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Keep out of reach of childrenIn case of overdoseget medical help or contact a Poison Control Center immediately.

Triamterene inhibits the epithelial sodium channels on principal cells in the late distal convoluted tubule and collecting tubulewhich are responsible for 1-2of total sodium reabsorptionAs sodium reabsorption is inhibitedthis increases the osmolarity in the nephron lumen and decreases the osmolarity of the interstitiumSince sodium concentration is the main driving force for water reabsorptiontriamterene can achieve a modest amount of diuresis by decreasing the osmotic gradient necessary for water reabsorption from lumen to interstitiumTriamterene also has a potassium-sparing effectNormallythe process of potassium excretion is driven by the electrochemical gradient produced by sodium reabsorptionAs sodium is reabsorbedit leaves a negative potential in the lumenwhile producing a positive potential in the principal cellThis potential promotes potassium excretion through apical potassium channelsBy inhibiting sodium reabsorptiontriamterene also inhibits potassium excretion.

Hyperkalemia has been reported in diabetic patients with the use of potassium-conserving agents even in the absence of apparent renal impairmentAccordinglyMAXZIDEtriamterene and hydrochlorothiazideshould be avoided in diabetic patientsIf it is employedserum electrolytes must be frequently monitored.

Hypersensitivity to triamterene Anuriasevere liver diseaseand kidney failure Hyperkalemia Concomitant use with potassium sparing diureticor potassium supplementation.

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