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triamterene/hydrochlorothiazide (Rx)Brand and Other Names:Dyazide, Maxzide

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

triamterene/hydrochlorothiazide

capsule

  • 37.5mg/25mg
  • 50mg/25mg

tablet

  • 37.5mg/25mg
  • 75mg/50mg
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Hypertension

1-2 tablets/capsules (37.5-50 mg triamterene and 25 mg HCTZ) PO qDay

1 tablet (75 mg triamterene and 50 mg HCTZ) PO qDay

Dosing considerations

  • Monitor serum potassium

Edema

1-2 tablets/capsules (37.5-50 mg triamterene and 25 mg HCTZ) PO qDay

1 tablet  (75 mg triamterene and 50 mg HCTZ)  PO qDay

Dosing considerations

  • Monitor serum potassium

Safety and efficacy not established

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Interactions

Interaction Checker

triamterene/hydrochlorothiazide and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Triamterene

            • Jaundice
            • Weaknes
            • Headache
            • Azotemia
            • Dizziness
            • Fatigue
            • Xerostomia
            • Photosensitivity
            • Rash
            • Diarrhea
            • Nausea
            • Vomiting
            • Hyperuricemia
            • Hyper/hypokalemia
            • Interstitial nephritis

            Hydrochlorothiazide

            • Hypotension
            • Dizziness
            • Vertigo
            • Headache
            • Alopecia
            • Erythema multiforme
            • Toxic epidermal necrolysis
            • Stevens-Johnson syndrome
            • Fever
            • Hyperglycemia
            • Anorexia
            • Epigastric distress
            • Glycosuria
            • Hypokalemia
            • Phototoxicity
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            Warnings

            Balck Box Warning

            Triamterene can cause hperkalemia in patients at risk including patients with renal dysfunction, diabetes mellitus, the severely ill, the elderly; monitor serum potassium levels at frequent intervals especially with any illness that may cause renal dysfunction or when dosages are changed

            Contraindications

            Hypersensitivity to triamterene, hydrochlorothiazide, or sulfonamides (hydrochlorothiazide is a sulfonamide)

            Concomitant administration with potassium rich diets, or any other form of potassium supplementation

            Chronic or significant renal insufficiency or significant renal impairment

            Anuria

            Hyperkalemia ≥5.5 mEq/L

            Cautions

            Acute transient myopia and acute angle-closure glaucoma have been reported, particularly with history of sulfonamide or penicillin allergy

            Hydrochlorothiazide can cause electrolyte disturbances including hypokalemia, hypochloremic alkalosis, and hyponatremia

            Photosensitization may occur

            Use with caution in diabetes mellitus, hepatic impairment, gout, hypercalcemia, hypercholesterolemia, kidney stones, parathyroid disease, systemic lupus erythematosus, and renal impairment

            Risk of cross-reaction in patients with allergy to sulfonylurea, sulfonamides, thiazides, loop diuretics, or carbonic anhydrase may occur

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Not recommended; discontinue drug or do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Triamterene: Has direct effect on renal distal tubule to inhibit Na+ reabsorption; inhibits Na/K-ATPase, decreases Ca++ , Mg++ and hydrogen excretion

            Hydrochlorothiazide: Inhibits sodium reabsorption in distal renal tubules, resulting in increased excretion of water and of sodium, potassium, and hydrogen ions

            Pharmacokinetics

            Triamterene

            • Half-Life: 1.5-2.5 hr
            • Duration: 7-9 hr
            • Onset: Initial effect: 2-4 hr
            • Max effect: Diuresis: several days, HTN: 2-3 months
            • Peak Plasma Time: 1.5-3 hr
            • Bioavailability: 30-70%
            • Protein Bound: 55-67%
            • Metabolism: Liver
            • Metabolites: Hydroxytriamterene sulfate (active)
            • Excretion: Urine (21%)
            • Dialyzable: Yes (hemodialysis)

            Hydrochlorothiazide

            • Onset: ~2 hr (diuresis); 3-4 days (hypertension)
            • Peak plasma time: 1-2.5 hr
            • Peak effect: 4-6 hr (diuresis)
            • Bioavailability: 65-75%
            • Protein bound: 40-68%
            • Vd: 3.6-7.8 L/kg
            • Minimally metabolized
            • Half-life: 5.6-14.8 hr
            • Dialyzable: No (hemodialysis)
            • Excretion: Urine
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            Images

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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