Pyrazinoylguanidine (PZG) is an analogue of the potassium-sparing diuretic amiloride. It can reduce systolic and diastolic blood pressure in patients with primary hypertension and has a slight effect on reducing heart rate without altering serum concentrations of electrolytes such as sodium, potassium, or chloride. Pyrazinoylguanidine also alleviates hyperglycemia and hyperinsulinemia in type 2 diabetes patients, lowers triglycerides, cholesterol, and free fatty acids, and can reverse the hyperglycemia and hyperlipidemia induced by thiazide diuretics like hydrochlorothiazide. Additionally, it inhibits renal tubular reabsorption of urea, enhancing urea clearance and excretion, thus reducing serum urea concentration and its toxic accumulation.

PZG