Ranitidine with Triamterene Interaction Details
Brand Names Associated with Ranitidine
- Ranitidine
- Tritec®
- Zantac®
- Zantac® 75
- Zantac® EFFERdose®
- Zantac® Syrup
Brand Names Associated with Triamterene
- Dyrenium®
- Triamterene
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Decreased triamterene effectiveness
Interaction Summary
Concomitant ranitidine and triamterene administration may slightly reduce the diuretic response, but not the potassium-sparing response to triamterene. Coadministration resulted in a 51% decrease in renal clearance and a 21% reduction in the area under the concentration time curve for triamterene. The renal clearance of ranitidine was reduced by 14%. The clinical significance of this interaction has not been established.
Severity
Minor
Onset
Delayed
Evidence
Probable
How To Manage Interaction
If hemodynamic response to triamterene is inadequate, increase dose and monitor clinical response and potential changes in serum potassium concentration.
Mechanism Of Interaction
Decreased renal clearance and reduced absorption
Literature Reports
A) Concomitant ranitidine and triamterene administration may slightly reduce the diuretic response, but not the potassium-sparing response to triamterene . Triamterene 100 mg once daily orally and oral ranitidine 150 mg twice daily were randomly administered alone or in combination to eight healthy subjects for four days. Coadministration of triamterene and ranitidine resulted in a 51% decrease in triamterene renal clearance and reduction in triamterene hepatic metabolism. Despite these reductions in triamterene clearances, however, the area under the triamterene concentration-time curve (AUC) was reduced by an average of 21% and the urinary recovery of triamterene and its metabolite was decreased by 52% probably due to a reduction in triamterene absorption. The lower triamterene plasma concentration resulted in a small reduction in urinary sodium excretion but had no effect on potassium excretion. These effects probably result from ranitidine-induced reductions in triamterene metabolism, inhibition of renal and hepatic transport, and a reduction in triamterene absorption due to reduced triamterene solubility in a relatively alkaline stomach produced by ranitidine administration. Triamterene administration also caused a 14% reduction in the renal clearance of ranitidine.
Ranitidine Overview
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Ranitidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Over-the-counter ranitidine is used to prevent and treat symptoms of heartburn associated with acid indigestion and sour stomach. Ranitidine is in a class of medications called H2 blockers. It decreases the amount of acid made in the stomach.
Triamterene Overview
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Triamterene is used alone or with other medications to treat edema (fluid retention; excess fluid held in body tissues) caused by various conditions, including liver and heart disease. Triamterene is in a class of medications called diuretics ('water pills'). It causes the kidneys to eliminate unneeded water and sodium from the body into the urine, but reduces the loss of potassium.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.