Megaloblastic Anemia Possibly Induced by Triamterene in Patients with Alcoholic Cirrhosis

Abstract
Both patients had low serum folate levels. One patient was critically ill, but survived when triamterene was stopped and folic and folinic acids were administered. Because triamterene is a folic acid antagonist in vitro, it may precipitate megaloblastic anemia in alcoholic cirrhosis by inhibiting the utilization of folic acid in the presence of low stores of folic acid.