Triamterene, A New Natruretic Agent

Abstract

Observations were made in 4 normal subjects and 16 patients with a variety of cardiac, hepatic, and renal diseases following the use of triamterene (2,4,7-triamino-6-phenylpteridine) (SKAF No. 8542) in a single daily oral dose. The patients were maintained on diets containing approximately 1 meq of Na and 50-75 meq of K per day. The results demonstrated that the compound is absorbed from the gastrointestinal tract and excreted in the urine. A close temporal correlation appeared to exist between the excretion of the drug and the resulting naturesis. K excretion showed some variability but, in all but 2 cases, the patients were maintained in positive K balance. In general, Cl output followed the excretory pattern of Na. Increased daily urinary volumes were noted in some, but not all cases. Based on its ability to antagonize the Na retaining effects of 9 alpha fluorohydro-cortisone and hydrocortisone as well as its lack of influence on the 24 hour excretion rates of 17 ketosteroids and Porter-Silber chromogens it was concluded that this compound posseses anti-mineralocorticoid activity which occurs at the renal tubular level.