Drug interactions
Ramipril + Triamterene
Severity: Major
Ramipril and Triamterene: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ramipril lowers aldosterone and combined with triamterene can cause serious hyperkalemia, particularly in renal impairment, diabetes or older patients. Additive hypotension may also occur.
What this interaction means in plain words
Ramipril and Triamterene can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ramipril belongs to Cardiovascular; Triamterene belongs to Cardiovascular.
Why it happens
ACE inhibition reduces aldosterone-mediated potassium excretion while triamterene blocks distal sodium channels, giving additive potassium retention.
What to do
Avoid the combination where possible; if used, check potassium and creatinine within the first week and periodically thereafter. Avoid potassium supplements and salt substitutes and stop triamterene if hyperkalemia develops.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Triamterene
- Amiloride + Triamterene Contraindicated
- Eplerenone + Triamterene Contraindicated
- Potassium citrate / citric acid + Triamterene Contraindicated
- Potassium citrate + Triamterene Contraindicated
- Spironolactone + Triamterene Contraindicated
- Aceclofenac + Triamterene Major
Other interactions of Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Ramipril with Triamterene?
MediHelp rates the interaction as major. Ramipril and Triamterene can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ramipril lowers aldosterone and combined with triamterene can cause serious hyperkalemia, particularly in renal impairment, diabetes or older patients. Additive hypotension may also occur.
How serious is the interaction between Ramipril and Triamterene?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if used, check potassium and creatinine within the first week and periodically thereafter. Avoid potassium supplements and salt substitutes and stop triamterene if hyperkalemia develops.
What other medicines interact with Triamterene?
MediHelp also lists interactions of Triamterene with, for example, Amiloride, Eplerenone, Potassium citrate / citric acid. The full list is on the Triamterene page.
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