ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Triamterene: Drug information

Triamterene: Drug information
(For additional information see "Triamterene: Patient drug information" and see "Triamterene: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Hyperkalemia:

Abnormal elevation of serum potassium levels (at least 5.5 mEq/L) can occur with all potassium-sparing agents, including triamterene. Hyperkalemia is more likely to occur in patients with renal impairment and diabetes (even without evidence of renal impairment), and in elderly or severely ill patients. Because uncorrected hyperkalemia may be fatal, serum potassium levels must be monitored at frequent intervals especially in patients receiving triamterene, when dosages are changed, or with any illness that may influence renal function.

Brand Names: US
  • Dyrenium
Pharmacologic Category
  • Antihypertensive;
  • Diuretic, Potassium Sparing
Dosing: Adult
Edema

Edema:

Note: Although included as an FDA-approved use in the manufacturer's prescribing information for the management of edema, other diuretics are preferred in clinical practice (Ref).

Oral: Initial: 50 to 100 mg once daily; titrate as needed based on patient response. Maximum: 300 mg/day in divided doses (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

CrCl ≤50 mL/minute: Avoid use (Ref).

Manufacturer's labeling:

Mild to moderate impairment: There are no dosage adjustments provided in the manufacturer's labeling.

Severe impairment, progressive kidney disease, or anuria: Use is contraindicated.

Dosing: Hepatic Impairment: Adult

Mild to moderate impairment: There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).

Severe impairment: Use is contraindicated.

Dosing: Older Adult

Refer to adult dosing. In the management of hypertension, consider lower initial doses and titrate to response (Ref).

Dosing: Pediatric

(For additional information see "Triamterene: Pediatric drug information")

Edema

Edema: Children and Adolescents: Limited data available: Oral: 1 to 4 mg/kg/day divided into 1 to 2 doses; maximum daily dose: 6 mg/kg/day or 300 mg/day, whichever is lower (Ref)

Hypertension

Hypertension: Limited data available: Children and Adolescents: Oral: Initial: 0.5 to 1 mg/kg/dose twice daily; maximum daily dose: 3 to 4 mg/kg/day or 300 mg/day, whichever is lower (Ref)

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Mild to moderate impairment: There are no dosage adjustments provided in the manufacturer's labeling; use with caution, monitor serum potassium.

Severe impairment or progressive kidney disease: Use is contraindicated.

Dosing: Hepatic Impairment: Pediatric

Mild to moderate impairment: There are no dosage adjustments provided in the manufacturer's labeling.

Severe hepatic disease: Use is contraindicated.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.

Central nervous system: Dizziness, fatigue, headache

Dermatologic: Skin photosensitivity, skin rash

Endocrine & metabolic: Hyperkalemia, hypokalemia, increased uric acid, metabolic acidosis

Gastrointestinal: Diarrhea, nausea, vomiting, xerostomia

Genitourinary: Azotemia

Hematologic & oncologic: Hematologic abnormality, megaloblastic anemia, thrombocytopenia

Hepatic: Jaundice, liver enzyme disorder

Hypersensitivity: Anaphylaxis

Neuromuscular & skeletal: Weakness

Renal: Acute interstitial nephritis (rare), acute renal failure (rare), increased blood urea nitrogen, increased serum creatinine, nephrolithiasis

Contraindications

Hypersensitivity to triamterene or any component of the formulation; anuria; severe or progressive kidney disease or dysfunction with the possible exception of nephrosis; severe hepatic disease; hyperkalemia; coadministration with other potassium-sparing agents or other formulations containing triamterene

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Warnings/Precautions

Concerns related to adverse effects:

• Fluid/electrolyte loss: Triamterene can lead to profound diuresis with fluid and electrolyte loss; close medical supervision and dose evaluation are required. Patients with heart failure, renal disease, or cirrhosis may be particularly susceptible to fluid and electrolyte abnormalities. Watch for and correct electrolyte disturbances; adjust dose to avoid dehydration.

• Hyperkalemia: [US Boxed Warning]: Hyperkalemia can occur; patients at risk include those with renal impairment, diabetes, the elderly, and the severely ill. Serum potassium levels must be monitored at frequent intervals especially when dosages are changed or with any illness that may cause renal dysfunction. . In patients who develop hyperkalemia or if hyperkalemia is suspected, obtain an electrocardiogram to rule out hyperkalemia-induced QRS prolongation or other cardiac arrhythmias. Discontinue triamterene and any potassium supplementation in patients who develop hyperkalemia; treat cardiac arrhythmias as clinically indicated.

• Hypersensitivity reactions: Isolated occurrences have been reported. Observe for blood dyscrasias, liver damage or idiosyncratic reactions

• Photosensitivity: Can cause photosensitivity.

Disease-related concerns:

• Adrenal insufficiency: Avoid use of diuretics for treatment of elevated blood pressure in patients with primary adrenal insufficiency (Addison disease). Adjustment of glucocorticoid/mineralocorticoid therapy and/or use of other antihypertensive agents is preferred to treat hypertension (Bornstein 2016; Inder 2015).

• Diabetes: Use with caution in patients with prediabetes or diabetes mellitus; may increase blood glucose concentrations and necessitate dosage adjustment of hypoglycemic agents.

• Gout: May cause elevation in uric acid.

• Hepatic impairment: Use with caution in patients with severe hepatic dysfunction; in cirrhosis, avoid electrolyte and acid/base imbalances that might lead to hepatic encephalopathy.

• Kidney stones: Use with caution in patients with kidney stones.

Other warnings/precautions:

• Abrupt discontinuation: In patients who have received triamterene for prolonged periods of time, a hypothetical risk of rebound kaliuresis may occur when abruptly discontinued; withdraw triamterene gradually in these patients.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

Dyrenium: 50 mg, 100 mg [contains fd&c yellow #6 (sunset yellow)]

Generic: 50 mg, 100 mg

Generic Equivalent Available: US

Yes

Pricing: US

Capsules (Dyrenium Oral)

50 mg (per each): $16.08

100 mg (per each): $16.08

Capsules (Triamterene Oral)

50 mg (per each): $11.93 - $11.94

100 mg (per each): $11.93 - $11.94

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Oral: Administer after meals.

Administration: Pediatric

Oral: Administer with food to avoid GI upset

Use: Labeled Indications

Edema: Although included as an FDA-approved use in the manufacturer's prescribing information for the management of edema, other diuretics are preferred in clinical practice (AHA/ACC/HFSA [Heidenreich 2022]; Brater 2022).

Medication Safety Issues
Sound-alike/look-alike issues:

Triamterene may be confused with trimipramine

Dyrenium may be confused with Pyridium

Older Adult: High-Risk Medication:

Beers Criteria: Diuretics are identified in the Beers Criteria as potentially inappropriate medications to be used with caution in patients 65 years and older due to the potential to cause or exacerbate syndrome of inappropriate antidiuretic hormone secretion (SIADH) or hyponatremia; monitor sodium concentration closely when initiating or adjusting the dose in older adults (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Substrate of OCT2

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Ammonium Chloride: Potassium-Sparing Diuretics may enhance the adverse/toxic effect of Ammonium Chloride. Specifically the risk of systemic acidosis. Risk C: Monitor therapy

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Angiotensin II Receptor Blockers: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Angiotensin-Converting Enzyme Inhibitors: Potassium-Sparing Diuretics may enhance the hyperkalemic effect of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

CycloSPORINE (Systemic): Potassium-Sparing Diuretics may enhance the hyperkalemic effect of CycloSPORINE (Systemic). Risk X: Avoid combination

Desmopressin: Hyponatremia-Associated Agents may enhance the hyponatremic effect of Desmopressin. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diacerein: May enhance the therapeutic effect of Diuretics. Specifically, the risk for dehydration or hypokalemia may be increased. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Dofetilide: Triamterene may increase the serum concentration of Dofetilide. Risk C: Monitor therapy

Drospirenone-Containing Products: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Erdafitinib: May increase the serum concentration of OCT2 Substrates (Clinically Relevant with Inhibitors). Management: Consider alternatives to this combination when possible. If combined, monitor for increased effects/toxicities of OCT2 substrates and consider OCT2 substrate dose reductions when appropriate. Risk D: Consider therapy modification

Fexinidazole: May increase the serum concentration of OCT2 Substrates (Clinically Relevant with Inhibitors). Management: Avoid use of fexinidazole with OCT2 substrates when possible. If combined, monitor for increased OCT2 substrate toxicities. Risk D: Consider therapy modification

Finerenone: Potassium-Sparing Diuretics may enhance the hyperkalemic effect of Finerenone. Risk C: Monitor therapy

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Heparin: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Management: Monitor serum potassium concentrations closely. The spironolactone Canadian product monograph lists its combination with heparin or low molecular weight heparins as contraindicated. Risk C: Monitor therapy

Heparins (Low Molecular Weight): May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Indomethacin: Triamterene may enhance the adverse/toxic effect of Indomethacin. Specifically, the risk for renal failure and hyperkalemia may be increased. Management: Consider alternatives to concomitant treatment with triamterene and indomethacin. If the combination cannot be avoided, monitor for development of renal failure and hyperkalemia. Risk D: Consider therapy modification

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

Lithium: Potassium-Sparing Diuretics may increase the serum concentration of Lithium. Potassium-Sparing Diuretics may decrease the serum concentration of Lithium. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Nonsteroidal Anti-Inflammatory Agents: May diminish the antihypertensive effect of Potassium-Sparing Diuretics. Nonsteroidal Anti-Inflammatory Agents may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Opioid Agonists: May enhance the adverse/toxic effect of Diuretics. Opioid Agonists may diminish the therapeutic effect of Diuretics. Risk C: Monitor therapy

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Diuretics may enhance the nephrotoxic effect of Polyethylene Glycol-Electrolyte Solution. Risk C: Monitor therapy

Potassium Salts: May enhance the hyperkalemic effect of Triamterene. Risk X: Avoid combination

Potassium-Sparing Diuretics: May enhance the hyperkalemic effect of other Potassium-Sparing Diuretics. Risk X: Avoid combination

Pramipexole: Triamterene may enhance the hypotensive effect of Pramipexole. Triamterene may increase the serum concentration of Pramipexole. Risk C: Monitor therapy

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sodium Phosphates: Diuretics may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Risk C: Monitor therapy

Tacrolimus (Systemic): Potassium-Sparing Diuretics may enhance the hyperkalemic effect of Tacrolimus (Systemic). Risk C: Monitor therapy

Tafenoquine: May increase the serum concentration of OCT2 Substrates (Clinically Relevant with Inhibitors). Management: Avoid use of OCT2 substrates with tafenoquine, and if the combination cannot be avoided, monitor closely for evidence of toxicity of the OCT2 substrate and consider a reduced dose of the OCT2 substrate according to that substrate's labeling. Risk D: Consider therapy modification

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Tolvaptan: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Pregnancy Considerations

Triamterene crosses the placenta and is found in cord blood. Use of triamterene to treat edema during normal pregnancies is not appropriate; use may be considered when edema is due to pathologic causes (as in the nonpregnant patient); monitor.

Breastfeeding Considerations

It is not known if triamterene is present in breast milk. Breastfeeding is not recommended by the manufacturer.

Monitoring Parameters

Blood pressure; serum electrolytes (especially potassium); kidney function; fluid intake and output.

Mechanism of Action

Blocks epithelial sodium channels in the late distal convoluted tubule (DCT) and collecting duct which inhibits sodium reabsorption from the lumen. This effectively reduces intracellular sodium, decreasing the function of Na+/K+ ATPase, leading to potassium retention and decreased calcium, magnesium, and hydrogen excretion. As sodium uptake capacity in the DCT/collecting duct is limited, the natriuretic, diuretic, and antihypertensive effects are generally considered weak.

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Diuresis: 2 to 4 hours; Note: Maximum therapeutic effect may not occur until after several days of therapy

Duration: Diuresis: 7 to 9 hours

Absorption: Rapid

Metabolism: Primarily metabolized to the sulfate conjugate of hydroxytriamterene

Time to peak, plasma: ~3 hours

Excretion: Urine (21% to <50%; primarily as metabolites)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (BE) Belgium: Dytac;
  • (CH) Switzerland: Dyrenium;
  • (DE) Germany: Jatropur;
  • (ES) Spain: Urocaudal;
  • (GB) United Kingdom: Dytac;
  • (JP) Japan: Diarrol | Kikuspan beppu | Kikuspan taisho | Triamterene isei | Triteren;
  • (KR) Korea, Republic of: Dyren;
  • (LT) Lithuania: Dytac;
  • (LU) Luxembourg: Dytac;
  • (LV) Latvia: Dytac;
  • (NL) Netherlands: Dytac;
  • (PR) Puerto Rico: Dyrenium;
  • (TW) Taiwan: Triamteren | Triteren
  1. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  2. Aronoff GR, Bennett WM, Berns JS, et al. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children. 5th ed. American College of Physicians; 2007. [PubMed 6356890]
  3. Aronow WS, Fleg JL, Pepine CJ, et al. ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation. 2011;123(21):2434-2506. [PubMed 21518977]
  4. Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(2):364-389. doi:10.1210/jc.2015-1710 [PubMed 26760044]
  5. Brater DC, Ellison DH. Causes and treatment of refractory edema in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 23, 2022.
  6. Dyrenium (triamterene) [prescribing information]. St. Michael, Barbados: Concordia Pharmaceuticals; September 2019.
  7. Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi:10.1210/jc.2015-4061 [PubMed 26934393]
  8. Gal P, Reed M. Medications. In: Kliegman RM, Behrman RE, Jenson HB, et al, eds. Nelson Textbook of Pediatrics. 18th ed. Saunders Elsevier; 2007:2955-2999.
  9. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 [PubMed 35363499]
  10. Hoorn EJ, Ellison DH. Diuretic resistance. Am J Kidney Dis. 2017;69(1):136-142. doi:10.1053/j.ajkd.2016.08.027 [PubMed 27814935]
  11. Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119(14):e391-e479. [PubMed 19324966]
  12. Inder WJ, Meyer C, Hunt PJ. Management of hypertension and heart failure in patients with Addison's disease. Clin Endocrinol (Oxf). 2015;82(6):789-792. doi:10.1111/cen.12592 [PubMed 25138826]
  13. James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. Published online December 18, 2013. [PubMed 24352797]
  14. National Heart, Lung, and Blood Institute. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Clinical Practice Guidelines, 2011. National Institutes of Health. http://www.nhlbi.nih.gov/guidelines/cvd_ped/peds_guidelines_full.pdf. Accessed June 2012. [PubMed 22084329]
  15. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114(2)(suppl):555-576. [PubMed 15286277]
  16. Refer to manufacturer's labeling.
  17. van der Vorst MM, Kist JE, van der Heijden AJ, et al. Diuretics in Pediatrics: Current Knowledge and Future Prospects. Paediatr Drugs. 2006;8(4):245-264. [PubMed 16898855]
  18. Weber MA, Schiffrin EL, White WB, et al, Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014;16(1):14-26. [PubMed 24341872]
  19. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published online ahead of print on November 13, 2017.]. Hypertension. 2017. doi:10.1161/HYP.0000000000000065 [PubMed 29133356]
  20. Yamaguchi E, Yoshikawa K, Nakaya I, et al. Liddle's-like syndrome associated with nephrotic syndrome secondary to membranous nephropathy: the first case report. BMC Nephrol. 2018;19(1):122. doi:10.1186/s12882-018-0916-3 [PubMed 29792170]
Topic 10016 Version 238.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟