Triamterene and hydrochlorothiazide (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 on 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 in 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 help 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 decide if you should keep taking it. Blood and urine tests may be needed to check 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 contain triamterene. Using these medicines together may cause serious problems.

This medicine may increase the potassium levels in your blood (hyperkalemia). Contact 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, trouble breathing, or weakness or heaviness in your legs.

Contact your doctor immediately if you notice blurred vision, difficulty reading, eye pain, or any other changes in your vision during or after treatment. Your doctor may want you to see an ophthalmologist (eye doctor).

This medicine may affect your blood sugar levels. Talk to your doctor if you notice a change in the results of your blood or urine sugar tests.

This medicine may cause dizziness or drowsiness. Avoid driving, using machines, 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 by sweating, having diarrhea, or vomiting. Inform your doctor if this medicine makes you feel lightheaded or dizzy after you have vomited or had diarrhea.

Contact your doctor right away if you experience drowsiness, fainting, confusion, muscle pain, weakness, and/or a fast heartbeat. Be extra careful 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 the body).

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

This medicine may cause serious kidney problems, including kidney stones. Contact 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 in your face, fingers, or lower legs, weight gain, or trouble breathing.

Ensure any doctor or dentist treating you knows that you are using this medicine. You may need to stop using 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 they have been discussed with your doctor. This is especially true for over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, as they may raise your blood pressure.

In deciding to use a medicine, you and your doctor will evaluate the risks of the medicine against its benefits. For this medicine, consider the following:

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 professional know about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For non-prescription products, check the label or package ingredients carefully.

Pediatric

There have been no appropriate studies on how triamterene and hydrochlorothiazide combination affects children. Safety and effectiveness have not been established.

Geriatric

There is no information regarding 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 during breastfeeding. Consider the potential benefits and risks before using this medicine while breastfeeding.

Interactions with Medicines

Some medicines should not be taken together at all, while others can be used together even if an interaction may occur. In these cases, your doctor may adjust the dose or take other precautions. It is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been chosen based on their importance and do not include all possible interactions.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide to not prescribe 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 of one or both 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 taking both drugs may be necessary for your treatment. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both 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 eating food or certain types of food due to possible interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions have been chosen based on their importance and do not include all possible interactions.

Using this medicine with any of the following is usually not recommended, but may be necessary in some cases. If used together, your doctor may adjust the dose or frequency of this medicine, or provide special instructions regarding food, alcohol, or tobacco.

• Tobacco

Using this medicine with any of the following may increase the risk of certain side effects but may be necessary in some cases. If used together, your doctor may adjust the dose or frequency of this medicine, or give you special instructions regarding food, alcohol, or tobacco.

• Potassium Containing Food

Other Medical Problems

Other medical issues may affect the use of this medicine. Make sure to inform your doctor if you have any other medical conditions, 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 the risk for more serious medical issues (e.g., hyperkalemia, metabolic acidosis).

• Electrolyte imbalance or
• Glaucoma, secondary angle closure or
• Gout or
• Heart failure or
• Heart rhythm problems (e.g., arrhythmia), history of 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
• Kidney stones, history of 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 of these side effects will occur, but if they do, you may need medical attention.

Check with your doctor right away if you experience any of the following side effects:

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 standing 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 you notice any of these overdose symptoms:

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 happen that usually do not need medical attention. These side effects may go away as your body adjusts to the medicine. Your healthcare professional might be able to suggest ways to prevent or lessen some of these side effects. Talk to your healthcare professional if any of the following side effects continue, 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, speak with your healthcare professional.

Call your doctor for medical advice about side effects. You can 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.