Hydrochlorothiazide and triamterene

Hydrochlorothiazide is a water pill (thiazide diuretic). Triamterene is a potassium-sparing diuretic.

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 who have low potassium levels in their blood (hypokalemia) due to other diuretics.

Hydrochlorothiazide and triamterene may also be used for reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Hydrochlorothiazide and triamterene is usually taken once per day.

You may need frequent medical tests. Even if you have no symptoms, tests can help your doctor determine if hydrochlorothiazide and triamterene is effective.

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 you currently use this medicine. You may need to stop for a short time.

If you have 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.

You should not use hydrochlorothiazide and triamterene if you have kidney disease, urination problems, high levels of potassium in your blood, or if you are taking other diuretics similar to triamterene.

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, tingly feeling, feeling weak or tired, slow heartbeats, or loss of movement.

You should not use this medicine if you are allergic to hydrochlorothiazide or triamterene, 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 or spironolactone; 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 happen if you have kidney disease, diabetes, severe illness, or if you are an older adult. Ask your doctor about your individual risk.

Tell your doctor if you have ever had:

• diabetes;
• cirrhosis or other liver disease;
• heart disease, heart rhythm disorder;
• gout;
• cataracts or glaucoma;
• an allergy to sulfa drugs or penicillin;
• kidney stones; or
• if you are on a low-salt diet.

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

You should not breastfeed while using this medicine.

This medicine is not approved for use by anyone younger than 18 years old.

Get emergency medical help if you have signs of an allergic reaction (hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Stop taking this medicine and call your doctor right away if you have:

• blurred vision, tunnel vision, eye pain, or seeing halos around lights;
• feeling light-headed, like you might faint;
• fast, slow, or uneven heart rate;
• signs of liver or pancreas problems—loss of appetite, upper stomach pain (that may spread to your back), nausea or vomiting, fast heart rate, dark urine, jaundice (yellowing of the skin or eyes);
• high potassium level—nausea, weakness, tingling feeling, feeling weak or tired, slow heartbeats, loss of movement;
• low potassium level—leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or feeling limp;
• kidney problems—little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
• lupus-like symptoms—muscle or joint pain, flu symptoms, chest pain, and a rash or patchy skin color that worsens in sunlight; or
• 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.

Common side effects of hydrochlorothiazide and triamterene 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.

Usual Adult Dose for Edema:

Hydrochlorothiazide 25 to 50 mg-Triamterene 37.5 to 100 mg orally once a dayComments:-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 dayComments:-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.).

Take the medicine as soon as you remember, but skip the missed dose if it is almost time for your next dose. Do not take two doses at once.

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.

Do not use potassium supplements, salt substitutes, or low-sodium milk unless your doctor has told you to.

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

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. 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.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Tell your doctor about all your other medicines, especially:

• any other blood pressure medicine;
• amphotericin B;
• chlorpropamide;
• digoxin;
• laxatives;
• lithium;
• methenamine;
• a blood thinner;
• oral diabetes medicine;
• steroid medication (prednisone and others);
• an ACE inhibitor--benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect hydrochlorothiazide and triamterene, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.