Potassium-Sparing Diuretic

Aka: Potassium-Sparing Diuretic, Amiloride, Midamor, Triamterene, Dyrenium

advertisement

II. Indications: Potassium-Sparing Diuretics only (Aldosterone independent, Amiloride and Triamterene)

  1. Hypertension
    1. Weak Diuretics primarily used to counter urinary Potassium loss with other Diuretics

III. Indications: Aldosterone Antagonists (Spironolactone, Eplerenone)

  1. Congestive Heart Failure
    1. Counter Aldosterone adverse effects on myocardial remodeling

IV. Mechanism

  1. Weak Diuretics (compared with Loop Diuretics or Thiazide Diuretics)
  2. Potassium-Sparing Diuretics only
    1. Primarily used to counter urinary Potassium loss with other Diuretics
    2. Act directly at the distal convoluted tubule (Aldosterone independent)
      1. Increase Sodium excretion
      2. Decrease Potassium secretion
  3. Aldosterone Antagonists (Spironolactone and Eplerenone)
    1. Commonly used as adjunctive in Congestive Heart Failure management
    2. Counter Aldosterone adverse effects on myocardial remodeling

V. Preparations: Potassium-Sparing Diuretics only (Aldosterone independent)

  1. Amiloride (Midamor)
    1. Dose: 5 mg orally daily (maximum: 20 mg/day)
    2. Renal excretion (unchanged in urine)
    3. Half-Life: 6 hours
  2. Triamterene (Dyrenium)
    1. Dose: 100 mg orally twice daily (maximum: 300 mg/day)
    2. Typically used as Combination Medication with Thiazide Diuretic
    3. Rapidly absorbed, highly metabolized in liver and Kidney and rapidly excreted

VI. Preparations: Potassium-Sparing Diuretic and Aldosterone Antagonists

  1. Spironolactone (Aldactone)
  2. Eplerenone (Inspra)

VII. Precautions

  1. Monitor Serum Potassium after starting a Potassium-Sparing Diuretic in those at Hyperkalemia risk
    1. Obtain Serum Potassium at 3 days, 7 days and then monthly for the first 3 months

VIII. Adverse Effects: Potassium-Sparing Diuretics (Amiloride and Triamterene)

  1. Hyperkalemia
    1. Risk factors
      1. Renal Insufficiency
      2. Concurrent use with agents that raise Potassium (e.g. ACE Inhibitors, Potassium supplements)
  2. Blue Urine Color
    1. Specific to Triamterene
  3. Decreased renal perfusion (if Sodium and water depletion)
  4. Glucose Intolerance
    1. Potassium-Sparing Diuretics

IX. Drug Interactions

  1. Potassium supplements (risk of Hyperkalemia)

X. References

  1. Olson (2020) Clinical Pharmacology, Medmaster, Miami, p. 62-3
  2. Hamilton (2010) Tarason Pocket Pharmacopeia, p. 100

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Potassium-Sparing Diuretic." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Cost: Medications

amiloride (on 7/20/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
AMILORIDE HCL 5 MG TABLET Generic $0.15 each
AMILORIDE HCL-HYDROCHLOROTHIAZIDE 5-50 MG TAB Generic $0.43 each
triamterene (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG CP Generic $0.12 each
TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5-25 MG TB Generic $0.09 each
TRIAMTERENE-HYDROCHLOROTHIAZIDE 75-50 MG TAB Generic $0.13 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

advertisement