Triamterene-thiazide combination: Alternative therapy for primary aldosteronism

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Abstract
The hypertension and hypokealemia of primary aldosteronism are related to excessive aldosterone secretion. Spironolactone, an aldosterone antagonist, is used in high doses to treat the disorder, but it may induce a number of side effects that can limit its use. The feasibility was investigated of treating a group of 8 patients with hyperaldosteronism with a triameterene-thiazide combination to induce volume depletion and increase serum K concentration. All patients responded with normalization or near normalization of blood pressure. Serum K could be maintained within the normal range with or without K supplements in all but 1 patient. The effectiveness of the therapy suggests that thiazide-triamterene treatment may offer an alternative in some patients with primary aldosteronism who do not tolerate spironlactone.

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