Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/1235
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Dyrenium (Capsule)
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| dailymed-instance:dosage |
Adult Dosage Dosage
should be titrated to the needs of the individual patient. When used alone,
the usual starting dose is 100 mg twice daily after meals. When combined with
another diuretic or antihypertensive agent, the total daily dosage of each
agent should usually be lowered initially and then adjusted to the patient's
needs. The total daily dosage should not exceed 300 mg. Pleaserefer to PRECAUTIONS���General. When
Dyrenium (triamterene) is added to other diuretic therapy or when patients
are switched to Dyrenium from other diuretics, all potassium supplementation
should be discontinued.
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| dailymed-instance:clinicalP... |
Triamterene has a unique mode of action; it inhibits the
reabsorption of sodium ions in exchange for potassium and hydrogen ions at
that segment of the distal tubule under the control of adrenal mineralocorticoids
(especially aldosterone). This activity is not directly related to aldosterone
secretion or antagonism; it is a result of a direct effect on the renal tubule. The
fraction of filtered sodium reaching this distal tubular exchange site is
relatively small, and the amount which is exchanged depends on the level of
mineralocorticoid activity. Thus, the degree of natriuresis and diuresis produced
by inhibition of the exchange mechanism is necessarily limited. Increasing
the amount of available sodium and the level of mineralocorticoid activity
by the use of more proximally acting diuretics will increase the degree of
diuresis and potassium conservation. Triamterene
occasionally causes increases in serum potassium which can result in hyperkalemia.
It does not produce alkalosis, because it does not cause excessive excretion
of titratable acid and ammonium. Triamterene has
been shown to cross the placental barrier and appear in the cord blood of
animals.
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| dailymed-instance:supply |
Capsules: 50 mg in bottles of 100, and 100 mg in bottles
of 100.
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| dailymed-instance:genericDr... | |
| dailymed-instance:boxedWarn... |
Abnormal elevation of serum potassium levels (greater than
or equal to 5.5 mEq/liter) can occur with all potassium-sparing agents, including
Dyrenium. Hyperkalemia is more likely to occur in patients with renal impairment
and diabetes (even without evidence of renal impairment), and in the elderly
or severely ill. Since uncorrected hyperkalemia may be fatal, serum potassium
levels must be monitored at frequent intervals especially in patients receiving
Dyrenium, when dosages are changed or with any illness that may influence
renal function.
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| dailymed-instance:activeMoi... | |
| dailymed-instance:inactiveI... | |
| dailymed-instance:possibleD... | |
| dailymed-instance:genericMe... |
Triamterene
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| dailymed-instance:fullName |
Dyrenium (Capsule)
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| dailymed-instance:adverseRe... |
Adverse effects are listed in decreasing order of frequency;
however, the most serious adverse effects are listed first, regardless of
frequency. All adverse effects occur rarely (that is, 1 in 1000, or less). Hypersensitivity:
anaphylaxis, rash, photosensitivity. Metabolic: hyperkalemia,
hypokalemia. Renal: azotemia, elevated BUN and creatinine,
renal stones, acute interstitial nephritis (rare), acute renal failure (one
case of irreversible renal failure has been reported). Gastrointestinal:
jaundice and/or liver enzyme abnormalities, nausea and vomiting, diarrhea. Hematologic:
thrombocytopenia, megaloblastic anemia. Central Nervous
System: weakness, fatigue, dizziness, headache, dry mouth.
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| dailymed-instance:indicatio... |
Dyrenium (triamterene) is indicated in the treatment of
edema associated with congestive heart failure, cirrhosis of the liver and
the nephrotic syndrome; steroid-induced edema, idiopathic edema and edema
due to secondary hyperaldosteronism. Dyrenium may
be used alone or with other diuretics, either for its added diuretic effect
or its potassium-sparing potential. It also promotes increased diuresis when
patients prove resistant or only partially responsive to thiazides or other
diuretics because of secondary hyperaldosteronism. Usage in Pregnancy. The routine use of diuretics
in an otherwise healthy woman is inappropriate and exposes mother and fetus
to unnecessary hazard. Diuretics do not prevent development of toxemia of
pregnancy, and there is no satisfactory evidence that they are useful in the
treatment of developed toxemia. Edema during pregnancy
may arise from pathological causes or from the physiologic and mechanical
consequences of pregnancy. Diuretics are indicated in pregnancy (however,
see PRECAUTIONS below) when edema
is due to pathologic causes, just as they are in the absence of pregnancy.
Dependent edema in pregnancy, resulting from restriction of venous return
by the expanded uterus, is properly treated through elevation of the lower
extremities and use of support hose; use of diuretics to lower intravascular
volume in this case is illogical and unnecessary. There is hypervolemia during
normal pregnancywhich is harmful to neither the fetus nor the mother (in
the absence of cardiovascular disease), but which is associated with edema,
including generalized edema, in the majority of pregnant women. If this edema
produces discomfort, increased recumbency will often provide relief. In rare
instances, this edema may cause extreme discomfort which is not relieved by
rest. In these cases, a short course of diuretics may provide relief and may
be appropriate.
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| dailymed-instance:name |
Dyrenium
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