Triamterene is a potassium-sparing diuretic commonly used to reduce fluid retention (edema) associated with conditions like heart failure, cirrhosis, and certain kidney disorders. It may also be used as part of a regimen for hypertension. Because triamterene conserves potassium, it is frequently combined with a thiazide diuretic—most often hydrochlorothiazide—in products such as Dyazide or Maxzide to balance potassium losses and enhance blood pressure control.
Mechanistically, triamterene blocks epithelial sodium channels (ENaC) in the late distal tubule and collecting duct, decreasing sodium reabsorption and reducing potassium excretion. The result is a mild diuresis that is less likely to cause hypokalemia than thiazides or loop diuretics alone. This makes it valuable when patients experience low potassium on other diuretics or when potassium conservation is a therapeutic priority.
Triamterene is not typically first-line for blood pressure control on its own. Most often, it is used adjunctively, alongside lifestyle measures like sodium restriction, weight loss, exercise, and other antihypertensive medications tailored to individual risk profiles and comorbidities.
Always follow your prescriber’s instructions. Typical adult dosing for triamterene alone is 50–100 mg twice daily, with a maximum recommended total daily dose of 300 mg. When triamterene is combined with hydrochlorothiazide, common fixed-dose strengths include 37.5 mg/25 mg or 75 mg/50 mg taken once daily. Your clinician may adjust the regimen based on blood pressure, edema control, lab results, and tolerability.
Take triamterene with food to improve absorption and reduce stomach upset. Because it increases urine output, morning dosing is preferred to minimize nighttime urination. If a second daily dose is prescribed, take it in the early afternoon rather than the evening.
Do not use salt substitutes containing potassium chloride unless your clinician explicitly approves them. Triamterene can raise potassium levels; excessive dietary potassium or supplements increase the risk of hyperkalemia. Maintain adequate hydration, particularly during illness, hot weather, or exercise to avoid dehydration and acute kidney injury.
Your care team will typically order baseline and periodic labs, including serum electrolytes (especially potassium), kidney function (creatinine, BUN), and sometimes uric acid. Report symptoms such as muscle weakness, palpitations, lightheadedness, or decreased urine output promptly, as these may signal electrolyte imbalance or kidney issues.
Hyperkalemia risk: Triamterene can elevate potassium, especially in patients with chronic kidney disease, diabetes, older age, or those taking ACE inhibitors, ARBs, aliskiren, NSAIDs, or potassium supplements. Recognize hyperkalemia warning signs—weakness, numbness/tingling, slow or irregular heartbeat—and seek care immediately if they occur.
Kidney and liver considerations: Avoid use in anuria or severe renal impairment. Caution is warranted in moderate kidney disease and in hepatic impairment, where fluid and electrolyte shifts may be poorly tolerated. Routine monitoring helps detect early changes in renal function or electrolytes.
Kidney stones: Triamterene has been associated, albeit infrequently, with kidney stone formation. Staying well hydrated can help reduce risk. If you have a history of nephrolithiasis, inform your prescriber so they can weigh risks and benefits and consider alternative diuretics.
Pregnancy and lactation: Data in pregnancy are limited; use only if potential benefits justify potential risks. Discuss family planning and pregnancy intentions with your clinician. It is unknown if triamterene is excreted in human milk; exercise caution and consider alternative therapies or monitoring plans if breastfeeding.
Do not use triamterene in patients with hyperkalemia, anuria, or significant renal insufficiency where potassium-sparing diuretics are unsafe. It is also contraindicated in known hypersensitivity to triamterene or formulation excipients, and in combination with other potassium-sparing diuretics (for example, spironolactone, eplerenone, amiloride) due to additive risk of dangerous hyperkalemia.
In fixed-dose combinations with hydrochlorothiazide, additional cautions apply to sulfonamide allergies and hyponatremia risk. Avoid routine use with potassium supplements or potassium-rich salt substitutes unless clinically justified and closely monitored.
Common adverse effects include dizziness, headache, mild gastrointestinal upset, and increased urination—particularly when therapy begins. These symptoms often improve as your body adapts. Taking doses with food and earlier in the day may help mitigate GI discomfort and nocturia.
Electrolyte disturbances are the most clinically significant risks. Hyperkalemia can present with muscle weakness, fatigue, paresthesias, or cardiac rhythm changes. Although triamterene tends to conserve potassium, hyponatremia may still occur—especially when used with hydrochlorothiazide—leading to confusion, nausea, or seizures in severe cases.
Kidney-related effects include elevations in serum creatinine and, rarely, interstitial nephritis or kidney stones. Triamterene can increase uric acid levels, occasionally triggering gout flares in susceptible individuals. Skin rashes and photosensitivity are more commonly associated with the thiazide component but may be reported in combination therapy.
Seek immediate medical attention for signs of an allergic reaction (hives, swelling, breathing difficulty), severe dehydration (very dry mouth, minimal urination, dizziness), or heart rhythm changes. Your clinician may adjust the dose, modify co-therapies, or switch medications if side effects are persistent or severe.
Medications that raise potassium: Concomitant use with ACE inhibitors (e.g., lisinopril), ARBs (e.g., losartan), aliskiren, or potassium supplements increases hyperkalemia risk. Combining with other potassium-sparing agents (spironolactone, eplerenone, amiloride) is generally contraindicated. Trimethoprim-containing antibiotics (e.g., TMP-SMX) can also elevate potassium and warrant caution.
Renal and hemodynamic effects: NSAIDs (ibuprofen, naproxen) may blunt diuretic and antihypertensive effects and, with diuretics, can increase risk of kidney injury and hyperkalemia. Calcineurin inhibitors (cyclosporine, tacrolimus) further predispose to hyperkalemia. Monitor renal function and electrolytes closely if these combinations are unavoidable.
Other notable interactions: Lithium clearance can be reduced by diuretics, potentially increasing lithium toxicity—be cautious, especially with fixed triamterene/HCTZ products. Digoxin sensitivity may be influenced by electrolyte shifts. Cimetidine has been reported to increase triamterene levels. Alcohol can enhance dizziness and orthostatic symptoms; limit intake.
Dietary products and supplements: Potassium-rich salt substitutes, high-potassium diets, and certain supplements (e.g., potassium citrate) can compound hyperkalemia risk. Licorice-containing products can affect electrolyte balance, though the effect is more pronounced with non–potassium-sparing diuretics. Discuss all prescription drugs, OTCs, and supplements with your healthcare professional.
If you miss a dose, take it as soon as you remember unless it is close to your next scheduled dose. If it is near the time of the next dose, skip the missed dose and resume your regular schedule. Do not double up. To minimize sleep disruption from nighttime urination, avoid taking a make-up dose late in the evening.
If you miss multiple doses or feel unwell after a missed dose, contact your clinician for individualized guidance. Maintain regular lab appointments to keep your therapy safe and effective.
An overdose may lead to profound electrolyte disturbances (especially hyperkalemia), dehydration, dizziness, and kidney dysfunction. Severe hyperkalemia can cause dangerous heart rhythm abnormalities. If overdose is suspected, call emergency services or your local poison control center immediately.
Do not attempt to self-treat. Bring a list of all medications, supplements, and dosages to the emergency department to assist rapid, accurate care. Ongoing monitoring of electrolytes, kidney function, and cardiac rhythm is typical in medical management of overdose.
Store triamterene at room temperature (generally 20°C–25°C or 68°F–77°F), away from excess heat, moisture, and direct light. Keep the bottle tightly closed and out of reach of children and pets. Do not store in the bathroom. Properly discard expired or unused medication according to local guidelines or pharmacy take-back programs.
Across communities like r/Hypertension, r/AskDocs, and r/Meniere’s, discussions around triamterene and triamterene/HCTZ often center on electrolyte monitoring, timing doses to avoid nighttime urination, and balancing benefits with side effects such as dizziness or leg cramps. Several threads mention its role in Ménière’s disease management—particularly the combination with hydrochlorothiazide—to help reduce inner ear fluid and vertigo frequency.
Users frequently ask about potassium-containing salt substitutes, interactions with ACE inhibitors or ARBs, and whether lab work is needed after dose changes. The consensus from clinicians responding on these forums emphasizes individualized medical advice, routine labs, and caution against relying on anecdotes over professional guidance.
Patient reviews on WebMD commonly describe moderate effectiveness for controlling edema and contributing to blood pressure management, particularly in combination products like Dyazide/Maxzide. Many appreciate once-daily convenience with the combo pill and the reduced risk of hypokalemia compared with thiazide therapy alone.
Reported drawbacks include increased urination, occasional dizziness or lightheadedness, and concerns about potassium levels requiring lab checks. Some users note gout flares or, rarely, kidney stone experiences. As with any user-reported data, these comments reflect individual experiences and should not replace clinician oversight and shared decision-making.
In the United States, triamterene is a prescription-only medication. Federal and state laws require that a licensed clinician evaluate your medical history, current medications, and lab results to determine safety and appropriateness. Be wary of websites offering “no-prescription” sales; such offers are often unsafe, illegal, or both, and they bypass critical safety checks like potassium and kidney function monitoring.
Nunzia Pharmaceutical offers a legal, structured pathway to access triamterene by facilitating a compliant telehealth evaluation with U.S.-licensed clinicians. This means you do not need a prior paper prescription or in-person visit; instead, a qualified provider reviews your case remotely and, if appropriate, issues a valid prescription that is filled through legitimate channels. Patient identity verification, medication counseling, and follow-up support help keep the process safe and transparent.
Availability may vary by state, and clinical approval is never guaranteed. The goal is to combine convenience with safety—ensuring you receive the correct medication, dosing, and lab monitoring plan while upholding all regulatory requirements and best-practice standards.
Triamterene is a potassium-sparing diuretic that helps your body get rid of extra salt and water without losing potassium. It blocks epithelial sodium channels (ENaC) in the distal nephron, reducing sodium reabsorption and potassium excretion, which leads to mild diuresis and potassium conservation.
It is used to treat edema (swelling) from conditions like heart failure, cirrhosis, or nephrotic syndrome and as an adjunct for hypertension. It is often combined with a thiazide diuretic to improve blood pressure control and reduce hypokalemia.
Triamterene can be used alone but is more commonly prescribed in a fixed-dose combination with hydrochlorothiazide (HCTZ) to balance potassium levels and enhance blood pressure control. Common brand combinations include Dyazide and Maxzide.
Diuretic effects typically begin within a few hours of a dose and can last about half a day. Some people notice peak effect around 3–4 hours, with duration roughly 7–9 hours.
Take it with food to improve absorption and reduce stomach upset, at the same time each day. Avoid taking it late in the evening to prevent nighttime urination unless directed otherwise by your clinician.
Common effects include dizziness, headache, nausea, fatigue, and mild dehydration symptoms. Lab changes can include increased potassium and sometimes elevated uric acid or mild increases in creatinine.
The main risk is hyperkalemia (high potassium), which can cause muscle weakness, tingling, or dangerous heart rhythm problems—seek urgent care if you develop palpitations or severe weakness. Rarely, kidney stones, allergic reactions, or blood disorders (such as megaloblastic anemia) can occur.
Avoid triamterene if you have hyperkalemia, significant kidney impairment or anuria, or are taking other potassium-sparing agents that raise potassium dangerously. Use caution in liver disease, diabetes, and in older adults, with close monitoring.
Avoid potassium supplements and salt substitutes containing potassium. Use caution with ACE inhibitors, ARBs, aliskiren, NSAIDs, cyclosporine, tacrolimus, trimethoprim (including TMP-SMX), and other potassium-sparing diuretics; these can increase potassium or affect kidney function. Lithium levels may also rise with diuretics—monitor if used together.
Yes. Check potassium and kidney function (creatinine/eGFR) within 1–2 weeks of starting or changing a dose and periodically thereafter, especially if you have kidney disease, diabetes, or are on interacting drugs.
It can, though it’s uncommon. Triamterene can crystallize in the urine and has been found in some kidney stones; staying well hydrated can help reduce the risk.
No. Avoid potassium-containing salt substitutes and high-potassium diets because they can raise potassium to unsafe levels when combined with a potassium-sparing diuretic.
Data in pregnancy are limited; other agents are usually preferred unless the benefits clearly outweigh risks. It is unknown if triamterene passes into breast milk; discuss risks and alternatives with your clinician.
These groups have a higher risk of hyperkalemia and kidney function changes. Lower doses, alternative drugs, or avoidance may be appropriate; if used, monitor labs closely.
Take it when you remember unless it is close to your next dose. Do not double up; resume your regular schedule.
Yes. It can raise uric acid levels and may trigger gout in susceptible individuals, particularly when combined with thiazide diuretics.
Rarely, triamterene has been associated with megaloblastic anemia related to folate deficiency; this typically reverses with folic acid supplementation and stopping the drug. Report unusual fatigue or pallor to your clinician.
Alcohol may worsen dizziness and dehydration; use cautiously. NSAIDs can reduce the diuretic effect and increase the risk of kidney problems and hyperkalemia when combined with triamterene—ask your clinician before use.
It can help when paired with a thiazide like HCTZ, especially by correcting hypokalemia that limits thiazide dosing. However, spironolactone often has stronger evidence for resistant hypertension; choice depends on the clinical scenario and tolerability.
Triamterene is available generically and commonly combined with hydrochlorothiazide under brand names such as Dyazide and Maxzide. Exact brand availability varies by region.
Both block ENaC and spare potassium. Amiloride is generally preferred due to a more predictable effect and fewer idiosyncratic issues (like kidney stones), while triamterene is widely used in fixed-dose HCTZ combinations; the best choice depends on patient-specific factors and availability.
Triamterene directly blocks ENaC, while spironolactone blocks aldosterone receptors. Spironolactone has proven benefits in conditions driven by aldosterone (heart failure with reduced ejection fraction, primary aldosteronism) but can cause hormonal side effects like gynecomastia; triamterene lacks hormonal effects but is less potent for those indications.
Eplerenone is a selective aldosterone blocker with fewer endocrine side effects than spironolactone and strong evidence in heart failure and post–myocardial infarction settings. Triamterene is better suited as a potassium-sparing add-on for edema or hypertension, especially in HCTZ combinations, not for aldosterone-driven diseases.
Adding triamterene to HCTZ helps prevent low potassium and can improve blood pressure control. However, it increases the risk of hyperkalemia and potential kidney issues; monitoring is essential.
Amiloride is preferred and is first-line for Liddle syndrome because of robust experience and predictable ENaC inhibition. Triamterene may be considered if amiloride is unavailable, with careful potassium and renal monitoring.
Spironolactone (or eplerenone) is superior because these conditions are driven by aldosterone, and mineralocorticoid receptor antagonists improve outcomes. Triamterene does not target aldosterone and is not a substitute in these indications.
Amiloride is generally safer because triamterene can crystallize and contribute to stone formation. Adequate hydration is important with either drug, but triamterene carries the higher stone risk.
Spironolactone typically produces greater blood pressure reductions in true resistant hypertension. Triamterene/HCTZ can be effective, particularly if hypokalemia limits thiazide dosing, but may not match spironolactone’s potency.
Loop diuretics are much more potent for fluid removal and are preferred for significant edema. Triamterene provides mild diuresis and is often used as an add-on to reduce potassium loss rather than as a primary diuretic for heavy fluid overload.
They work differently. ACE inhibitors and ARBs lower blood pressure and offer heart and kidney protection; triamterene is an adjunct diuretic mainly used with thiazides. If combined, monitor potassium closely due to additive hyperkalemia risk.
Both triamterene and eplerenone avoid the gynecomastia risk seen with spironolactone. Choose eplerenone when aldosterone blockade is needed (e.g., heart failure); choose triamterene when you simply need a potassium-sparing diuretic add-on.
Both increase the risk of hyperkalemia in CKD and may need to be avoided or used with extreme caution. If an ENaC blocker is necessary, amiloride is often chosen with careful dosing and close monitoring; many patients with moderate to severe CKD are better managed with loop diuretics.