Maxzide (Oral)

Triamterene and hydrochlorothiazide combination is used alone or with other medicines to treat water retention (edema) or high blood pressure (hypertension). High blood pressure increases the workload of the heart and arteries. If it lasts for a long time, the heart and arteries may not work properly. This can harm the blood vessels of the brain, heart, and kidneys, leading to a stroke, heart failure, or kidney failure. High blood pressure may also raise the risk of heart attacks. Controlling blood pressure may help reduce the chances of these problems.

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

This medicine is available only with your doctor's prescription.

It is very important for your doctor to check your progress at regular visits to ensure this medicine is working properly and to determine if you should keep taking it. Blood and urine tests may be needed to look for unwanted effects.

Make sure your doctor knows if you are also taking potassium supplements or salt substitutes that contain potassium, or certain diuretics like amiloride (Midamor®, Moduretic®), spironolactone (Aldactazide®, Aldactone®), or other products that include triamterene. Using these medicines together may cause serious problems.

This medicine may increase the amount of potassium in your blood (hyperkalemia). Check with your doctor right away if you experience stomach pain, confusion, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in your hands, feet, or lips, difficulty breathing, or weakness or heaviness in your legs.

Check with your doctor immediately if you have blurred vision, difficulty reading, eye pain, or any other change in your vision during or after treatment. Your doctor may want you to have an eye examination by an ophthalmologist (eye doctor).

This medicine may affect your blood sugar levels. Check with your doctor if you notice changes in your blood or urine sugar test results.

This medicine may cause dizziness or drowsiness. Avoid driving, operating machinery, or doing anything else that could be dangerous if you are not alert. Dizziness may be worse if you lose too much water from your body. You can lose water through sweating, diarrhea, or vomiting. Tell your doctor if you feel lightheaded or dizzy after vomiting or having diarrhea.

Check with your doctor right away if you experience drowsiness, fainting, confusion, muscle pain, weakness, or a fast heartbeat. Take extra care if you exercise or if the weather is hot. Heavy sweating can lead to dehydration (loss of too much water) or electrolyte imbalances (loss of sodium, potassium, or magnesium in your body).

This medicine may increase your risk of developing skin cancer (e.g., non-melanoma skin cancer). Avoid sun exposure. Use sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

This medicine may cause serious kidney problems, including kidney stones. Check with your doctor right away if you have lower back or side pain, decreased frequency or amount of urine, bloody urine, increased thirst, loss of appetite, nausea, vomiting, unusual tiredness or weakness, swelling of your face, fingers, or lower legs, weight gain, or trouble breathing.

Make sure any doctor or dentist treating you knows that you are using this medicine. You may need to stop taking this medicine several days before having surgery or medical tests, as the results of some tests may be affected by this medicine.

Do not take other medicines unless you have discussed them with your doctor. This is especially important for over-the-counter (nonprescription) medicines for appetite control, asthma, colds, coughs, hay fever, or sinus problems, as they may raise your blood pressure.

In deciding to use a medicine, you must consider the risks of taking it against the benefits it may provide. This is a decision you and your doctor will make together. For this medicine, the following points should be considered:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare provider know if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

There have not been appropriate studies to determine how triamterene and hydrochlorothiazide combination affects children. Safety and effectiveness have not been established.

Geriatric

There is no information on how triamterene and hydrochlorothiazide combination affects older adults. However, elderly patients are more likely to have kidney issues and high blood potassium (hyperkalemia), which may require caution when using this medicine.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication while breastfeeding. Consider the potential benefits and risks before taking this medication during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction could happen. If you are taking this medicine, it is especially important for your healthcare provider to know if you are taking any of the medicines listed below. The following interactions are based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Amiloride
• Dofetilide
• Eplerenone
• Potassium Citrate
• Spironolactone

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or frequency for one or both of the medicines.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Alacepril
• Albiglutide
• Albuterol
• Alogliptin
• Amphetamine
• Amtolmetin Guacil
• Arginine
• Arsenic Trioxide
• Aspirin
• Benazepril
• Benzphetamine
• Bromfenac
• Bromocriptine
• Bufexamac
• Buprenorphine
• Canagliflozin
• Captopril
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Cilazapril
• Clonixin
• Codeine
• Dapagliflozin
• Delapril
• Deslanoside
• Desmopressin
• Dexibuprofen
• Dexketoprofen
• Dextroamphetamine
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dipyrone
• Dofetilide
• Droperidol
• Droxicam
• Dulaglutide
• Empagliflozin
• Enalaprilat
• Enalapril Maleate
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Formoterol
• Fosinopril
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Imidapril
• Indomethacin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Ketanserin
• Ketoprofen
• Ketorolac
• Levomethadyl
• Linagliptin
• Liraglutide
• Lisdexamfetamine
• Lisinopril
• Lithium
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Methamphetamine
• Methotrexate
• Metildigoxin
• Miglitol
• Moexipril
• Morniflumate
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Ouabain
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Pentopril
• Perindopril
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Pixantrone
• Porfimer
• Potassium
• Potassium Phosphate
• Pramlintide
• Pranoprofen
• Proglumetacin
• Propyphenazone
• Proquazone
• Proscillaridin
• Quinapril
• Ramipril
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• Sotalol
• Sparsentan
• Spirapril
• Sulindac
• Tacrolimus
• Tapentadol
• Temocapril
• Tenoxicam
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Topiramate
• Trandolapril
• Trimethoprim
• Valdecoxib
• Vildagliptin
• Zofenopril

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency for one or both of the medicines.

• Amantadine
• Aminolevulinic Acid
• Bepridil
• Carbamazepine
• Cholestyramine
• Ginkgo
• Gossypol
• Licorice

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken at the same time as certain foods, as interactions may occur. Using alcohol or tobacco with some medicines may also cause interactions. The following interactions have been chosen based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Tobacco

Using this medicine with any of the following may increase the risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Potassium Containing Food

Other Medical Problems

Having other medical issues may affect the use of this medicine. Make sure to inform your doctor if you have any other medical problems, especially:

• Anuria (not able to pass urine) or
• Hyperkalemia (high potassium in the blood) or
• Kidney problems (e.g., kidney failure), severe or
• Sulfa drug allergy (e.g., sulfamethoxazole, Bactrim®, Septra®)—Should not be used in patients with these conditions.

• Diabetes or
• Weakened immune system, severe—May increase risk for more serious medical issues (e.g., hyperkalemia, metabolic acidosis).

• Electrolyte imbalance or
• Glaucoma, secondary angle closure or
• Gout or
• Heart failure or
• History of heart rhythm problems (e.g., arrhythmia) or
• Hyperuricemia (high uric acid in the blood) or
• Hypochloremia (low chloride in the blood) or
• Hypokalemia (low potassium in the blood) or
• Hyponatremia (low sodium in the blood) or
• History of kidney stones or
• Liver disease (including cirrhosis) or
• Parathyroid disease—Use with caution. May worsen these conditions.

Along with its necessary effects, this medicine may cause some unwanted effects. Not all side effects may happen, but if they do, they may require medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

• Agitation
• back or leg pains
• black, tarry stools
• bleeding gums
• blisters, hives, itching, skin rash
• bloating
• blood in the urine or stools
• blue lips and fingernails
• blurred vision
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• chest pain or tightness
• chills
• clay-colored stools
• cloudy urine
• cold sweats
• coma
• confusion
• constipation
• cough or hoarseness
• coughing that sometimes produces a pink frothy sputum
• dark urine
• decreased urine output
• depression
• difficult, fast, or noisy breathing
• difficulty swallowing
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
• drowsiness
• dry mouth
• fast, slow, or irregular heartbeat
• fever with or without chills
• flushed, dry skin
• fruit-like breath odor
• general body swelling
• general feeling of discomfort, illness, or weakness
• greatly decreased frequency of urination or amount of urine
• headache
• hostility
• incoherent speech
• increased hunger
• increased sweating
• increased thirst
• increased urination
• indigestion
• irritability
• joint pain, stiffness, or swelling
• lethargy
• loss of appetite
• loss of consciousness
• lower back or side pain
• metallic taste
• mood changes
• muscle pain, cramps, weakness, or twitching
• nausea or vomiting
• nervousness
• nosebleeds
• numbness or tingling in the hands, feet, or lips
• pain in the groin or genitals
• painful or difficult urination
• pains in the stomach, side, or abdomen, possibly radiating to the back
• pale skin
• persistent non-healing sore
• pink growth
• pinpoint red or purple spots on the skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid weight gain
• reddish patch or irritated area
• seizures
• sharp back pain just below the ribs
• shiny bump
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• stomachache
• stupor
• sugar in the urine
• swelling of the face, ankles, hands, feet, or lower legs
• swollen or painful glands
• thickening of bronchial secretions
• trouble breathing
• unexplained weight loss
• unpleasant breath odor
• unusual bleeding or bruising
• unusual tiredness or weakness
• vomiting of blood
• weak pulse
• weakness or heaviness of the legs
• white, yellow or waxy scar-like area
• yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Face is warm or hot to touch
• frequent urination
• increased volume of pale, dilute urine
• loss of strength or energy
• pain or weakness in the hands or feet
• redness to face
• reflexes are unusually strong
• trembling

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also be able to tell you how to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Decreased interest in sexual intercourse
• feeling of constant movement of self or surroundings
• inability to have or keep an erection
• increased sensitivity of the skin to sunlight
• loss in sexual ability, desire, drive, or performance
• redness or other discoloration of the skin
• sensation of spinning
• severe sunburn
• welts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Dyazide
• Maxzide

Available Dosage Forms:

• Tablet
• Capsule

Therapeutic Class: Diuretic, Potassium Sparing/Thiazide Combination

Pharmacologic Class: Diuretic, Potassium Sparing

Chemical Class: Thiazide

This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Swallow the capsule whole. Do not break, crush, or chew it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (capsules):For hypertension or edema: Adults—One or two capsules once a day. Each capsule contains 25 milligrams (mg) hydrochlorothiazide and 37.5 mg triamterene. Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.