Triamterene and Hydrochlorothiazide (patient information)

# Why is this medication prescribed
The combination of triamterene and hydrochlorothiazide is used to treat high blood pressure and edema (fluid retention; excess fluid held in body tissues) in patients who have lower amounts of potassium in their bodies or for whom low potassium levels in the body could be dangerous. The combination of triamterene and hydrochlorothiazide is in a class of medications called diuretics ('water pills'). It causes the kidneys to get rid of unneeded water and sodium from the body into the urine, but reduces the loss of potassium.

# How should this medicine be used
The combination of triamterene and hydrochlorothiazide comes as a capsule and tablet to take by mouth. It usually is taken once a day. Take triamterene and hydrochlorothiazide at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take triamterene and hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
This medication controls high blood pressure but does not cure it. Continue to take triamterene and hydrochlorothiazide even if you feel well. Do not stop taking triamterene and hydrochlorothiazide without talking to your doctor.

# Other uses for this medicine
This medicine may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
Before taking triamterene and hydrochlorothiazide
- tell your doctor and pharmacist if you are allergic to triamterene, hydrochlorothiazide, sulfonamide-derived medications ('sulfa drugs'), or any other medications.
- do not take triamterene and hydrochlorothiazide if you are taking amiloride (Midamor), spironolactone (Aldactone), or other medications containing triamterene.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention amphotericin B (Amphocin, Fungizone); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril, (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); anticoagulants ('blood thinners') such as warfarin (Coumadin); barbiturates (phenobarbital); digoxin (Lanoxin); laxatives; lithium (Eskalith, Lithobid); medications for diabetes, gout, or high blood pressure; methenamine (Hiprex, Urex); narcotic pain relievers; nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had kidney stones, systemic lupus erythematosus (SLE, a chronic inflammatory condition), diabetes, gout, or thyroid, heart, kidney, or liver disease.
- tell your doctor if you are pregnant or plan to become pregnant. Do not breastfeed if you are taking triamterene and hydrochlorothiazide. If you become pregnant while taking triamterene and hydrochlorothiazide, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking triamterene and hydrochlorothiazide.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Triamterene and hydrochlorothiazide may make your skin sensitive to sunlight.
- You should know that triamterene and hydrochlorothiazide may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking triamterene and hydrochlorothiazide and may be made worse by drinking alcohol. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

# What special dietary instructions should I follow
Follow your doctor's directions for your meals, including advice for a reduced salt (sodium) diet . Avoid potassium-containing salt substitutes while you are taking this medication. Talk with your doctor about the amount of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) that you may have in your diet.

# What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side Effects

## Minor Side Effects
Triamterene and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- gas
- frequent urination
- dizziness
- headache

## Severe Side Effects
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- rash or hives
- difficulty breathing or swallowing
- pain in the upper stomach area
- swelling or tenderness of stomach area
- upset stomach
- vomiting
- fever
- rapid pulse
- extreme tiredness
- unusual bruising or bleeding
- loss of appetite
- yellowing of skin or eyes
- flu-like symptoms
- muscle weakness or cramps
- feelings of numbness, tingling, pricking, burning, or creeping on the skin
- inability to move arms and legs
- slow or irregular heartbeat
- severe dry mouth
- severe thirst
- muscle pain or fatigue
- decreased urination
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What storage conditions are needed for this medicine
Keep this medicine in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medicine that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medicine.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- increased urination
- upset stomach
- vomiting
- weakness or tiredness
- fever

# What other information should I know
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to triamterene.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking triamterene and hydrochlorothiazide.
Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Dyazide
- Maxzide