Products
Piretanide is commercially available in tablet form (Trialix + ramipril). It has been approved in many countries since 1985. In many countries, only the fixed combination with the ACE inhibitor ramipril is currently available.
Structure and properties
Piretanide (C17H18N2O5S, Mr = 362.40 g/mol) has structural similarities to other loop diuretics and is a sulfonamide. It exists as a yellowish white to yellowish powder that is very sparingly soluble in water.
Effects
Piretanide (ATC C03CA03) has diuretic and antihypertensive properties. Like other loop diuretics, piretanide blocks the Na+/K+/2Cl–-transporter in the ascending branch of the loop of Henle in the nephron. It promotes excretion of sodium, water, chloride, potassium, calcium, and magnesium.
Indications
For the treatment of edema of various causes, in heart failure and hypertension.
Dosage
According to the professional information. Medicines are usually taken once or twice daily, preferably in the morning or at noon and after meals. Sustained-release and non-retarded dosage forms are available.
Contraindications
- Hypersensitivity, including to other sulfonamides.
- Renal failure with anuria
- Coma
- Precoma hepaticum
- Severe hypokalemia
- Hyponatremia
- Hypovolemia
- Dehydration
- Pregnancy and lactation
Full precautions can be found in the drug label.
Interactions
Treatment must take into account the many possible drug-drug interactions.
Adverse effects
The most common potential adverse effects include disturbances in electrolyte and fluid balance, such as hypokalemia and hyponatremia, allergic reactions, and metabolic disturbances such as hyperuricemia and gout.