Drug-induced nutrient depletion

Triamterene & Nutrient Depletion

Also searched as Dyrenium. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.

2Nutrient associations
Moderate DepletionHighest rating
The bottom line

Triamterene has been associated with depletion of FOLIC ACID and COENZYME Q10. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Triamterene long-term, worth raising with your pharmacist or healthcare provider.

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Take more than one medication? Open the checker with Triamterene pre-loaded and add the rest to see overlapping nutrient signals.

The evidence

Reported nutrient depletions with Triamterene

Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.

FOLIC ACID

Moderate Depletion

TRIAMTERENE (Dyrenium)

Triamterene might reduce folate absorption and increase the risk of folate deficiency.

Triamterene is a folate antagonist that prevents conversion of folic acid to its active form, and also reduces folate absorption. Reduced serum and red blood cell folate and occasional cases of megaloblastic anemia have occurred, usually in people with other conditions contributing to folate deficiency. Advise patients on chronic triamterene therapy to maintain the recommended dietary folate intake, or to take a supplement if this is not possible. For information on foods that are rich in folate, see our chart.
Taking Triamterene? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Folate is a B vitamin your body needs to build healthy cells, including red blood cells and the cells that line your gut. Triamterene works against folate in two ways: it blocks some of the absorption from food in the digestive tract, and it also interferes with the step that converts folic acid into the active form your cells can actually use. Because of this double effect, long-term triamterene users can see their folate levels drop, and in some cases this has led to a type of anemia. This is a moderate concern worth taking seriously, so if you have been on triamterene for a while, it is worth asking your pharmacist or doctor whether your diet is providing enough folate or whether a supplement makes sense for you.

What Folic acid (folate) does & food sources

Folate is needed for cell division, red blood cell formation, and healthy fetal development.

Common food sources:

  • Leafy green vegetables
  • Beans, lentils, and peas
  • Fortified grains and cereals
  • Citrus fruits

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.

Learn more about this nutrient: Folic Acid — uses, safety & interactions

References (4)
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Lambie DG, Johnson RH. Drugs and folate metabolism. Drugs 1985;30:145-55. PubMed
  3. Joosten E, Pelemans W. Megaloblastic anaemia in an elderly patient treated with triamterene. Neth J Med 1991;38:209-11.
  4. Corcino J, Waxman S, Herbert V. Mechanism of triamterene-induced megaloblastosis. Ann Intern Med 1970;73:419-24. PubMed

COENZYME Q10

Insufficient Evidence

ANTIHYPERTENSIVE DRUGS

Some antihypertensive drugs can modestly decrease endogenous levels of coenzyme Q10.

Some antihypertensive drugs, including beta blockers, diazoxide, hydralazine, and others, appear to inhibit coenzyme Q10 enzyme activity and may decrease endogenous levels of coenzyme Q10. However, it is not clear if this reduction is clinically significant. There is no reliable evidence that coenzyme Q10 depletion contributes to antihypertensive drug side effects.
Taking Triamterene? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Coenzyme Q10 is a compound your cells use to produce energy, and it also acts as an antioxidant. Some blood pressure medications have been reported to interfere with enzymes involved in the body's own CoQ10 production, which could modestly lower its levels, though whether triamterene specifically does this is not well studied. The evidence here is simply too thin to draw firm conclusions, so most people taking triamterene do not need to worry about this. If you have questions or take triamterene long-term, it is worth bringing up with your pharmacist or doctor.

What Coenzyme Q10 (CoQ10) does & food sources

CoQ10 helps cells produce energy and acts as an antioxidant; heart and muscle tissue use it heavily.

Common food sources:

  • Organ meats and fatty fish
  • Whole grains
  • Nuts and seeds

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

There is no routine blood test for CoQ10 in everyday practice. If you have new, unexplained muscle symptoms on a medication linked to CoQ10 (statins are the best-known example), talk to your prescriber before changing anything — symptoms have many possible causes and your prescriber has several options.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

CoQ10 is generally well tolerated, but evidence for supplementing (for example, for statin muscle symptoms) is mixed. It may also modestly affect warfarin — check with your pharmacist before combining.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Do not stop a prescribed medication because of this association — discuss any symptoms with your prescriber first.

Learn more about this nutrient: Coenzyme Q10 — uses, safety & interactions

References (1)
  1. Kishi T, Kishi H, Watanabe T, et al. Bioenergetics in clinical medicine. XI. Studies on coenzyme Q and diabetes mellitus. J Med 1976;7:307-21.
Important

This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.

Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.

© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
Understand the basics

What drug-induced nutrient depletion means

Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.

Association is not deficiency

An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.

Evidence varies by pair

Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.

When to ask about labs

If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.

Don't self-supplement blindly

Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.

Never stop a medication over this

These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.

Food first, usually

For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.

Common questions

Triamterene & nutrients: FAQs

Does Triamterene deplete FOLIC ACID?
Triamterene has been associated with lower FOLIC ACID levels in the clinical literature — see the evidence rating and details above. An association is not a guarantee: dose, duration, diet, and your own health all matter. If you take Triamterene long-term, ask your healthcare provider whether checking your FOLIC ACID status is appropriate.
Should I take a supplement because I take Triamterene?
Not automatically. The right first step is usually a conversation with your pharmacist or provider — they can weigh your dose and duration, decide whether testing makes sense, and recommend food-first strategies or a supplement if genuinely needed. Some supplements can interact with medications, so do not add one without checking.
Should I stop taking Triamterene?
No — never stop a prescribed medication because of a nutrient association. Triamterene is prescribed for good reasons, and nutrient considerations are usually manageable with monitoring or diet. Any change to your medication belongs in a conversation with your prescriber.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English context is written and reviewed by licensed HelloPharmacist pharmacists.

Questions about Triamterene and your nutrition?

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Sources

Sources & How We Checked

Nutrient depletion records for Triamterene are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

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