Metabolic Studies with the Diuretic Triamterene in Patients with Cirrhosis and Ascites

Abstract

TRIAMTERENE (2,4,7-triamino-6-phenylpteridine)¶ is a natriuretic agent unrelated chemically to any of the available diuretic drugs.^{1 2 3 4 5 6 7 8 9 10 11} As a pteridine derivative, it bears a chemical relation to folic acid. Amethopterin, a competitive inhibitor of folic acid, does not, however, produce similar changes in electrolyte metabolism¹²; on the other hand, in vivo animal studies and clinical studies have given no evidence of antifolic acid activity for triamterene. Unlike many diuretic agents currently in use, triamterene seldom increases urinary potassium excretion, and indeed most often reduces potassium excretion.^{1 2 3 4 5 6 7 8 9 10 11} Patients with cirrhosis of the liver frequently show serious complications of hypokalemia after induced diureses, . . .