Triamterene and Hydrochlorothiazide (Oral)

Triamterene and hydrochlorothiazide are diuretics, also known as water pills, which are designed to treat high blood pressure (known as hypertension) or water retention (known as edema, or swelling).

Overview

As diuretic medications, triamterene and hydrochlorothiazide are designed to assist patients who suffer from high amounts of water in the body and prevent the complications this condition can lead to. By boosting the natural flow of urine in the body's urinary system, cutting down on the amount of salt absorbed by the body and preventing potassium levels from dipping below appropriate levels, triamterene and hydrochlorothiazide can keep blood pressure under control. This, in turn, can prevent the many complications and life-threatening conditions associated with high blood pressure, including failure of the arteries to function, problems with the heart and increased likelihood of strokes, heart attacks or kidney failure.

Triamterene and hydrochlorothiazide are both diuretic medicines (water pills). They reduce the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure. Triamterene helps prevent your body from absorbing too much salt and keeps your potassium levels from getting too low.

Triamterene and hydrochlorothiazide are available as either a capsule or a tablet. Their brand names in the USA are Dyazide and Maxzide, which means you may see these labels on the boxes in pharmacies and stores.

Conditions treated

  • High blood pressure (hypertension)
  • Edema (fluid retention, or swelling)

Type of medicine

  • Diuretic

Side effects

As with most drugs which can be prescribed by your physician, there is a risk that you will develop side effects as well as experience a relief in symptoms. Side effects are a common phenomenon, and they are an unfortunate but necessary part of taking medications to get better.

In some cases, side effects can be controlled by other medications, and in other cases they can be left to go away by themselves as your treatment progresses.

With triamterene and hydrochlorothiazide, there are a number of possible side effects which you might experience. There is no guarantee that you will or will not have a particular side effect, and the experience can differ from patient to patient. The side effects which can be caused by these drugs can largely be split into three main categories: urgent, non-urgent and incidental.

Firstly, there are some potential side effects which can arise as a result of using triamterene and hydrochlorothiazide which require urgent medical attention if they are observed in the patient who has taken the medication. In the event that these symptoms of overdose appear, you should immediately report to the emergency room or other urgent care provider to receive the medical attention you need.

Some of these symptoms are related to urination, including noticeably frequent urination or a higher volume of pale urine. Others are to do with your facial area: if you experience heat to the touch around your face or a pronounced facial redness, you should report to the emergency room right away.

In addition, there are also several miscellaneous symptoms of overdose from triamterene and hydrochlorothiazide, including a marked decline in your energy levels, hurting or weakness in your feet or hands, trembling and shaking, or oddly strong reflexes. Once again, it is imperative that you visit an emergency medical provider straightaway if you find yourself experiencing these symptoms after taking triamterene and hydrochlorothiazide, as you may be suffering from the symptoms of overdose.

Secondly, there are some non-urgent symptoms which can arise as a result of taking triamterene and hydrochlorothiazide. If you find yourself experiencing these side effects, you should arrange to consult your physician to discuss the problem.

Some of these not-so-serious side effects include problems with digestion, excretion and urination. These range from abnormal stool colours and textures (such as tarry or clay-colored), blood or a cloudy hue in your stools or urine, constipation, or less urine than usual.

Other digestion-related problems you may experience as a result of taking triamterene and hydrochlorothiazide include a reduction in appetite, a taste of metal in the mouth, vomiting or a feeling of nausea, and stomach pains.

A further significant group of non-urgent side effects of taking this medication include the appearance of pinprick-style purple or red skin spots, unexpected skin rashes, swelling around your face or lips, a yellow tinge to the skin, or swelling around your feet, hands, ankles or elsewhere.

There may also be some non-urgent mental and psychological side effects as a result of taking triamterene and hydrochlorothiazide. These include hostility towards others, irritability and mood changes. In the event that you experience these kinds of side effects, ensure you talk to your physician or another healthcare professional to find out if you can reduce the symptoms.

The final group of possible side effects as a result of taking triamterene and hydrochlorothiazide are those which in most cases do not require you to seek medical attention. They are often simply the body's way of dealing with the drugs, and are nothing to worry about. The only circumstances in which you would need to speak to your team of healthcare professionals if you experience these problems is if they persist for long periods or if you wish to find out more about how you cut them down.

These include several sexual dysfunctions, including erection problems, a new-found lack of interest in sex, or the loss of ability to perform sexually. Other potential side effects in this category include problems with the skin, including higher sensitivity of your skin to the sun, discoloration of the skin, and an increased propensity to sunburn.

Finally, you may also find that you experience some feelings related to disorientation, like a spinning sensation or feeling like your surroundings are moving a lot. Again, these particular side effects do not necessarily require medical attention, but you may find that speaking to your healthcare professional is a good idea if symptoms like this are causing you trouble.

Dosage

The exact dosage of triamterene and hydrochlorothiazide you will be required to take is likely to vary depending on your circumstances. Standard ranges exist, but the precise dosage you will receive from your medical professional will be determined by a variety of factors relevant specifically to you and your health.

In cases of both edema (swelling) and hypertension, your physician is likely to prescribe you hydrochlorothiazide between the amounts of 25 to 50 mg (milligrams) per day, and triamterene between the amounts of 37.5 to 100 mg per day. These are to be taken orally.

In some cases, patients who are taking only hydrochlorothiazide at the 50 mg level may develop hypokalemia, the name given to low potassium levels in the body. Patients who suffer from this problem can get transferred straight away on to a combination of 50 mg of hydrochlorothiazide accompanied by a 75 mg dose of triamterene, again taken orally at a frequency of once a day.

Your physician may decide that the risk of hypokalemia is too great in your case, in which case your dosage of triamterene and hydrochlorothiazide is likely to be started at a lower level (25 mg of hydrochlorothiazide and 37.5 mg of triamterene per day).

If you are unsure what this means, it is a good idea to ask your healthcare professional for further clarification.

In the event that you miss your scheduled dose of triamterene and hydrochlorothiazide, you should not take more than one dose at once. The first thing to do is to check how close the time is until your next planned dose. If this is still a long way away, you should take the missed dose as soon as you can. If the next dose is impending, however, you can forget about the missed dose, take the next one and then return to your normal schedule.

Interactions

Triamterene and hydrochlorothiazide interact with a very large number of other medications. This means that once the drugs are inside your body they can react in a negative way to other drugs also in your system, causing people in some cases to suffer from additional complications.

Many of the drugs which interact with triamterene and hydrochlorothiazide are over-the-counter drugs which you may have stored in your medicine cupboard, so it is important to take this risk of interaction seriously.

It's very important to research the full list of possible interactions between triamterene and hydrochlorothiazide and other drugs you may be using, as there are 115 known major drug interactions. These include a wide range of citric acids and related-drugs, such as potassium bicarbonate, sodium bicarbonate and potassium citrate. Various isolytes and LVP solutions with potassium are also included in this category, such as Isolyte E, Isolyte H and 5 % Dextrose, Isolyte M and 5% Dextrose, Isolyte P and 5% Dextrose, and Isolyte R and 5% Dextrose.

Also included are some nutrition solutions, including travasol with added electrolytes and travasol with electrolytes dual chamber. Many medications from the Uro family are affected in particular, such as Uro Blue (composed of methenamine, sodium biphosphate, hyoscyamine and methylene blue), Uro-458 (made up of sodium biphosphate, hyoscyamine, methylene blue, phenyl salicylate and methenamine) and Uro-KP-Neutral (composed of sodium phosphate and potassium phosphate).

This is not an exhaustive list of major interactions, and if you are concerned at all, you should speak to your physician or healthcare professional. The potential for interactions is why you should always have a detailed and up to date list of your current medications to hand, both for yourself and for your physician in your medical notes.

In addition to these major interactions, there are also a wider range of moderate-level interactions between triamterene and hydrochlorothiazide and other drugs. These include some standard medicine cupboard staples, including Allens Junior Cough (glycerin), Aller-G-Time (diphenhydramine) and ibuprofen.

Other drugs which are known for their moderate-level interactions with triamterene and hydrochlorothiazide include Adlone-40 and Adlone-80 (methylprednisolone), Cymbalta (duloxetine), Adrucil (fluorouracil) Advance Care Plus multivitamins and prenatal pills, and antidepressants like fluoxetine and citalopram.

A range of diphenhydramines are also known for their moderate-level interactions. The diphenhydramines involved include diphenhydramine guaifenesin, diphenhydramine hydrocodone/phenylephrine, diphenhydramine/ibuprofen and diphenhydramine/naproxen.

This is not a full list, and there are many more medications which have the potential to interact badly with triamterene and hydrochlorothiazide. Again, your medical records and your own monitoring of the names of your medications should prevent any adverse interactions from occurring inside your body. Remember to keep medication lists up to date and to consult your physician or other healthcare professional in the event that you are concerned.

Finally, there are just under 80 minor drug interactions between other drugs and triamterene and hydrochlorothiazide. These include various drugs in the Adoxa family, such as Adoxa CK, Adoxa Pak and Adoxa TT. While these interactions may not be quite as serious, it is still vital that you keep a full list of your current medications so that you can prevent any problems from arising.

Warnings

As with all medications, your use of triamterene and hydrochlorothiazide should be carried out with caution and care. If you are ever in any doubt about how to take this medication appropriately or what precautions to take, you should consult the information pack that comes with the medication and speak to your healthcare team if you have any queries.

You should make sure you do not take triamterene and hydrochlorothiazide if you suffer from certain medical conditions. These include high blood levels of potassium, disease of the kidneys, issues with urinating, or if you are taking medications which have a similar diuretic function to triamterene.

In addition, unless given express advice by your physician or other medical professional, it is recommended that you do not use certain substitute foods while taking triamterene and hydrochlorothiazide. These include salt substitutes, potassium supplements and milk which is particularly low in sodium.

For many patients, taking triamterene and hydrochlorothiazide is necessary to keep the problems they are suffering from at bay. But it is important to remember that this medication is not a cure, but simply a way of managing your condition and allowing you to live a healthier life in spite of the illness.

It is important to remember that triamterene and hydrochlorothiazide should not be used as a first response to the symptoms you're experiencing. Your physician should always be able to provide you with other options prior to prescribing triamterene and hydrochlorothiazide, and you should only try this medication once you have exhausted other options.

Should you feel well during the course of taking this medicine, you should not come off the medication without talking to a healthcare professional first. This is because the symptoms of the conditions it treats are not always obvious; in fact, they are sometimes well-hidden. Coming off the medication or ceasing to take it as it is directed could lead to further problems down the line.

It is also possible that you will need to take triamterene and hydrochlorothiazide alongside implementing a variety of other measures designed to keep you in good health. For example, patients who suffer from high blood pressure may need to accompany their use of these drugs with lifestyle changes, such as cutting back on foodstuffs which contain a lot of salt. This should always be carried out in conjunction with a medical professional's advice, and he or she will be able to point you in the right direction for finding out more.

Storage

When it comes to storing your triamterene and hydrochlorothiazide, it's vital to make sure the tablets or capsules are kept free from extremes of temperature and other environmental conditions. If this does not happen, your triamterene and hydrochlorothiazide could become unhealthy to use or damaged.

Firstly, ensure that the container in which your medication is stored is closed, and keep it at room temperature. It should be kept out of direct sunlight or any other forms of nearby light, and it should also be kept far from sources of heat and moisture. Never freeze your triamterene and hydrochlorothiazide.

If you have children in your home or visiting your home, it is imperative that you prevent them from accessing your triamterene and hydrochlorothiazide. Your medication should always be kept away from children, and stored in a location they cannot reach. This will help to prevent accidental consumption and other problems.

It is also a good idea to keep stock of any medication in your home left over from past prescriptions, and ensure you regularly dispose of any medications which aren't needed. Once you have finished with your triamterene and hydrochlorothiazide, you should throw away any unused batches or pills which are no longer needed. If you are unsure as to how you should appropriately dispose of medicine, you can contact your healthcare professional to find out more about the best way to do it.

Summary

Triamterene and hydrochlorothiazide are two useful drugs in a patient's fight against conditions like edema and hypertension. They act in a number of different ways on the human body, including by reducing the amount of salt present, improving urine flow and keeping potassium at an appropriate level. They have been known to keep a number of conditions at bay, such as high blood pressure, and reduce the risk of further complications such as artery failure and strokes.

Taken orally, these medications do come - like most medications - with a range of possible side effects. Some of these potential side effects, such as high volumes of pale urine or oddly strong reflexes, require urgent treatment from an emergency medical provider. Others, such as a reduction in appetite or abnormal stools, also require you to speak to a medical professional when you are able to. And yet others, like sexual dysfunction and higher sensitivity than usual to the sun, are minor and only need to be addressed if they are causing you long-term problems.

Triamterene and hydrochlorothiazide, like many drugs, can interact with other medicines once inside your body. In the case of this drug, there are lots of other drugs with potential moderate level interactions which you are at risk of experiencing. These drugs include medicine cupboard staple items, such as Allens Junior Cough (glycerin), and also other drugs such as some diphenhydramines. You should research the full list and ensure you maintain an accurate and up to date list of medications you are currently on at all times. There are also a smaller number of drugs which are at a particularly low or particularly high risk of interacting with triamterene and hydrochlorothiazide: providing you do some research and your physician is up to speed on your current medical situation, this should not be a problem.

There are several warnings associated with triamterene and hydrochlorothiazide. For example, you should always keep these drugs out of the reach of children, and ensure they do not remain in your medicine storage area after you have ceased to take them. If you are unsure how to dispose of them, consult a medical professional.

If you have any questions whatsoever about your usage of triamterene and hydrochlorothiazide, it's a good idea to speak to your physician, pharmacist or other medical professional immediately. Remember, even if you begin to feel well again while taking triamterene and hydrochlorothiazide, you should ensure you continue to take the medication so that it can run its full course and provide you with the medical assistance you need.

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Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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