Favre L, Glasson P, Vallotton M B
Ann Intern Med. 1982 Mar;96(3):317-20. doi: 10.7326/0003-4819-96-3-317.
As part of a study on the interaction between diuretics and renal prostaglandins, four healthy medical students receiving indomethacin for 8 days were also given triamterene for 3 days. Whereas renal function was initially normal in all four subjects, creatinine clearance decreased in two by 62% and 72% after concomitant administration of the two drugs, and was only restored to normal after 4 weeks. In control periods when triamterene or indomethacin was given alone renal function was preserved in all subjects. Urinary prostaglandin E2 was stimulated by triamterene and inhibited by indomethacin in all four subjects; both changes were more marked in the two sensitive subjects. Thus prostaglandin inhibition by indomethacin may unmask triamterene toxicity and contribute to the pathogenesis of the renal failure observed in sensitive subjects. As alternative therapy is readily available, avoidance of this potentially nephrotoxic association is recommended.
作为一项关于利尿剂与肾前列腺素相互作用研究的一部分，四名接受吲哚美辛治疗8天的健康医学生同时服用氨苯蝶啶3天。虽然所有四名受试者的肾功能最初均正常，但在两种药物联合使用后，两名受试者的肌酐清除率分别下降了62%和72%，且仅在4周后才恢复正常。在单独使用氨苯蝶啶或吲哚美辛的对照期，所有受试者的肾功能均得以保留。在所有四名受试者中，氨苯蝶啶刺激尿前列腺素E2分泌，而吲哚美辛则抑制其分泌；这两种变化在两名敏感受试者中更为明显。因此，吲哚美辛对前列腺素的抑制作用可能会掩盖氨苯蝶啶的毒性，并导致敏感受试者出现肾衰竭的发病机制。由于有 readily available 的替代疗法，建议避免这种潜在的肾毒性联合用药。 （注：原文中“readily available”直译为“容易获得的”，在这里意译为“有现成的”更符合语境，但按照要求不添加解释，保留原文表述。）
