Triamteren

Structural formula
General
Non-proprietary name	Triamteren
other names	6-phenylpteridine-2,4,7-triamine 2,4,7-triamino-6-phenylpyrazino [2,3- d ] pyrimidine Latin : Triamterenum
Molecular formula	C 12 H 11 N 7
Brief description	Yellow solid
External identifiers / databases
CAS number 396-01-0 EC number 206-904-3 ECHA InfoCard 100.006.278 PubChem 5546 DrugBank DB00384 Wikidata Q221520
Drug information
ATC code	C03 DB02
Drug class	Potassium sparing diuretic
properties
Molar mass	253,26 g · mol -1
Physical state	firmly
Melting point	316 ° C
boiling point	> 300 ° C
pK s value	pK S1 : 6.3 pK S2 : −1.2
solubility	practically insoluble in water, chloroform and diethyl ether
safety instructions
Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed GHS labeling of hazardous substances Caution H and P phrases H: 302-315-319-335 P: 261-305 + 351 + 338
Toxicological data	285 mg kg −1 ( LD 50 ,  mouse ,  oral )
As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Triamterene is an organic chemical substance with a pteridine structure , a binuclear nitrogen-containing aromatic . It is used in medicine as a drug from the group of potassium-sparing diuretics . Triamteren has a diuretic effect by promoting the excretion of sodium via the kidneys . Sodium binds water in a hydration shell so that more water is excreted as a result. By acting on the late distal tubular lumen and the collecting tube - i.e. in the last section of urine production - triamterene retains potassium in the body.

Pure triamterene is a yellow, crystalline powder.

Mode of action

See also : diuretics  and potassium-sparing diuretics

Like the substance amiloride, triamterene inhibits the aldosterone- dependent epithelial sodium channel in the late distal tubule . In this section of the tubular system, sodium ions are passively absorbed from the urine. Since these ions have a positive charge, positive charges must be released into the urine in exchange. It does this in the form of potassium ions. If the sodium absorption is now inhibited by blocking the duct, the secondary potassium excretion is reduced.

The more sodium ions there are in the urine of the late distal tubule, the more are normally reabsorbed and the more potassium is lost at this point. Since other diuretics mainly work by increasing the excretion of sodium in the urine (earlier in the tubule system), a lot of potassium is lost here - which can be prevented by triamterene and amiloride. Therefore, the more sodium there is in the lumen, the stronger the effect of these diuretics, thus increasing the effect of the thiazide diuretics.

application areas

Triamteren is usually used in combination with thiazide diuretics (e.g. bemeticide , hydrochlorothiazide , xipamide ) or loop diuretics in the treatment of hypertension and chronic heart failure: the decreasing water content reduces the amount of blood , the heart is relieved and the blood pressure decreases . Also, water accumulations in the tissue ( edema ) - for example as a result of liver or kidney diseases or due to cardiac insufficiency - can be flushed out, as water that has passed into the tissue is returned to the bloodstream by osmosis .

Since thiazide diuretics are increasingly used in combination with potassium-sparing ACE inhibitors or sartans , triamterene has lost its therapeutic importance.

Pharmacokinetics

Triamteren is subject to a remarkable first-pass effect : with an absorption of 85%, it has a bioavailability of around 50%. The diuretic effect occurs after about an hour and reaches its maximum after 3 to 4 hours. The plasma half-life in healthy people is 2 to 4 hours, significantly shorter than that of amiloride; however, the phase II metabolite p-hydroxytriamterene sulfuric acid ester is still effective.

Trade names

Monopreparations

Dyrenium (USA)

Combination with

• Bemeticide : Dehydro Sanol tri (D), Diucomb (D),
• Hydrochlorothiazide : Diuretic Verla (D), Diu Venostasin (D), Dytide H (D, A), Nephral (D), Triampur comp. (D), Triarese (D), Turfa gamma (D)
• Hydrchlorothiazide and propanolol : Beta-Turfa (D), Dociteren (D), Propra comp. (D)
• Xipamide : Neotri (D)

and other.

Individual evidence

1. ↑ ^{a b c} data sheet Triamteren at AlfaAesar, accessed on March 23, 2010 ( PDF )(JavaScript required) .
2. ↑ ^{a b} Entry on triamterene in the ChemIDplus database of the United States National Library of Medicine (NLM) .
3. ↑ ^{a b} Entry on Triamteren. In: Römpp Online . Georg Thieme Verlag, accessed on November 11, 2014.
4. ↑ Sean Sweetman (Editor): Martindale: The Complete Drug Reference, 35th Edition: Book and CD-ROM Package . Pharmaceutical Press, ISBN 978-0-85369-704-6 .
5. ↑ ^{a b} Data sheet Triamterene from Sigma-Aldrich , accessed on April 24, 2011 ( PDF ).
6. ↑ Klaus Aktories, Ulrich Förstermann, Franz Hofmann, Klaus Starke: General and Special Pharmacology and Toxicology , 10th Edition, Elsevier, Urban & Fischer, Munich and Jena 2009, ISBN 978-3-437-42522-6 .
7. ↑ Busch AE; Suessbrich H; Kunzelmann K; et al. (September 1996). "Blockade of epithelial Na + channels by triamterenes - underlying mechanisms and molecular basis". Pflügers Arch . 432 (5): 760-766. doi : 10.1007 / s004240050196 . PMID 8772124 .
8. ↑ ^{a b c d} Mutschler drug effects, 10th edition, Wissenschaftl. Verlagsgesellschaft mbH Stuttgart, p. 654, ISBN 978-3-8047-2898-1 .

Pharmacopoeia Comment 6.2 as secondary literature with the following references:

1. ↑ E. Mutschler et al., Clin. Exp. Hypertension A5, 249 (1983).
2. ↑ B. Grebian et al., Medic. Forsch. 28, 1420 (1978)

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !