Dyrenium Side Effects

Generic name: triamterene

Note: This document contains side effect information about triamterene. Some of the dosage forms listed on this page may not apply to the brand name Dyrenium.

Some side effects of Dyrenium may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to triamterene: oral capsule

Get emergency medical help if you have any of these signs of an allergic reaction while taking triamterene (the active ingredient contained in Dyrenium) hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using this medication and call your doctor at once if you have any of these serious side effects:

• numbness or tingly feeling;

• muscle pain or weakness;

• slow, fast, or uneven heartbeat;

• feeling drowsy, restless, or light-headed;

• urinating less than usual or not at all;

• shallow breathing;

• tremors, confusion; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Continue using triamterene and talk with your doctor if you have any of these less serious side effects:

• mild nausea, vomiting, or diarrhea;

• dizziness, headache;

• dry mouth; or

• skin rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

For Healthcare Professionals

Applies to triamterene: compounding powder, oral capsule

General

Triamterene (the active ingredient contained in Dyrenium) is generally well-tolerated, especially in patients with adequate urine output. Side effects are reported in less than 1% of patients.

Metabolic

Metabolic abnormalities include hyperkalemia, which is more likely in the elderly, diabetic, and in patients with renal insufficiency. It is recommended that serum potassium concentrations be monitored, and that an electrocardiogram be obtained if hyperkalemia is suspected to check for peaked T waves and QRS segment changes.

The presence of an arrhythmia or widened QRS complex associated with hyperkalemia requires prompt administration of 10% calcium gluconate 10 to 20 mL intravenously over a 20 to 30 minute interval. Noncardiotoxic hyperkalemia usually responds to 10 units of regular insulin plus glucose 25 grams (as a 20% solution infused over 30 minutes) and consideration of sodium bicarbonate 40 to 150 mEq infused over a 30 to 60 minute interval. Insulin-dependent diabetic patients with preexisting hyperglycemia may not require the concomitant glucose infusion.

Gastrointestinal

Gastrointestinal side effects, such as nausea and vomiting, may be lessened by administering the drug after meals.

Renal

Renal insufficiency, manifested as increased serum creatinine and BUN, has been reported in less than 1% of patients, but is far more likely, even in patients without preexisting renal insufficiency, if nonsteroidal anti-inflammatory drugs are being coadministered. Triamterene renal calculi is estimated to occur in 1/1,500 to 1/2,000 patients. Rare cases of interstitial nephritis and triamterene (the active ingredient contained in Dyrenium) bladder calculi are reported.

Triamterene is less soluble in solutions with a pH below 6, becoming crystallized and precipitating calculi formation under certain circumstances. In addition, triamterene alone, and when combined with hydrochlorothiazide, is associated with interstitial nephritis and acute renal failure in rare cases.

Hypersensitivity

Hypersensitivity reactions include rare cases of drug fever, hepatitis, photosensitive dermatitis, and erythema multiforme. In some cases, other drugs were coadministered, making implication of triamterene (the active ingredient contained in Dyrenium) difficult.

Hematologic

Triamterene (the active ingredient contained in Dyrenium) inhibits dihydrofolate reductase, resulting in decreased folate production. This may be important in patients who have borderline folate stores, such as pregnant women and alcohol abusers.

Hematologic side effects include thrombocytopenia and macrocytic anemia. Rare cases of drug-induced dose-dependent hemagglutination resulting in acute intravascular hemolysis is reported.

Hepatic

Hepatic side effects are rare. A case of cholestatic jaundice and centrolobular necrosis of the liver is reported, thought to be due to hypersensitivity. Triamterene (the active ingredient contained in Dyrenium) may cause a spurious elevation in serum lactate dehydrogenase concentrations.

Other

A laboratory abnormality is spurious elevation of lactate dehydrogenase concentrations.

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