Triamterene

[Captainutrition]

I did a search on this diuretics and only found one bit of information. Is there anybody out there who knows about this one. Rumor has it it's a generic brand of Dyazide. I'm doing my first show this weekend, July 19, 2003, and was wondering how to use it. Does a persons weight have anything to do with how much one should take??

[sigrabbit]

I have no idea, but I will bump it for you.

[ed mass]

I think its one of the ingredients in dyazide.....the less powerful ingredient. Here is a cut and paste from anabolex: diuretics 101

POTASSIUM SPARING DIURETICS
Although not technically diuretics, the drugs in this family are often prescribed for this reason. Spironolactone (aldactone) and triamterene (dyrenium) are examples of potassium sparing diuretics. Potassium sparing diuretics are also known as aldosterone antagonists. Aldosterone is a hormone which is released in times of any kind of stress and causes an increase in potassium excretion and a decreased excretion of sodium and water. Since drugs from this family are antagonistic to the effects of this hormone, then potassium is spared in the body, and sodium and water are excreted. (For a detailed description of aldosterone, see the Venice Beach article on sodium in a previous issue of MuscleMag) Compared to the other families of diuretics, drugs from this family are considered the mildest of the diuretics. Women are sometimes prescribed aldactone to control bloating during their menstrual cycle. Used appropriately, diuretics from this family would be the safest choice an athlete could make. However most athletes have no idea how to use these drugs effectively, and therefore, use of these drugs can also become dangerous. Drugs from this family can cause or aggravate the condition known as hyponatremia. Hyponatremia is a dangerous condition of lowered plasma sodium levels. Bodybuilders who restrict sodium intake and take drugs from this group while restricting fluids could easily find themselves in this dangerous state. And since most bodybuilders do needlessly restrict sodium before a show, this scenario is often the rule rather than the exception. The physician's desk reference warns not to restrict sodium when taking drugs from this family. When this situation arises athletes will feel confusion, dizziness, weakness, tremors, etc. Athletes who drastically cut their carbs before a show can further exacerbate this situation. Not only does this add to the above problems but also it can contribute to the condition of orthostatic hypotension. This is when overall blood volume and blood pressure are dangerously low, and simple things like standing up quickly can cause a loss of consciousness or worse. Often times, many bodybuilders who aren't in the know are already in this state as a result of a prolonged lack of sodium and carbohydrate intake. The addition of any type of diuretic to such a metabolic profile produces the above worse case scenario.
The above is merely the sodium related side of the coin when it comes to using the potassium sparing diuretics. In the case of potassium the potential for real problems is much higher and much more severe. With this family of drugs all patients are warned not to use any kind of potassium supplements since hyperkalemia is a very real possibility. Often, for certain individuals even diets high in potassium can result in hyperkalemia, and hyperkalemia by definition is a life-threatening event, where the high potassium levels cause cardiac irregularities, which can be fatal. It is important to note that for those prone to this condition, hyperkalemia can occur even in the absence of potassium supplementation. Therefore bodybuilders trying to follow the traditional but faulty logic of their previous compatriots, who supplement potassium and limit sodium are courting disaster even with what is known as the least dangerous of the diuretics. Individuals who are genetically more prone to this condition and also happen to be bodybuilders could find this out the hard way. Not to mention even if the situation doesn't get dangerous, the previous symptomology would make it hard for an athlete to compete at all least of all enjoy it while they are doing it.
The top biochemists in the field that are in the know also think that clenbuterol may have a pronounced effect in this area. It is felt that clenbuterol may cause potassium to exit the cell and this is why many clenbuterol users get intense muscle cramps. More importantly, the potassium that clenbuterol causes to exit the cell will increase the plasma levels of potassium. Combine this with the use of diuretics from this family and the potential for hyperkalemia increases tremendously. This is just another example of the possible conflicts of self-medication when athletes know nothing of drugs metabolic effects and therefore why it may be contra-indicated with other drugs that athletes will use anyway. Sometimes this only means putting up with bothersome side effects, but in this case the result could be a tragedy. The early signs of hyperkalemia include parathesia, intense cramps, palpitations or angina (heart or chest pain) and extreme weakness. Anyone who experiences such effects before a show while using drugs from this family should immediately get to a hospital.
However, some of the more benign side effects related to this family of drugs, are completely mis-represented. Although the literature reports that these drugs may cause gynocomastia, this effect is related to duration and dosage. Mostly gyno from this group of drugs is only noticed in the elderly who have very low circulating levels of testosterone, and because of heart or kidney problems they are on high doses of these drugs for very extended periods of time, like months or years. So your guru guides who warn of this effect are not only missing the more serious nature of the issue but they are proving once again that a little knowledge is a dangerous thing.
For women who because of bad advice, have taken strong male androgens for a contest, taking drugs from this family after a show under the correct medical and nutritional guidance (see above) may offset the potential for androgenic side effects caused by other androgenic steroids. Hopefully women don't get into this situation at all, but if they do this may be one example where a course of drug therapy may be of use to athletes who have mistakenly or otherwise abused their bodies.
Because I've stated this group of diuretics are among the more safe ones, and because they are often prescribed for less serious conditions like menstrual bloating etc. let's review what was actually said above before bodybuilders start thinking how safe and great this family of diuretics must be. First consider that these drugs are prescribed to normal individuals who probably are not eliminating crucial electrolytes like sodium from their diets for extended periods of time. Moreover, the normal populace is less likely to be doing crazy things with their carb intake, and cutting their fluids before undertaking diuretics therapy. These factors of use and misuse are what influences potentially dangerous drugs into becoming dangerous drugs in the hands of the uneducated user. Hopefully enough said here!

THIAZIDES
Considered among the more intense diuretics therapies are the group of drugs known as the thiazides. Examples include hydrochlorothiazide which is a generic name that comes under a variety of trade names. Others from this family are drugs like dyazide which combine hydrochlorothiazide with a potassium sparing diuretic, in this case triamterene (see above). Of course the combination of diuretics from the two different families is usually for more serious conditions and also increases the chances of unwanted side effects and health consequences in the hands of the uninitiated who mistakenly think "great, two different diuretics in one pill" Again, this more is better and the stronger the better mentality of bodybuilders using these drugs is a foolish and moronic mindset.
Drugs from this family are generally prescribed for edema related to more severe conditions associated with heart failure, cirrhosis, and renal failure. The influence on electrolytes by this group is more profound and invasive than the potassium sparing diuretics. The thiazides increase sodium excretion, chloride excretion, and water excretion, and thus it causes a decrease in the amount of extracellular fluid, which is the goal of using these drugs. However, there is a corresponding reduction in circulatory volume, which can lead to orthostatic hypotension, which we covered above. Again because of the way almost all bodybuilders are treating their bodies before a show because of mis-information and bad advice this situation would be quite common amongst bodybuilders. Moreover, the sodium depletion, which accompanies the use of these drugs, can be of immediate concern for the athletes who are needlessly keeping sodium out of their diets to begin with. (hyponatremia) The consequences of these effects are weakness, fatigability, parathesias, and metabolic alkalosis. Because these drugs also cause potassium excretion the condition of hypokalemia is a very real possibility. This is why some manufacturers decided to add a potassium sparing diuretics component to these compounds. This also may be where athletes mistakenly began to get the idea of potassium supplementing before a show. Remember however that drugs given to normal individuals for entirely different medical concerns than why athletes are using them, often means that applying the same logic to their use by athletes is a faulty proposition. This is one such case. Also the combination of low potassium levels and the great loss of magnesium, and some believe chloride, when using these drugs can lead to intense muscle cramps, and most of the other effects listed above. For some unknown reason these drugs cause a reabsorption of calcium in the distal tubule, which can in rare instances cause hypercalcemia, or too much calcium in the blood. However in general, this effect is one of the things that makes this group slightly less dangerous than the next group of diuretics that we will discuss. In mentioning calcium it should be noted that calcium and magnesium need to be present together to prevent intense muscle cramping in real world situations. This delicate balance between calcium and magnesium is often why hard training athletes find themselves cramping regularly in the offseason in specific muscle groups that have recently undergone intense training sessions. Most often cramping related to this situation seem to come at night. Most hardcore athletes know what I'm talking about here but until now never really knew why it was happening.
The physicians desk reference guide recommends that in cases of extreme adverse reactions, sodium replacement therapy is the treatment of choice. Many mis-informed and mis-guided bodybuilders have found themselves in the hospital following a bad diuretics episode. Most are given I.V. fluids to help restore them to normal and almost always these fluids are nothing more than saline solution, or in other words, sodium and chloride intravenous. Funny how these bodybuilders whine about their veins disappearing and feeling flat when using these drugs, yet their vascularity returns almost immediately after receiving sodium by intravenous feeding. Has anyone clicked in yet? Again keep your sodium intake high, all through the year but especially pr-contest and especially if you are going to use diuretics. Not only is this a safer and healthier thing to do, but it is also an advantage cosmetically. (see previous article on sodium by the Venice Beach Group)
As we can see the list of potential conflicts grows with the more potent diuretics. The one thing to consider here then, is dose indications. The physicians desk reference is quick to point out that doses above 25-50 mgs. one to two times daily will do little to increase effectiveness but will certainly lead to more pronounced side effects. And this is in relation to these drugs as prescribed for actual medical situations. Bodybuilders who try to convince themselves that a little more may be a little better will usually regret such a decision. Consider that bodybuilders close to a contest are already fairly lean, especially compared to normal individuals. Consider also that these athletes are not suffering from any real world edematous conditions. Combine these points with the way bodybuilders try to use these drugs and it becomes obvious that the potential for danger is real and immediate. Sometimes the danger lies with athletes who manage to escape serious side effects the first time they try these drugs so they see them as harmless. This roll of the dice mentality with such potentially dangerous drugs will usually come back to haunt these athletes at some time in the future.
So far we've learned that athletes should be keeping their sodium high and that they should probably be supplementing with a good and strong cal/mag especially before a show. We've also learned about the myth and the dangers of potassium supplementation especially in connection with diuretics use, and hopefully we've learned by now that diuretics use is no game, and that different families of these drugs carry with them their own distinct dangers. A diuretic is not a diuretic. Each kind influences the body in different ways and uninformed athletes who don't understand this will not know what to do should specific and real problems arise.

THE LOOP DIURETICS
There is never a reason that any athletes would need or want to use drugs from this family. That being the case why are the drugs from this family the most popular among bodybuilders? The answer is easy. Bodybuilders are extremists, and they think the most potent drugs are automatically the drugs of choice. Unfortunately, so-called experts who also give the drugs from this group a positive review have verified this opinion to them. Let me tell you, they are wrong, wrong, wrong. These drugs have caused more hospital trips and bad and embarrassing cramping episodes than the other two groups put together. Also I've never ever seen these drugs do anything positive for a bodybuilder and those who were fortunate enough using these drugs to escape harm usually always regret using drugs from this family because their entire physique looks worse instead of better. I will explain why below.
The diuretics from this family are the most powerful diuretics, and are short acting diuretics. Examples include furosemide, better known as lasix, and its analogs, such as bumetanide and piretanide. Even stronger drugs from this family often used only with racehorses have found their way into the athletes drug arsenal. This of course is a colossal mistake. For all intents and purposes these drugs are similar to the thiazides but are quantitatively greater in effect. Unlike the thiazides however, drugs from this group also cause profound losses of calcium. Being by far the strongest and most potent of the diuretics these drugs are usually prescribed for the most severe conditions of acute heart failure, pulmonary edema, and hypercalcemia of the life threatening nature. The drugs from this family cause massive changes in fluid balance. Severe electrolyte depletion can occur with the loop agents especially with higher doses and a restricted sodium intake. This is obviously a situation which would be common to bodybuilders should they choose to use the loop agents. Earliest warning signs are very intense cramps usually beginning in the legs. Athletes using loop agents and experiencing this effect should consider this a warning sign of imminent danger ahead.
Unlike the thiazides, loop agents cause a decrease in serum levels of calcium and magnesium because of an increased excretion of both. These conditions are known as hypocalcemia and hypomagnesemia respectively. Intense cramps caused by this effect are painful warning signs of more extreme trauma ahead. Extremely low levels of calcium in the blood can lead to muscle tetany, where the muscles feel locked in a cramped and contracted position and could even tear away from the bone. So important is calcium in the blood that only 1% of calcium in the body circulates in the blood while the other 99% is stored in the bones etc. in order to control the delicate calcium ratios which must be maintained. Calcium can be considered the patriarch of all the electrolytes and in a hypocalcemic situation a cascade of negative and life threatening events can occur.
Because the loop agents cause indiscriminate losses of all the electrolytes every dangerous situation of individual low levels of particular electrolyte imbalance is a possibility. We've already discussed the calcium and magnesium related problem potential but the loop agents also cause losses of potassium and sodium, two situations that are life threatening and have already been discussed elsewhere. Because these agents act so swiftly and powerfully, effecting all electrolytes either directly or indirectly, extreme hypotension often occurs. (low blood volume) When left unchecked this condition can and has caused a reduction of blood volume to the point of circulatory collapse. This is another of the possible ways that Momo Benaziza may have died. In regards to the situation of hypovolimia the physician's desk reference warns that since rigid sodium restriction is conducive to both hyponatremia (too low of serum sodium levels) and hypovolimia (too low of circulating blood volume) strict restriction of sodium intake is not advisable in patients receiving the loop agents. This is yet another scientific explanation to keep a high sodium intake in the diet of a pre-contest athlete. The use of loop agents just makes the situation worse.
Often athletes for some unnecessary and foolish reason stack the loop agents with other diuretics. Obviously this only increases the potential for tragic complications. The thinking here is that the athletes would need less of each drug if they combine the two together and hence, they can avoid serious consequences. At best this is just wishful thinking. Remember when discussing the thiazides that very low doses were efficient even for medical reasons. Therefore combining the loop agents with other diuretics in order to not have to use, as much is faulty logic since an athlete should be getting results with small doses anyway. The other reason this is a bad idea is because of the indiscriminate nature of the effect of the loop agents. The loop agents will cause electrolyte depletion both inside and outside the muscle cells. This obviously causes smaller, flat muscles, which will be difficult to respond to peaking strategies like carb, or fat loading since crucial electrolyte balance is compromised, and thus so is normal metabolic processes.
Indeed the physicians desk reference warns that if loop agents are combined with other diuretics, other diuretics dosage must be reduced by 50% as soon as loop agents are added in order to prevent an excessive drop in blood pressure. When blood pressure continues to fall total discontinuation of other agents is necessary to prevent serious consequences. And remember this is in medically prescribed situations where there is a severe edematous problem to begin with.
The bottom line on the use of loop agents is that they are totally unnecessary for bodybuilders before a contest. At best they will make your body look worse, usually flat and soft because of extreme electrolyte depletion; and the worse case scenario is that this family of drugs could cause serious and immediate life threatening consequences via a number of different causative metabolic pathways. Simply because athletes think the stronger drugs are automatically better does not make it so, and in the case of the loop agents this is a ridiculous notion.

[Captainutrition]

Ask and you shall receive...damn good job!
Thank you very much