Triamterene Side Effects

Brand Names: Dyrenium

Please note - some side effects for Triamterene may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Triamterene - for the Consumer

Triamterene/Hydrochlorothiazide

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Triamterene/Hydrochlorothiazide:

Changes in blood sugar; constipation; dizziness; fatigue; headache; inflammation of a salivary gland; loss of appetite; nausea; sensitivity to sunlight; stomach pain; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); dry mouth; excessive thirst; impotence; leg or muscle cramps; mental confusion; rapid, weak, or irregular heartbeat; stomach pain; urination problems; vomiting; yellowing of skin or eyes.

Triamterene

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Triamterene:

Diarrhea; headache; loss of appetite; nausea; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); dry mouth; excessive thirst; slow or irregular heart rate; unusual muscle weakness; unusual tiredness; vomiting; yellowing of the skin or eyes.

Side Effects by Body System

General

Triamterene 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 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 difficult.

Hematologic

Triamterene 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 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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