Continued Could it be a heart problem? Patients who require hydrochlorothiazide and in whom hypokalemia cannot be risked may initiate therapy with Maxzide -25 mg 37. When triamterene is used in fixed combination with hydrochlorothiazide, consider the cautions, precautions, and contraindications associated with hydrochlorothiazide. Instruct patient to take medication early in day to avoid diuretic effect at night.
Gravity keeps lower in your body. That increases the pressure inside the blood vessels in your legs and feet and causes fluid to leak into those tissues. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. It is sparingly soluble in methanol.
UpToDate: “Patient Information” Edema swelling Beyond the basics. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee JNC 8. JAMA. Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, gout, high level of potassium in the blood, kidney disease including kidney stones liver disease, lupus. Could it be your veins?
May reduce thiazide absorption; give thiazide at least 2 h before sequestrant. Anorexia; gastric irritation; nausea; vomiting; abdominal pain or cramping; bloating; diarrhea; constipation; pancreatitis; sialadenitis; dry mouth. May increase incidence of hypersensitivity reactions to allopurinol. This medication passes into milk. Potassium-sparing diuretic; pteridine derivative.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. WPC 003 for the 100-mg strength. Tell patient to take drug with food or milk and to report GI symptoms. Hummel SL, Konerman MC. Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt? Upton RA, Williams RL, Lin ET et al. Absence of a significant pharmacokinetic interaction between hydrochlorothiazide and triamterene when coadministered. J Pharmacokinet Biopharm. It usually goes away after a few days. Hormones taken for or can also cause you to hold water. Could it be your medication? Symptoms may include decreased or excessive urination; fainting; fever; flushed face; light-headedness, especially when standing; nausea; severe dizziness; vomiting; weakness. Patterson JH, Adams KF Jr, Applefeld MM et al. Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Pharmacotherapy. Warning signs of hyperkalemia include paresthesias, muscular weakness, fatigue, flaccid paralysis of the extremities, bradycardia, and shock. Following cardiac surgery, a continuous infusion is as effective as intermittent boluses of furosemide. Total daily urine output and change in serum electrolyte levels were similar between the two methods of administration.
This may not be a complete list of all interactions that may occur. Ask your health care provider if triamterene may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Triamterene appears in animal milk and is likely present in human milk. Dyrenium should be gradual. DASH eating plan or a typical American diet. Results showed that reducing dietary sodium lowered blood pressure for both the DASH eating plan and the typical American diet. May decrease renal excretion of lithium; monitor lithium levels. For the management of fluid retention associated with heart failure, experts state that diuretics should be administered at a dosage sufficient to achieve optimal volume status and relieve congestion without inducing an excessively rapid reduction in intravascular volume, which could result in hypotension, renal dysfunction, or both. Excreted in urine, primarily as 6- p-hydroxytriamterene. Monitor serum electrolytes regularly. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens Greenwich. CycloSPORINE Systemic: Potassium-Sparing Diuretics may enhance the hyperkalemic effect of CycloSPORINE Systemic. Adrenal insufficiency: Avoid use of diuretics for treatment of elevated blood pressure in patients with primary adrenal insufficiency Addison disease. Tell your doctor if you just had or will be having major surgery, or if you will be confined to a chair or bed for a long time such as a long plane flight. These conditions increase your risk of getting blood clots, especially if you are taking hormonal products. You may need to stop this medication for a time or take special precautions.
Monitor serum potassium concentrations following changes in dosage or with concurrent illness or drug therapy. b d See Hyperkalemia under Cautions and also see Interactions. If any of these effects last or get worse, tell your doctor or promptly. Triamterene has been found in renal stones; use drug with caution in patients with histories of stone formation. Maxzide should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. Do not use concurrent potassium supplementation or potassium-containing salt substitutes. b Discontinue potassium supplementation when triamterene is added to other diuretic therapy or when patients are switched to triamterene from other diuretics. During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor. Check the sodium levels of food and drinks before you buy them. You can help balance your sodium by eating -rich foods like bananas and spinach, and drinking plenty of water. Could it be your lifestyle? America Society of Clinical Oncology: “Fluid Retention or Edema. May occur in patients with or without history of allergy or bronchial asthma; cross-sensitivity with sulfonamides may also occur. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension.
Do not use as initial monotherapy in severe heart failure since bowel edema or intestinal hypoperfusion may delay absorption and subsequent therapeutic effect. Favre L, Glasson P, Vallotton MB. Reversible acute renal failure from combined triamterene and indomethacin. Ann Intern Med. This medication may affect your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist. Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Avoid use Aronoff 2007. Dofetilide: Triamterene may increase the serum concentration of Dofetilide. Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Most people get enough potassium by eating a well-. This drug may make you dizzy. not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit beverages. Do not exceed 300 mg daily. Orthostatic or general hypotension, tachycardia, syncope, electrolyte abnormalities, potassium deficiency, vomiting, nausea, shock, weakness, confusion, dizziness, cramps of calf muscles, thirst, polyuria, anuria, lethargy. Importance of taking drug after meals to help avoid stomach upset. Interindividual variation in degree of absorption reported. Reduced clearance and increased risk of hyperkalemia; monitor serum potassium concentrations frequently. b c d See Hyperkalemia under Cautions.
UpToDate: “Patient information: Chronic venous disease Beyond the basics. Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Special stockings or socks gently squeeze your lower legs to help keep your blood circulating. If you have any questions about Maxzide, please talk with your doctor, pharmacist, or other health care provider. IV: If needed, repeat dose in 2 hours, after another 2 hours increase dose by 20 to 40 mg until an adequate diuresis. This dose should then be given once or twice a day. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. This can affect the results of many laboratory tests. Make sure laboratory personnel and all your doctors know you use this medication. And on the subject of diet, water is important for preventing constipation, too. Try to drink at least 8 glasses of water a day. Take this by as directed by your doctor, with or without food, usually once daily. Pick a time of day that is easy for you to remember, and take your pill at the same time each day, 24 hours apart. National Heart, Lung, and Blood Institute.
LAB TESTS, including blood electrolytes, blood cell counts, kidney and liver function tests, blood uric acid levels, and blood pressure, may be performed while you use triamterene. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Potassium passes into milk. Consult your doctor before -feeding. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Richardson A, Bayliss J, Scriven AJ et al. Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. Lancet. Lederle Laboratories. Maxzide and Maxzide -25 MG tablets prescribing information. Pearl River, NY; 1988 May. The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply. Usually combined with a kaliuretic diuretic. Although effective alone, often used in combination with other diuretics that act at different sites in the nephron. Some drugs may cause hormonal to work less well by decreasing the amount of hormones in your body. Herbs Hypertensive Properties: May diminish the antihypertensive effect of Antihypertensive Agents. Mylan Pharmaceuticals. Maxzide and Maxzide -25 triamterene and hydrochlorothiazide tablets prescribing information. Morgantown, WV; 2011 Jan.
Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure, and share the results with your doctor. Ask your doctor or pharmacist for information about how to switch from other forms of hormonal birth control such as the patch, other to this product. Your condition will not improve any faster, and your risk of side effects will increase. May cause rapid progression into acute renal failure. Because triamterene conserves potassium, it has been suggested that patients who have received intensive therapy or have been given the drug for prolonged periods may develop a rebound kaliuresis if such therapy is discontinued abruptly. b Discontinue drug gradually in such patients. Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Jaundice; liver enzyme abnormalities. Cardiac Glycosides: Potassium-Sparing Diuretics may diminish the therapeutic effect of Cardiac Glycosides. In particular, the inotropic effects of digoxin appear to be diminished. Potassium-Sparing Diuretics may increase the serum concentration of Cardiac Glycosides. This particular effect may be unique to Spironolactone. L hyponatremia, hypochloremia, and increases in BUN may occur. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Intramuscular: 10 to 20 mg once over 1 to 2 minutes. A repeat dose similar to the initial dose may be given within 2 hours if there is an inadequate response. Following the repeat dose, if there is still an inadequate response within another 2 hours, the last IV dose may be raised by 20 to 40 mg until there is an effective diuresis. Single doses exceeding 200 mg are rarely necessary. Store at room temperature between 59-86 degrees F 15-30 degrees C away from heat and moisture. not store in the bathroom. Keep all medicines away from children and pets.
Could it be something else? The manufacturer states there is no clinical experience to date with dosages of fixed-combination Maxzide or Maxzide -25 mg exceeding 75 mg of triamterene and 50 mg of hydrochlorothiazide daily. Tell your doctor or dentist that you take triamterene before you receive any medical or dental care, emergency care, or surgery. May precipitate azotemia or hypermagnesemia; use drug with caution. Take triamterene by mouth with or without food. Maxzide may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Maxzide with caution. Heparin: May enhance the hyperkalemic effect of Potassium-Sparing Diuretics. Management: Monitor serum potassium concentrations closely. The spironolactone Canadian product monograph lists its combination with heparin or low molecular weight heparins as contraindicated. Ask your health care provider any questions you may have about how to use triamterene. Some MEDICINES MAY INTERACT with Maxzide.
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IV: 20 to 100 mg every 1 to 2 hours over 1 to 2 minutes. Patients with cirrhosis and splenomegaly may have marked hematologic abnormalities; these patients should have periodic blood studies and be observed for exacerbations of underlying liver disease. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; burning, numbness, or tingling; confusion; decreased urination; drowsiness; dry mouth; excessive thirst; eye pain; fainting; fast, slow, or irregular heartbeat; fever, chills, or sore throat; mental or mood changes; muscle cramps, pain, or weakness; red, swollen, blistered, or peeling skin; restlessness; seizures; severe or persistent dizziness; shortness or breath; sluggishness; stomach pain; symptoms of high blood sugar eg, increased thirst, hunger, or urination; drowsiness; flushing; rapid breathing; fruit-like breath odor; tiredness or weakness; tremor; unusual bruising or bleeding; vision changes eg, decreased vision clearness; vomiting; yellowing of the skin or eyes.
Do not crush, chew, or suck extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or tells you to do so. Swallow the whole or split tablet without crushing or chewing. Risk of electrolyte imbalance and renal dysfunction may be increased when triamterene 75 mg daily with hydrochlorothiazide 50 mg daily is administered in 2 divided doses rather than 1 daily dose. DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine.
Photosensitivity: Can cause photosensitivity. Follow the package instructions to find the first tablet, start with the first tablet in the pack, and take them in the correct order. Do not skip any doses. is more likely if you miss pills, start a new pack late, or take your pill at a different time of the day than usual. This product may cause your body to lose too much water and salt dehydration. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.
Initial: 20 to 80 mg per dose. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Discuss the risks and benefits with your doctor. Initially, 100 mg twice daily after meals. b After edema is controlled, usual maintenance dosage is 100 mg daily or every other day. a Do not exceed 300 mg daily. For the treatment of hypertension, twice a day dosing is recommended.