Triamterene first saw extensive clinical use during the 1960s. It was used largely as a standalone agent at first, but went on to become a widely used agent in clinical medicine in combination products with other diuretic drugs. Today this usually includes other, more potent diuretics like thiazides and loop agents. Here, the potassium loss of the stronger diuretic is balanced to some degree by the potassium sparing triamterene, which often results in a reduced or even eliminated need for potassium supplementation during therapy. Single ingredient preparations of triamterene are still sold, however, and can be found in several countries including Belgium (Dytac), United Kingdom (Dytac), and the United States (Dyrenium).
How is Triamterene Supplied
Triamterene is most commonly supplied in capsules of 50 mg and 100 mg.
Structural Characteristics of Triamterene
Triamterene is a potassium-sparing diuretic. It has the chemical designation 2,4,7-triamino-6- phenyl-pteridine.
Triamterene Warnings (Dehydration, Death)
The misuse of diuretic drug(s) for physique- or performance-enhancing purposes is characterized as a high-risk practice. Diuretics may produce a life-threatening level of dehydration and electrolyte imbalance when administered without proper medical supervision. Many deaths have been associated with the misuse of these drugs. It is also important to note that the supplementation of potassium, either through pharmaceuticals or a diet rich in potassium, is generally not advised while taking a potassium-sparing diuretic like triamterene. Excessive potassium intake may cause hyperkalemia, which may lead to cardiac irregularities and possibly death.
Triamterene Side Effects
Triamterene use may be associated with electrolyte imbalance, including elevated or decreased potassium levels. Signs of electrolyte imbalance include dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pain, muscle cramping, seizures, reduced urine volume, low blood pressure, and gastrointestinal disturbances. Other side effects may include nausea, vomiting, jaundice, blood platelet deficiency, anemia, azotemia (buildup of metabolic waste products in the blood), renal stones, and other kidney disturbances. Additionally, some rare side effects characterized as hypersensitivity reactions have been reported including skin rash, photosensitivity, and anaphylaxis (an extreme and potentially life threatening allergic reaction).
When used medically to treat hypertension, the usual initial dosage in adults is 100 mg twice daily after meals (200 mg per day). This may be increased, but should never exceed 300 mg per day in total.
Among bodybuilders, this drug is commonly used for only a few days prior to a competition, adjusting the dosage over the course to elicit the best level of diuretic effect. Since it has a long lasting action, it is generally administered once per day. One capsule (100 mg) is usually taken the first thing in the morning with a meal, and the effect judged over the next several hours. The dosage is usually increased by one capsule per day for 2-3 days at most, until the user is noticing the proper water loss for competition. When looking for a stronger diuretic effect, many bodybuilders and athletes will opt to combine triamterene with another stronger diuretic such as hydrochlorthiazide or furosemide. The dosage of both agents would be adjusted downward to compensate for their combined effects. The goal here is usually to increase short-term diuresis, without causing the extreme potassium loss that can be associated with the use of thiazides or loop diuretics alone at higher doses.
Triamterene is widely sold throughout the developed world. Although single-ingredient preparations containing triamterene are available, this drug is most commonly sold in multiingredient preparations targeting edema and/or high blood pressure. Low cost, modest demand, and high availability make this drug a low-profit target for counterfeiting.
Wlliam Llewellyn (2011) - Anabolics