Triamterene hctz 75 50

Hydrochlorothiazide and triamterene

Generic Name: hydrochlorothiazide and triamterene (HYE dro klor oh THY a zide and trye AM ter een)
Brand Name: Dyazide, Maxzide, Maxzide-25

Medically reviewed by Drugs.com on Feb 7, 2019 – Written by Cerner Multum

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What is hydrochlorothiazide and triamterene?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Triamterene is a potassium-sparing diuretic that also prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

Hydrochlorothiazide and triamterene is a combination medicine used to treat fluid retention (edema) and high blood pressure (hypertension).

hydrochlorothiazide and triamterene is usually given to people in whom other diuretics have caused hypokalemia (low potassium levels in your blood).

Hydrochlorothiazide and triamterene may also be used for purposes not listed in this medication guide.

Important Information

You should not use this medicine if have kidney disease, urination problems, high levels of potassium in your blood, or if you are taking other diuretics similar to triamterene. Do not use potassium supplements, salt substitutes, or low-sodium milk unless your doctor has told you to.

This medicine can raise your blood potassium to dangerous levels, especially if you have kidney disease, diabetes, severe illness, or if you are an older adult. Call your doctor right away if you have signs of high potassium: nausea, slow or unusual heart rate, numbness, tingling, muscle weakness, or loss of movement in any part of your body.

Before taking this medicine

You should not use hydrochlorothiazide and triamterene if you are allergic to hydrochlorothiazide (HCTZ, HydroDiuril, Lotensin HCT, Zestoretic, and others) or triamterene (Dyrenium), or if:

  • you have kidney disease or are unable to urinate;

  • you have high potassium levels (hyperkalemia);

  • you are taking diuretics similar to triamterene, such as amiloride (Midamor, Moduretic), spironolactone (Aldactone, Aldactazide); or

  • you are taking potassium supplements (unless your doctor tells you to).

Diuretics such as triamterene can raise your blood potassium to dangerous levels. This is more likely to occur if you have kidney disease, diabetes, severe illness, or if you are an older adult. Ask your doctor about your individual risk.

To make sure this medicine is safe for you, tell your doctor if you have:

  • diabetes;

  • cirrhosis or other liver disease;

  • heart disease, heart rhythm disorder;

  • gout;

  • if you are on a low-salt diet;

  • a history of cataracts or glaucoma;

  • a history of kidney stones; or

  • an allergy to sulfa drugs or penicillin.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Hydrochlorothiazide and triamterene can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Hydrochlorothiazide and triamterene is not approved for use by anyone younger than 18 years old.

How should I take hydrochlorothiazide and triamterene?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Hydrochlorothiazide and triamterene is usually taken once per day.

You will need frequent blood tests to measure your potassium levels while taking this medicine, especially when you first start taking this medicine or when your doses are changed. You may not any symptoms, but your blood work will help your doctor determine if you have high potassium (hyperkalemia).

Your heart function may also need to be checked using an electrocardiograph or ECG (sometimes called an EKG).

Severe illness can affect your potassium levels. Call your doctor if you have a serious illness, injury, or medical emergency.

If you need surgery or medical tests, tell the doctor ahead of time that you are taking medicine that contains hydrochlorothiazide. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include increased urination, nausea, vomiting, weakness, fever, warmth or flushing in your face, or muscle spasms.

What should I avoid while taking hydrochlorothiazide and triamterene?

Do not use potassium supplements, salt substitutes, or low-sodium milk while you are taking hydrochlorothiazide and triamterene, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor’s instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

hydrochlorothiazide and triamterene may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.

Hydrochlorothiazide and triamterene side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking this medicine and call your doctor at once if you have:

  • blurred vision, tunnel vision, eye pain, or seeing halos around lights;

  • a light-headed feeling, like you might pass out;

  • fast, slow, or uneven heart rate;

  • dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • severe pain in your upper stomach spreading to your back, nausea and vomiting;

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  • high potassium–nausea, slow or unusual heart rate, numbness, tingling, muscle weakness, loss of movement in any part of your body;

  • low potassium–leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling;

  • other signs of an electrolyte imbalance–thirst, dry mouth, stomach pain, drowsiness, weakness, fast heart rate, muscle pain or weakness, feeling restless or light-headed;

  • kidney problems–little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or

  • lupus-like syndrome–joint pain or swelling with fever, swollen glands, muscle aches, chest pain, unusual thoughts or behavior, and patchy skin color.

Common side effects may include:

  • stomach pain, nausea, diarrhea, constipation;

  • dizziness, headache;

  • blurred vision; or

  • dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Hydrochlorothiazide and triamterene dosing information

Usual Adult Dose for Edema:

Hydrochlorothiazide 25 to 50 mg-Triamterene 37.5 to 100 mg orally once a day

-Patients who become hypokalemic on 50 mg of hydrochlorothiazide may be transferred directly to hydrochlorothiazide 50 mg-triamterene 75 mg orally once a day. Patients who become hypokalemic on 25 mg of hydrochlorothiazide may be transferred directly to hydrochlorothiazide 25 mg-triamterene 37.5 mg orally once a day.
-Patients in whom hypokalemia cannot be risked may be initiated on hydrochlorothiazide 25 mg-triamterene 37.5 mg orally once a day.
Uses:
-Treatment of hypertension or edema in patients who develop hypokalemia on hydrochlorothiazide alone.
-Initial therapy of hypertension or edema for patients in whom hypokalemia cannot be risked (e.g., patients on concomitant digitalis preparations or with a history of cardiac arrhythmias, etc.).

Usual Adult Dose for Hypertension:

Hydrochlorothiazide 25 to 50 mg-Triamterene 37.5 to 100 mg orally once a day

-Patients who become hypokalemic on 50 mg of hydrochlorothiazide may be transferred directly to hydrochlorothiazide 50 mg-triamterene 75 mg orally once a day. Patients who become hypokalemic on 25 mg of hydrochlorothiazide may be transferred directly to hydrochlorothiazide 25 mg-triamterene 37.5 mg orally once a day.
-Patients in whom hypokalemia cannot be risked may be initiated on hydrochlorothiazide 25 mg-triamterene 37.5 mg orally once a day.
Uses:
-Treatment of hypertension or edema in patients who develop hypokalemia on hydrochlorothiazide alone.
-Initial therapy of hypertension or edema for patients in whom hypokalemia cannot be risked (e.g., patients on concomitant digitalis preparations or with a history of cardiac arrhythmias, etc.).

What other drugs can affect hydrochlorothiazide and triamterene?

Tell your doctor about all your current medicines and any you start or stop using, especially:

This list is not complete. Other drugs may interact with hydrochlorothiazide and triamterene, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 11.01.

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More about hydrochlorothiazide / triamterene

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  • Drug class: potassium sparing diuretics with thiazides

Consumer resources

  • Hydrochlorothiazide and Triamterene
  • Triamterene and hydrochlorothiazide (Advanced Reading)

Other brands: Dyazide, Maxzide, Maxzide-25

Professional resources

  • Hydrochlorothiazide and Triamterene (Wolters Kluwer)
  • … +2 more

Related treatment guides

  • Edema
  • High Blood Pressure

Dyazide

PRECAUTIONS

Diabetes

Caution should be exercised when administering DYAZIDE (hydrochlorothiazide and triamterene) to patients with diabetes, since thiazides may cause hyperglycemia, glycosuria, and alter insulin requirements in diabetes. Also, diabetes mellitus may become manifest during thiazide administration. Impaired Hepatic Function: Thiazides should be used with caution in patients with impaired hepatic function. They can precipitate hepatic coma in patients with severe liver disease. Potassium depletion induced by the thiazide may be important in this connection. Administer DYAZIDE (hydrochlorothiazide and triamterene) cautiously and be alert for such early signs of impending coma as confusion, drowsiness, and tremor; if mental confusion increases discontinue DYAZIDE (hydrochlorothiazide and triamterene) for a few days. Attention must be given to other factors that may precipitate hepatic coma, such as blood in the gastrointestinal tract or preexisting potassium depletion.

Hypokalemia

Hypokalemia is uncommon with DYAZIDE (hydrochlorothiazide and triamterene) ; but, should it develop, corrective measures should be taken such as potassium supplementation or increased intake of potassium-rich foods. Institute such measures cautiously with frequent determinations of serum potassium levels, especially in patients receiving digitalis or with a history of cardiac arrhythmias. If serious hypokalemia (serum potassium less than 3.0 mEq/L) is demonstrated by repeat serum potassium determinations, DYAZIDE (hydrochlorothiazide and triamterene) should be discontinued and potassium chloride supplementation initiated. Less serious hypokalemia should be evaluated with regard to other coexisting conditions and treated accordingly.

Electrolyte Imbalance

Electrolyte imbalance, often encountered in such conditions as heart failure, renal disease or cirrhosis of the liver, may also be aggravated by diuretics and should be considered during therapy with DYAZIDE (hydrochlorothiazide and triamterene) when using high doses for prolonged periods or in patients on a salt-restricted diet. Serum determinations of electrolytes should be performed, and are particularly important if the patient is vomiting excessively or receiving fluids parenterally. Possible fluid and electrolyte imbalance may be indicated by such warning signs as: dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pain or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal symptoms.

Hypochloremia

Although any chloride deficit is generally mild and usually does not require specific treatment except under extraordinary circumstances (as in liver disease or renal disease), chloride replacement may be required in the treatment of metabolic alkalosis. Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction, rather than administration of salt, except in rare instances when the hyponatremia is life threatening. In actual salt depletion, appropriate replacement is the therapy of choice. Renal Stones: Triamterene has been found in renal stones in association with the other usual calculus components. DYAZIDE (hydrochlorothiazide and triamterene) should be used with caution in patients with a history of renal stones.

Laboratory Tests

Serum Potassium: The normal adult range of serum potassium is 3.5 to 5.0 mEq per liter with 4.5 mEq often being used for a reference point. If hypokalemia should develop, corrective measures should be taken such as potassium supplementation or increased dietary intake of potassium-rich foods.

Institute such measures cautiously with frequent determinations of serum potassium levels. Potassium levels persistently above 6 mEq per liter require careful observation and treatment. Serum potassium levels do not necessarily indicate true body potassium concentration. A rise in plasma pH may cause a decrease in plasma potassium concentration and an increase in the intracellular potassium concentration. Discontinue corrective measures for hypokalemia immediately if laboratory determinations reveal an abnormal elevation of serum potassium.

Discontinue DYAZIDE (hydrochlorothiazide and triamterene) and substitute a thiazide diuretic alone until potassium levels return to normal.

Serum Creatinine and BUN: DYAZIDE (hydrochlorothiazide and triamterene) may produce an elevated blood urea nitrogen level, creatinine level or both. This apparently is secondary to a reversible reduction of glomerular filtration rate or a depletion of intravascular fluid volume (prerenal azotemia) rather than renal toxicity; levels usually return to normal when DYAZIDE (hydrochlorothiazide and triamterene) is discontinued. If azotemia increases, discontinue DYAZIDE (hydrochlorothiazide and triamterene) . Periodic BUN or serum creatinine determinations should be made, especially in elderly patients and in patients with suspected or confirmed renal insufficiency.

Serum PBI: Thiazide may decrease serum PBI levels without sign of thyroid disturbance.

Parathyroid Function: Thiazides should be discontinued before carrying out tests for parathyroid function. Calcium excretion is decreased by thiazides. Pathologic changes in the parathyroid glands with hypercalcemia and hypophosphatemia have been observed in a few patients on prolonged thiazide therapy. The common complications of hyperparathyroidism such as bone resorption and peptic ulceration have not been seen.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Carcinogenesis: Long-term studies have not been conducted with DYAZIDE (hydrochlorothiazide and triamterene) (the triamterene/hydrochlorothiazide combination), or with triamterene alone.

Hydrochlorothiazide: Two-year feeding studies in mice and rats, conducted under the auspices of the National Toxicology Program (NTP), treated mice and rats with doses of hydrochlorothiazide up to 600 and 100 mg/kg/day, respectively. On a body-weight basis, these doses are 600 times (in mice) and 100 times (in rats) the Maximum Recommended Human Dose (MRHD) for the hydrochlorothiazide component of DYAZIDE (hydrochlorothiazide and triamterene) at 50 mg/day (or 1.0 mg/kg/day based on 50 kg individuals). On the basis of body-surface area, these doses are 56 times (in mice) and 21 times (in rats) the MRHD. These studies uncovered no evidence of carcinogenic potential of hydrochlorothiazide in rats or female mice, but there was equivocal evidence of hepatocarcinogenicity in male mice.

Mutagenesis: Studies of the mutagenic potential of DYAZIDE (hydrochlorothiazide and triamterene) (the triamterene/hydrochlorothiazide combination), or of triamterene alone have not been performed.

Hydrochlorothiazide: Hydrochlorothiazide was not genotoxic in in vitro assays using strains TA 98, TA 100, TA 1535, TA 1537 and TA 1538 of Salmonella typhimurium (the Ames test); in the Chinese Hamster Ovary (CHO) test for chromosomal aberrations; or in in vivo assays using mouse germinal cell chromosomes, Chinese hamster bone marrow chromosomes, and the Drosophila sex-linked recessive lethal trait gene. Positive test results were obtained in the in vitro CHO Sister Chromatid Exchange (clastogenicity) test, and in the mouse Lymphoma Cell (mutagenicity) assays, using concentrations of hydrochlorothiazide of 43 to 1300 mcg/mL. Positive test results were also obtained in the Aspergillus nidulans nondisjunction assay, using an unspecified concentration of hydrochlorothiazide.

Impairment of Fertility: Studies of the effects of DYAZIDE (hydrochlorothiazide and triamterene) (the triamterene/hydrochlorothiazide combination), or of triamterene alone on animal reproductive function have not been conducted.

Hydrochlorothiazide: Hydrochlorothiazide had no adverse effects on the fertility of mice and rats of either sex in studies wherein these species were exposed, via their diet, to doses of up to 100 and 4 mg/kg/day, respectively, prior to mating and throughout gestation. Corresponding multiples of the MRHD are 100 (mice) and 4 (rats) on the basis of body-weight and 9.4 (mice) and 0.8 (rats) on the basis of body-surface area.

Pregnancy

Category C: Teratogenic Effects: DYAZIDE (hydrochlorothiazide and triamterene) : Animal reproduction studies to determine the potential for fetal harm by DYAZIDE (hydrochlorothiazide and triamterene) have not been conducted. However, a One Generation Study in the rat approximated composition of DYAZIDE (hydrochlorothiazide and triamterene) by using a 1:1 ratio of triamterene to hydrochlorothiazide (30:30 mg/kg/day); there was no evidence of teratogenicity at those doses which were, on a body-weight basis, 15 and 30 times, respectively, the MRHD, and on the basis of body-surface area, 3.1 and 6.2 times, respectively, the MRHD.

The safe use of DYAZIDE (hydrochlorothiazide and triamterene) in pregnancy has not been established since there are no adequate and well-controlled studies with DYAZIDE (hydrochlorothiazide and triamterene) in pregnant women. DYAZIDE (hydrochlorothiazide and triamterene) should be used during pregnancy only if the potential benefit justifies the risk to the fetus.

Triamterene: Reproduction studies have been performed in rats at doses as high as 20 times the MRHD on the basis of body-weight, and 6 times the human dose on the basis of body-surface area without evidence of harm to the fetus due to triamterene.

Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Hydrochlorothiazide: Hydrochlorothiazide was orally administered to pregnant mice and rats during respective periods of major organogenesis at doses up to 3,000 and 1,000 mg/kg/day, respectively. At these doses, which are multiples of the MRHD equal to 3,000 for mice and 1,000 for rats, based on body-weight, and equal to 282 for mice and 206 for rats, based on body-surface area, there was no evidence of harm to the fetus.

There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Nonteratogenic Effects: Thiazides and triamterene have been shown to cross the placental barrier and appear in cord blood. The use of thiazides and triamterene in pregnant women requires that the anticipated benefit be weighed against possible hazards to the fetus. These hazards include fetal or neonatal jaundice, pancreatitis, thrombocytopenia, and possible other adverse reactions which have occurred in the adult.

Nursing Mothers

Thiazides and triamterene in combination have not been studied in nursing mothers. Triamterene appears in animal milk; this may occur in humans. Thiazides are excreted in human breast milk. If use of the combination drug product is deemed essential, the patient should stop nursing.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

Triamterene and Hydrochlorothiazide 37.5 mg / 25 mg

Clinical Pharmacology

Triamterene and hydrochlorothiazide is a diuretic, antihypertensive drug product, principally due to its hydrochlorothiazide component; the triamterene component reduces the excessive potassium loss which may occur with hydrochlorothiazide use.

Hydrochlorothiazide

Hydrochlorothiazide is a diuretic and antihypertensive agent. It blocks the renal tubular absorption of sodium and chloride ions. This natriuresis and diuresis is accompanied by a secondary loss of potassium and bicarbonate. Onset of hydrochlorothiazide’s diuretic effect occurs within 2 hours and the peak action takes place in 4 hours. Diuretic activity persists for approximately 6 to 12 hours.

The exact mechanism of hydrochlorothiazide’s antihypertensive action is not known although it may relate to the excretion and redistribution of body sodium. Hydrochlorothiazide does not affect normal blood pressure.

Following oral administration, peak hydrochlorothiazide plasma levels are attained in approximately 2 hours. It is excreted rapidly and unchanged in the urine.

Well controlled studies have demonstrated that doses of hydrochlorothiazide as low as 25 mg given once daily are effective in treating hypertension, but the dose-response has not been clearly established.

Triamterene

Triamterene is a potassium-conserving (antikaliuretic) diuretic with relatively weak natriuretic properties. It exerts its diuretic effect on the distal renal tubule to inhibit the reabsorption of sodium in exchange for potassium and hydrogen. With this action, triamterene increases sodium excretion and reduces the excessive loss of potassium and hydrogen associated with hydrochlorothiazide. Triamterene is not a competitive antagonist of the mineralocorticoids and its potassium-conserving effect is observed in patients with Addison’s disease, i.e., without aldosterone. Triamterene’s onset and duration of activity is similar to hydrochlorothiazide. No predictable antihypertensive effect has been demonstrated with triamterene.

Triamterene is rapidly absorbed following oral administration. Peak plasma levels are achieved within one hour after dosing. Triamterene is primarily metabolized to the sulfate conjugate of hydroxytriamterene. Both the plasma and urine levels of this metabolite greatly exceed triamterene levels.

The amount of triamterene added to 50 mg of hydrochlorothiazide in triamterene and hydrochlorothiazide tablets was determined from steady-state dose-response evaluations in which various doses of liquid preparations of triamterene were administered to hypertensive persons who developed hypokalemia with hydrochlorothiazide (50 mg given once daily). Single daily doses of 75 mg triamterene resulted in greater increases in serum potassium than lower doses (25 mg and 50 mg), while doses greater than 75 mg of triamterene resulted in no additional elevations in serum potassium levels. The amount of triamterene added to the 25 mg of hydrochlorothiazide in triamterene and hydrochlorothiazide tablets was also determined from steady-state dose-response evaluations in which various doses of liquid preparations of triamterene were administered to hypertensive persons who developed hypokalemia with hydrochlorothiazide (25 mg given once daily). Single daily doses of 37.5 mg triamterene resulted in greater increases in serum potassium than a lower dose (25 mg), while doses greater than 37.5 mg of triamterene, i.e., 75 mg and 100 mg, resulted in no additional elevations in serum potassium levels. The dose-response relationship of triamterene was also evaluated in patients rendered hypokalemic by hydrochlorothiazide given 25 mg twice daily. Triamterene given twice daily increased serum potassium levels in a dose-related fashion. However, the combination of triamterene and hydrochlorothiazide given twice daily also appeared to produce an increased frequency of elevation in serum BUN and creatinine levels. The largest increases in serum potassium, BUN and creatinine in this study were observed with 50 mg of triamterene given twice daily, the largest dose tested. Ordinarily, triamterene does not entirely compensate for the kaliuretic effect of hydrochlorothiazide and some patients may remain hypokalemic while receiving triamterene and hydrochlorothiazide. In some individuals, however, it may induce hyperkalemia .

The triamterene and hydrochlorothiazide components of this product are well absorbed and are bioequivalent to liquid preparations of the individual components administered orally. Food does not influence the absorption of triamterene or hydrochlorothiazide from Apotex’s triamterene and hydrochlorothiazide 37.5 mg/25 mg or 75 mg/50 mg tablets. The hydrochlorothiazide component of triamterene and hydrochlorothiazide tablets is bioequivalent to single entity hydrochlorothiazide tablet formulations.

triamterene-hydrochlorothiazide oral

uses

This drug is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This medication is a combination of two “water pills” (diuretics): triamterene and hydrochlorothiazide. This combination is used by people who have developed or are at risk for having low potassium levels on hydrochlorothiazide. It causes you to make more urine, which helps your body get rid of extra salt and water.This medication also reduces extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, or kidney disease. This can lessen symptoms such as shortness of breath or swelling in your ankles or feet.

how to use

Take this medication by mouth as directed by your doctor, usually once daily in the morning with or without food. It is best to avoid taking this medication within 4 hours of your bedtime to prevent having to get up to urinate.If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take this product at least 4 hours before or at least 4 to 6 hours after these medications.The dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings increase).

side effects

See also Warning section.

Dizziness, lightheadedness, headache, or upset stomach may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This product may cause your body to lose too much water and salt (dehydration). Tell your doctor right away if you notice any symptoms of dehydration, such as unusual dry mouth/thirst, fast heartbeat, or dizziness/lightheadedness.Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, muscle cramps/weakness, slow/fast/irregular heartbeat, decrease in vision, eye pain, signs of kidney problems (such as change in the amount of urine).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

precautions

Before taking this medication, tell your doctor or pharmacist if you are allergic to triamterene or hydrochlorothiazide; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, gout, high level of potassium in the blood, kidney disease (including kidney stones), liver disease, lupus, skin cancer.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Severe sweating, diarrhea, or vomiting can increase the risk for lightheadedness or a serious loss of body water (dehydration). Report prolonged diarrhea or vomiting to your doctor. To prevent dehydration, drink plenty of fluids unless your doctor directs you otherwise.If you have diabetes, this product may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.This medication may affect your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.This medication may make you more sensitive to the sun. It may also increase your risk for skin cancer, especially if you take it for a long time. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned, have skin blisters/redness, or notice new or changed moles/skin lesions.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the effects of this drug, especially dizziness, or high blood potassium levels.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.It is unknown if triamterene passes into breast milk. Hydrochlorothiazide passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

drug interactions

See also How to Use and Precautions sections.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.Some products that may interact with this drug include: dofetilide, lithium, other drugs that may increase potassium levels (such as spironolactone, amiloride, cyclosporine).Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).This medication may interfere with certain laboratory tests (including parathyroid function), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

notes

Do not share this medication with others.Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Laboratory and/or medical tests (such as kidney function, potassium levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure, and share the results with your doctor.

A new antihypertensive agent: Maxzide (75 mg triamterene/50 mg hydrochlorothiazide)

The combination of potassium-sparing diuretics with hydrochlorothiazideis extensively used by hypertensive patients. In the United States, a capsule formulation containing 50 mg triamterene and 25 mg hydrochlorothiazide (Dyazide) is the most popular fixedcombination product. However, several investigators have confirmed that absorption of both the triamterene and hydrochlorothiazide components of Dyazide is markedly reduced. This reduced bioavailability may reduce its effectiveness in hypertensive patients who change from optimally bioavailable hydrochlorothiazide tablets to Dyazide capsules in an effort to correct hypokalemia. Scored tablets containing 75 mg triamterene/50 mg hydrochlorothiazide (Maxzide) have been developed using a patented parallel granulation manufacturing process and evaluated in a series of bioavailability-bioequivalence studies. The triamterene and hydrochlorothiazide components of Maxzide tablets were found to be as bioavailable as liquid preparations of the active ingredients given singly or in combination. Unlike Dyazide capsules, the hydrochlorothiazide component of Maxzide tablets was found to be absorbed to the same extent as single-entity hydrochlorothiazide tablets. These studies demonstrated that two Dyazide capsules (total of 100 mg triamterene/50 mg hydrochlorothiazide) deliver to the bloodstream approximately one-half the quantity of hydrochlorothiazide as one Maxzide (75 mg triamterene/50 mg hydrochlorothiazide) tablet or one 50 mg hydrochlorothiazide tablet. Similarly, two Dyazide capsules deliver approximately one-half the quantity of triamterene as one Maxzide tablet. The safety of Maxzide tablets (dose of one tablet a day) was then evaluated in three groups of hypertensive patients: those who previously had been given two Dyazide capsules a day, those who had received four Dyazide capsules a day, and newly diagnosed patients who had received no medication. The clinical condition of the patients who changed from two or four Dyazide capsules to one Maxzide tablet was not compromised. Indeed, significant reductions in blood pressures were observed, especially in some patients who had remained hypertensive while receiving Dyazide. As expected, the blood pressures of the previously untreated group also decreased significantly with Maxzide tablets. Clinically significant hyperkalemia or hypokalemia did not develop. There were no clinically significant changes in blood urea nitrogen, creatinine, or uric acid levels. In addition to enhanced bioavailability, Maxzide tablets offer the advantages of once-a-day dosing.

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