Triamterene can be used in the treatment of congestive heart failure, cirrhosis, and the edema caused by secondary hyperaldosteronism. It is frequently used in combination with other diuretics except spironolactone. Amiloride, but not triamterene, possesses antihyperten-sive effects that can add to those of the thiazides.
These K+-sparing diuretics have low efficacy when used alone, since only a small amount of total Na+ reabsorption occurs at more distal sites of the nephron. These compounds are used primarily in combination with other diuretics, such as the thiazides and loop diuretics, to prevent or correct hypokalemia. The availability of fixed-dose mixtures of thiazides with nons-teroidal K+-sparing compounds has proved a rational form of drug therapy. Both triamterene and amiloride are available alone or in combination with hy-drochlorothiazide.
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