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트리암테렌

Triamterene

2,4,7-triamino-6-phenylpteridine

칼륨 보존성 이뇨제PO개

다른 이름: Dyrenium · Dytac · Dyazide · Maxzide · Triteren · NSC-77625 · KF-8542 · FI-6143 · triamteren · trimaterenum · triamtereen

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

1-2 mg/kg PO q12hPO· q12h
— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증용량경로빈도기간지역
Adjunctive treatment of recurrent heart failure associated with chronic mitral valve insufficiency1-2 mg/kg PO q12hPOq12h—🌎 NA
As a diuretic for adjunctive treatment of CHF2-(4) mg/kg/day POPOq24h—🌎 NA
  • Adjunctive treatment of recurrent heart failure associated with chronic mitral valve insufficiency: Documentation of use is limited; spironolactone is drug of choice.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

트리암테렌은 ​칼륨 보존성 이뇨제​로, 개의 ​울혈성 심부전(CHF)​ 보조 치료 시 스피로놀락톤의 대안으로 고려될 수 있습니다.

  • ​임상적 유용성​: 수의학에서의 사용 경험과 약동학적 데이터는 제한적입니다. 소동물에게는 여전히 스피로놀락톤이 선호되는 칼륨 보존성 이뇨제입니다.
  • ​주요 장점​: 루프 이뇨제(푸로세미드 등)나 티아지드계 이뇨제 사용 시 흔히 발생하는 과도한 칼륨 손실을 방지하면서 부종과 체액 과다를 관리하는 데 도움이 됩니다.

작용 기전

Triamterene exerts a direct effect on the late distal convoluted tubule and collecting duct of the kidneys.

  • Mechanism: It directly blocks ​epithelial sodium channels (ENaC)​ on the lumenal side of the kidney tubule → inhibits the reabsorption of sodium (Na+) → decreases the electrical gradient across the tubular membrane → reduces the driving force for the secretion and excretion of potassium (K+) and hydrogen (H+) ions.
  • Aldosterone Independence: Unlike spironolactone, triamterene does not competitively inhibit aldosterone. Its action is independent of endogenous aldosterone levels.
  • Net Effect: Increases urinary excretion of sodium, calcium, magnesium, and bicarbonate while retaining potassium and chloride. It has little effect on blood pressure when used alone but can slightly reduce Glomerular Filtration Rate (GFR).

안전성·주의사항

금기사항

  • Anuria
  • Severe or progressive renal disease
  • Severe hepatic disease
  • Hypersensitivity to triamterene
  • Preexisting hyperkalemia or history of triamterene-induced hyperkalemia
  • Concurrent therapy with another potassium-sparing agent (e.g., spironolactone, amiloride)
  • Concurrent potassium supplementation

부작용

  • Hyperkalemia (most significant risk)
  • Gastrointestinal upset
  • Hyponatremia
  • Headache or dizziness (reported in humans)
  • Increased sensitivity to sunlight
  • Hypersensitivity reactions (rare)
  • Nephrolithiasis (rare)
  • Blood dyscrasias such as agranulocytosis, thrombocytopenia, or megaloblastosis (rare)

주의

Warning: Hyperkalemia is a definite possibility. Monitoring of electrolytes and renal function is strictly necessary.

  • Renal Function: May slightly reduce GFR (reversible upon discontinuation). Use with caution in patients with compromised renal blood flow.
  • Pregnancy: Crosses the placental barrier. Animal studies (rats) at 6-20X human dose showed no adverse fetal effects, but adequate studies are lacking. Weigh potential benefits against risks.
  • Lactation: Distributed into milk. Safety during nursing cannot be assured.

약물 상호작용

ACE Inhibitors (e.g., enalapril, benazepril)

Increased risks for hyperkalemia.

Antidiabetic Agents (insulin, oral hypoglycemics)

Triamterene may increase blood glucose levels.

Antihypertensive Agents

Possible potentiation of hypotensive effects.

Diuretics, Potassium-Sparing (spironolactone, amiloride)

Increased risk of hyperkalemia; concurrent use is contraindicated.

Lithium

Triamterene may reduce lithium clearance, increasing the risk of lithium toxicity.

NSAIDs (especially indomethacin)

May increase the risks of nephrotoxicity when used concurrently.

Potassium Supplements or High Potassium Foods

Increased risk for hyperkalemia.

Quinidine

Laboratory interaction: Triamterene may interfere with the fluorescent assay of quinidine.

모니터링

  • Serum electrolytes (especially potassium)
  • BUN and creatinine
  • Hydration status
  • Blood pressure, if indicated
  • Signs of edema
  • Patient weight, if indicated

약동학

흡수

In humans, rapidly absorbed after oral administration with an oral bioavailability of about 85%. Onset of diuresis occurs in 2-4 hours and diminishes after about 8 hours.

분포

Crosses the placental barrier and is distributed into milk.

대사

Metabolized in the liver to 6-p-hydroxytriamterine and its sulfate conjugate.

배설

Metabolites are eliminated in the bile/feces and urine.

과다투여

The oral LD50 for triamterene in mice is 380 mg/kg.

  • Clinical Signs: Fluid and electrolyte imbalance (especially hyperkalemia) is the most likely risk. Gastrointestinal effects or hypotension are also possible.
  • Management: Consider gut emptying protocols for very large or unknown quantity ingestions. Acute overdoses should generally be managed by observation, with rigorous fluid, electrolyte (especially serum potassium), and acid-base monitoring. Initiate supportive treatment as required.

제품

제형

  • Capsules
  • Tablets (typically in combination with hydrochlorothiazide)

동물용의약품

  • None

인용의약품

  • Triamterene Capsules: 50 mg & 100 mg (Dyrenium)
  • Triamterene 37.5 mg / Hydrochlorothiazide 25 mg Tablets and Capsules (Dyazide, Maxzide-25MG, generic)
  • Triamterene 50 mg / Hydrochlorothiazide 25 mg Capsules (generic)
  • Triamterene 75 mg / Hydrochlorothiazide 50 mg Tablets (Maxzide, generic)

규제 현황

규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Triamterene capsules should be stored between 15-30°C (59-86°F) in tight, light-resistant containers.

보호자 정보

  • ​투여 방법​: 위장 장애를 예방하기 위해 음식과 함께 투여하십시오.
  • ​소변 색상​: 이 약을 복용하는 동안 반려동물의 소변이 ​푸른빛​을 럴 수 있으나, 이는 정상적이고 무해한 현상입니다.
  • ​모니터링​: 이 약은 개나 고양이에게 자주 사용되지 않으므로, 반려동물을 주의 깊게 관찰하고 이상 반응(심한 무기력증, 허약, 구토 등)이 나타나면 짩시 수의사에게 알리십시오.
  • ​식이 제한​: 수의사의 특별한 지시가 없는 한 칼륨 보충제나 칼륨이 많이 함유된 음식/간식을 주지 마십시오.

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