Drug & supplement interaction

Malic Acid + Triamterene

Triamterene brand name: Dyrenium.

Moderate Interaction
The bottom line Moderate

Malic Acid has a moderate interaction with Triamterene. Theoretically, malic acid might increase the risk of hypotension when taken with antihypertensive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Malic Acid and Triamterene

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Triamterene

Triamterene falls under ANTIHYPERTENSIVE DRUGS — the group Malic Acid interacts with.

Theoretically, malic acid might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research shows that malic acid isolated from tagetes roots can reduce mean arterial blood pressure.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: Triamterene (Dyrenium) is a water pill that helps your body shed extra fluid, and like other blood-pressure-lowering medicines it can nudge your blood pressure down. The concern on file is that malic acid might add a little extra blood-pressure-lowering effect on top of it. If both push in the same direction, you could feel lightheaded, dizzy, or wobbly when you stand up, especially if you're also losing fluid.

That said, I want to keep this in perspective. This is a theoretical worry based mostly on animal research, not solid human studies, and the malic acid found in apples and food won't be an issue. Concentrated supplement doses are the bigger question mark. If you're considering one, just run it past your pharmacist or doctor first so they can keep an eye on your blood pressure.

References
  1. Saleem R, Ahmad M, Naz A, et al. Hypotensive and toxicological study of citric acid and other constituents from Tagetes patula roots. Arch Pharm Res 2004;27(10):1037-42.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Malic Acid Also Interacts With Other Medications

Malic Acid has 171 moderate known drug interactions in our database — the Triamterene one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Malic Acid

Covers the 2,830 medications we’ve checked against Malic Acid. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Triamterene

This page covers Malic Acid only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Triamterene page lists 165 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Siberian Cocklebur (major).

By severity: 6 major · 136 moderate · 23 minor.

From our pharmacist’s overview on the Triamterene page

“Because triamterene (Dyrenium) both lowers blood pressure and hangs onto potassium, its supplement list calls for real vigilance. Six of the 165 ingredients on file carry a major rating, and those six deserve your attention before any others.”

Reviewed by 2 · Jul 18, 2026

Open the Triamterene interaction page

One more smart check

Taking Malic Acid as Part of a Dietary Supplement Product? Check It for Interactions

We hold 678 real supplement products containing Malic Acid, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Malic Acid. Your product may carry other ingredients that interact with Triamterene too, on top of Malic Acid — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Malic Acid and Triamterene Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Malic Acid
Top 25%

#215 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Triamterene
Steady interest

#2,780 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Malic Acid

What is Malic Acid?

Malic Acid
  • Fibromyalgia symptoms
  • Muscle pain and fatigue
  • Dry mouth (used in some lozenges)
  • Skin exfoliation (topical)
  • Flavoring and food additive

Malic acid is a natural acid found in apples and other fruits, often combined with magnesium in supplements marketed for fibromyalgia and muscle pain. The evidence for its health benefits is weak and limited, and it is mostly used as a food flavoring. It is generally well tolerated in food amounts, but talk to your pharmacist or doctor before using supplement doses.

Read the full Malic Acid monograph & all interactions
Medication

About Triamterene

What Is Triamterene Used For?

Brand name: Dyrenium

Triamterene capsules are used to treat edema — excess fluid buildup in the body — linked to several conditions, including congestive heart failure, cirrhosis of the liver, and nephrotic syndrome (a kidney disorder causing protein loss and swelling). It is also used for steroid-induced edema, idiopathic edema (fluid retention with no clear cause), and edema due to secondary hyperaldosteronism (overproduction of a hormone that causes the body to hold onto sodium and water).

It can be used on its own or alongside other diuretics, either to boost fluid removal or to help preserve potassium levels. Both Dyrenium and Triamterene capsules share the same approved uses as described above.

See full Triamterene drug information
Keep checking

Other Drugs & Malic Acid

Browse every other medication we’ve checked against Malic Acid — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
171Moderate
0Minor
2,658No known interaction
Moderate

171 interactions

Showing 60 of 171 moderate interactions — see all 171 on the Malic Acid page.

No interaction 2,658 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Malic Acid and Triamterene Together: Common Questions

Can you take Malic Acid with Triamterene?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Malic Acid and Triamterene interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Triamterene and Malic Acid?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.