dysfunction
Severe hepatic disease
Hyperkalemia
Potassium-sparing diuretics, eplerenone

Black Box Warnings ⬆ ⬇

Potassium-sparing agents, including triamterene can cause abnormal elevation of serum potassium levels (5.5 mEq/l). Patients with renal impairment and diabetes and elderly or severely ill patients are at higher risk of hyperkalemia. As uncorrected hyperkalemia can be fatal, monitor serum potassium levels at frequent intervals especially when dosages are changed or with any illness that may influence renal function

Dosing Adjustment ⬆ ⬇

Renal Dose Adjustments

Severe renal impairment: Contraindicated
Anuria: Contraindicated

Hepatic Dose Adjustments

Severe hepatic impairment: Contraindicated

Warnings/Precautions ⬆ ⬇

See Supplemental Patient Information

Potassium-sparing agents, including triamterene can cause abnormal elevation of serum potassium levels [US Black Box Warning]
Hypersensitivity reactions have been reported, hence monitor the patients regularly for the possible occurrence of blood dyscrasias, liver damage or other idiosyncratic reactions
Monitor BUN and serum potassium periodically to check kidney function, especially in patients with suspected or confirmed renal insufficiency
Obtain an ECG if hyperkalemia is present or suspected. Discontinue the drug and any potassium supplementation, if ECG shows no widening of the QRS or arrhythmia in the presence of hyperkalemia and substitute thiazide alone. The presence of a widened QRS complex or arrhythmia in association with hyperkalemia requires prompt additional therapy
Administer sodium polystyrene sulfonate to enhance the excretion of excess potassium or remove it by dialysis. Infuse 44 mEq of sodium bicarbonate or 10 mL of 10% calcium gluconate or calcium chloride over several minutes for tachyarrhythmia
Diuretic agent including triamterene can cause electrolyte imbalance, especially in patient with congestive heart failure, renal disease or cirrhosis
Low-salt syndrome has been reported with the use of full doses of a diuretic when salt intake is restricted
Triamterene can cause a decrease in alkali reserve, resulting in metabolic acidosis
Megaloblastosis has been observed in patients with low folic acid, as triamterene is a weak folic acid antagonist. Perform blood studies periodically in these patients and also for exacerbations of underlying liver disease
Triamterene elevates uric acid, especially in persons predisposed to gouty arthritis

Cautions: Use cautiously in

Renal impairment
Hepatic impairment
Histories of renal stones
Gouty arthritis
Diabetes mellitus
Elderly or severely ill

Supplemental Patient Information

Advise patient to take drug after meals preferably in the morning to minimize the effect of increased frequency of urination on nighttime sleep
Advise patient not take more than the prescribed dose at the next dosing interval, if a dose is missed

Interactions ⬆ ⬇

Dyrenium interacts with :

Pregnancy/Breast Feeding ⬆ ⬇

Pregnancy Category:C

Breastfeeding: It is not a reason to discontinue breastfeeding, if triamterene is required by the mother. However an alternate drug may be preferred, as no information is available on the use of triamterene during breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 29 April 2011). Manufacturer advises to stop nursing, if use of the triamterene is deemed essential.

Adverse Reactions ⬆ ⬇

METABOLIC: Hyperkalemia, hypokalemia
GU: Azotemia, elevated BUN and creatinine, renal stones, acute interstitial nephritis, acute renal failure
GI: Jaundice and/or liver enzyme abnormalities, nausea, vomiting, diarrhea, dry mouth
HEMA: Thrombocytopenia, megaloblastic anemia
CNS: Weakness, fatigue, dizziness, headache
HYPERSENSITIVITY: Anaphylaxis, rash, photosensitivity

Clinical Pharmacology ⬆ ⬇

Potassium-sparing agents; inhibits the reabsorption of sodium ions in exchange for potassium and hydrogen ions at the segment of the distal tubule under the control of adrenal mineralocorticoids
Rapidly absorbed
Metabolized by liver
Renally excreted (21% unchanged)
Half-life: 1.7-2.5 hrs

Brands and Availability ⬆ ⬇

US Trade Name(s)

Dyrenium

US Availability

Dyrenium

CAPS: 50, 100 mg

Canadian Trade Name(s)

Canadian Availability

UK Trade Name(s)

Dytac

UK Availability

triamterene (generic)

CAPS: 50 mg

Dytac

CAPS: 50 mg

Australian Trade Name(s)

Australian Availability

[Outline]

Classification ⬆ ⬇

Cardiovascular

Diuretics
Potassium-sparing Diuretics

Pricing ⬆ ⬇

Pricing data from www.DrugStore.com in U.S.A.

Dyrenium 100 MG CAPS [Bottle] (WELLSPRING PHARMACEUTICAL CORP)
30 mg = $75.99
90 mg = $205.97
Dyrenium 50 MG CAPS [Bottle] (WELLSPRING PHARMACEUTICAL CORP)
30 mg = $49.99
90 mg = $126.99

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

Pill ⬆

Drug Name: Dyrenium 100 MG Oral Capsule

Pill Image:

small/000764ss.jpg [
See full size image]

Ingredient(s): Triamterene

Imprint: DYRENIUM;100;mg;WPC;003

Color(s): Red

Shape: Capsule

Size (mm): 10.00

Score: 1

Inactive Ingredient(s): d&c red no. 33 / fd&c yellow no. 6 / gelatin / lactose / magnesium stearate / sodium lauryl sulfate / titanium dioxide / silicon dioxide

Drug Label Author:
WellSpring Pharmaceutical Corporation

DEA Schedule:
Non-Scheduled

Drug Name: Dyrenium 50 MG Oral Capsule