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氨苯蝶啶

Triamterene

2,4,7-triamino-6-phenylpteridine

保鋎利尿劑PO狗

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

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

1-2 mg/kg PO q12hPO· q12h
— 🐕

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
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.

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概覽

氨苯蝶啶是一種​保鋎利尿劑​，可作為螺內酯 (spironolactone) 的替代藥物，用於犬隻​充血性心臟衰竭 (CHF)​ 的輔助治療。

  • ​臨床應用​：其在獸醫學中的使用經驗及藥代動力學數據有限。對於小動物，螺內酯通常仍是首選的保鋎利尿劑。
  • ​主要優勢​：它有助於控制水腫和體液過載，同時防止使用環利尿劑（如呅塞米）或噻嗪類利尿劑時常見的鋎離子過度流失。

作用機制

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).

安全性與警告

禁忌症

  • 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

不良反應

  • 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)

注意事項

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.

藥物相互作用

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.

監測

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

藥物動力學

吸收

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.

分佈

Crosses the placental barrier and is distributed into milk.

代謝

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

排除

Metabolites are eliminated in the bile/feces and urine.

過量

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.

可用產品

劑型

  • Capsules
  • Tablets (typically in combination with hydrochlorothiazide)

獸醫用

  • None

人用標示

  • 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)

各地核准狀態

暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

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

飼主須知

  • ​給藥方式​：請隨餐給予此藥物，以幫助減少腸胃不適。
  • ​尿液顏色​：服藥期間，您寵物的尿液可能會呈現​藍色​，這是正常且無害的現象。
  • ​監測​：由於此藥物在犬貓中並不常用，請密切觀察您的寵物，若發現任何異常反應（如嚴重喺睡、虛弱或嘔吐），請立即通知獸醫師。
  • ​飲食限制​：除非獸醫師特別指示，否則請勿給予寵物鋎補充劑或高鋎食物/零食。

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