TRIAMTERENE & HYDROCHLOROTHIAZIDE

Brand & Generic Names

Apo-Triazide
Dyazide
Maxzide
Novotriamzide

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Diuretic

Uses

• Reduces fluid retention (edema).
• Reduces potassium loss.
• Controls, but doesn't cure, high blood pressure.

Dosage & Usage Information

How to take:
Tablet or capsule--Swallow with liquid. If you can't swallow whole, crumble tablet or open capsule and take with liquid or food.

When to take:
1 dose per day--Take after breakfast.
More than 1 dose per day--Take last dose no later than 6 p.m.

If you forget a dose:
Take as soon as you remember up to 6 hours late. If more than 6 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Increases urine production to eliminate sodium and water from body while conserving potassium.
Forces sodium and water excretion, reducing body fluid.
Relaxes muscle cells of small arteries.
Reduced body fluid and relaxed arteries lower blood pressure.

Time lapse before drug works:
4 to 6 hours. May require several weeks to lower blood pressure.

Don't take with:
Any prescription or non-prescription drugs without consulting your doctor.

Overdose

SYMPTOMS:
Lethargy, irregular heartbeat, cramps, nausea, vomiting, hypotension, weakness, drowsiness, weak pulse, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Irregular heartbeat, Discontinue. Seek weak pulse, shortness emergency treatment. of breath; hives, rash, intense itching, faintness soon after a dose (anaphylaxis).

Common:

• Mood change, muscle cramps.
• Numbness or tingling in hands or feet, constipation, decreased interest in sex.

Infrequent:

• Blurred vision, abdominal pain, nausea, vomiting, kidney stones, fever and chills, red tongue, cracked mouth corners, black stools, dry mouth.
• Dizziness, mood change, headache, weakness, tiredness, weight gain or loss.

Rare:

Sore throat, mouth sores, jaundice, rash, joint or muscle pain, hives, unexplained bleeding or bruising.

Warnings & Precautions

Don't take if:

• If you are allergic to triamterene or any thiazide diuretic drug.
• If you have had severe liver or kidney disease.

Before you start, consult your doctor:

• If you have gout, diabetes, liver, pancreas or kidney disorder.
• You are allergic to any sulfa* drug.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:

• Adverse reactions and side effects may be more frequent and severe than in younger persons, especially dizziness and excessive potassium loss.
• Warm weather or fever can decrease blood pressure. Dose may require adjustment.
• Extended use can increase blood clots.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use. Consult doctor.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Used infrequently. Use only under medical supervision.

Prolonged use:

• Potassium retention which may lead to heart rhythm problems.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure, kidney function, ECG* and serum electrolytes.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:

• Hot weather and fever may cause dehydration and drop in blood pressure. Dose may require temporary adjustment. Weigh daily and report any unexpected weight decreases to your doctor.
• May cause rise in uric acid, leading to gout.
• May cause blood sugar rise in diabetics.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
ACE inhibitors*:	Decreased blood pressure.
Allopurinol	Decreased allopurinol effect.
Amiloride	Dangerous retention of potassium.
Amphotericin B	Increased potassium.
Antidepressants*	Dangerous drop in blood pressure.
	Avoid combination unless under
	medical supervision.
Antihypertensives*	Increased hypertensive effect.
Barbiturates*	Increased hydrochlorothiazide
	effect.
Beta-adrenergic	Increased antihypertensive effect.
blockers*	Dosages of both drugs may require
	adjustment.
Cholestyramine	Decreased hydrochlorothiazide
	effect.
Cortisone drugs*	Excessive potassium loss that
	causes dangerous heart rhythms.
Digitalis	Excessive potassium loss that
preparations*	causes dangerous heart rhythms.
Diuretics, thiazide*	Increased effect of other thiazide
	diuretics.
Indapamide	Increased diuretic effect.
Indomethacin	Possible acute renal failure.
Lisinopril	Possible severe blood pressure drop
	with first dose.
Lithium	Increased lithium effect.
MAO inhibitors*	Increased hydrochlorothiazide
	effect.
Nicardipine	Dangerous blood pressure drop.
	Dosages may require adjustment.
Nimodipine	Dangerous blood pressure drop.
Nitrates*	Excessive blood pressure drop.
Non-steroidal	Possible excessive potassium level
anti-inflammatory	in blood.
Opiates*	Weakness and faintness when arising
	from bed or chair.
Potassium	Possible excessive potassium
supplements*	retention. Decreased potassium
	effect.
Probenecid	Decreased probenecid effect.
Spironolactone	Dangerous retention of potassium.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Dangerous blood pressure drop.
Low-salt milk.	Possible potassium toxicity.
Cocaine:	Decreased triamterene effect.
Salt, salt substitutes.	Possible potassium toxicity.
Marijuana:	Daily use--Fainting likely.
Tobacco:	Decreases drug's effectiveness.