Triamterene/Hydrochlorothiazide: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

What is triamterene/hydrochlorothiazide used for?

Triamterene/hydrochlorothiazide is a diuretic, also called a water pill, commonly used to treat high blood pressure (hypertension).

Triamterene/hydrochlorothiazide is also commonly used to reduce fluid retention (edema) caused by the following conditions.

Congestive heart failure, which is a condition where the heart is not pumping as well as it should
Liver disease, such as cirrhosis, which can lead to a buildup of fluid in the abdomen (ascites)
Kidney disease, including protein in the urine (nephrotic syndrome)
Fluid caused by the use of hormones, such as estrogen or other steroids

Triamterene/hydrochlorothiazide may also be used for other conditions as determined by your healthcare provider.

How does triamterene/hydrochlorothiazide work (mechanism of action)?

Triamterene/hydrochlorothiazide works by increasing how much you pee. It does this by helping the kidneys remove electrolytes, such as sodium (salt), and water from the body. It also appears to allow blood to flow more freely (less resistance to flow), which may help with lowering blood pressure. The triamterene in this combination medicine helps your kidneys keep more potassium in your blood, which could get too low if you take hydrochlorothiazide alone.

How is triamterene/hydrochlorothiazide supplied (dosage forms)?

Brands and other names

Dyazide
Maxzide
Maxzide-25

Dosage forms and strengths

37.5 mg/25 mg oral capsules
37.5 mg/25 mg oral tablets
75 mg/50 mg oral tablets

How should I store triamterene/hydrochlorothiazide?

Triamterene/hydrochlorothiazide should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep tightly closed.

Side Effects

What are the most common side effects of triamterene/hydrochlorothiazide?

The most common side effects of triamterene/hydrochlorothiazide are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

Low blood pressure (see below)
Electrolyte changes and increased blood sugar (see below)
An increase in how much you pee
Nausea and vomiting
Diarrhea
Headache
Dizziness
Fatigue
Rash

There may be other side effects of triamterene/hydrochlorothiazide that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of triamterene/hydrochlorothiazide?

While less common, the most serious side effects of triamterene/hydrochlorothiazide are described below, along with what to do if they happen.

Low Blood Pressure with Worsening Kidney Function. Water loss from triamterene/hydrochlorothiazide can lower your blood pressure too much and cause dehydration. Both may lead to problems that are more serious than light-headedness. Poor blood flow to important organs such as your kidneys can occur, especially if you are elderly. Drink enough water to stay hydrated, especially if you have excess sweating, vomiting, or diarrhea. Get out of bed or from a seated position slowly. Tell your healthcare provider right away if you have any of the following symptoms.

Dizziness, feeling lightheaded, or fainting
Confusion
Feeling weak or tired
Difficulty catching your breath or chest pain/pressure
Sudden weight gain
Swelling in your feet, ankles, or legs
Reduced need to pee
Increased thirst
Dark or strong-smelling pee
Dry mouth
Sunken eyes
Headache
Fast heartbeat
Seizures

Kidney Stones. Kidney stones (nephrolithiasis) can happen when taking triamterene/hydrochlorothiazide. Call your healthcare provider right away if you have any of the following symptoms of kidney stones.

Pain in your side, back, or below your ribs
Pain in your lower belly
Pain in your groin or testicles
Burning when you pee
Needing to pee more often
Trouble peeing
Passing only small amounts of pee
Pink, red, or brown blood in your pee (hematuria)
Small stones in your pee
Cloudy or bad-smelling pee
Nausea and vomiting
Fever and chills

Electrolyte Changes and Increased Blood Sugar. Triamterene/hydrochlorothiazide may increase your blood sugar (glucose) levels and cause changes to the levels of certain minerals in your body, called electrolytes. For example, it may cause low potassium levels (hypokalemia), high potassium levels (hyperkalemia), low sodium levels (hyponatremia), low magnesium levels (hypomagnesemia), high calcium levels (hypercalcemia), or low chloride levels (hypochloremia), or high glucose levels (hyperglycemia). These changes can be serious. Your healthcare provider will do bloodwork to check your glucose and electrolyte levels, especially if you take certain other medicines. Keep your appointments to have your blood checked. Call your healthcare provider if you have any of the following symptoms.

Weakness, including muscle weakness
Unusual tiredness
Muscle cramps or twitching
Constipation
Nausea, vomiting, or loss of appetite
Dizziness
Restlessness or irritability
Difficulty breathing
Confusion or decreased alertness
Abnormal heart rhythm, such as slow or skipped heartbeats
Seizures

Short-Sightedness and Glaucoma. Triamterene/hydrochlorothiazide may make it harder to see faraway objects (short-sightedness). It also may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. These issues may be more likely with taking triamterene/hydrochlorothiazide if you have a sulfa or penicillin allergy. Tell your healthcare provider right away if you have any of the following symptoms.

Trouble seeing faraway objects
Loss of vision
Eye pain or redness
Severe headache or vomiting
Seeing bright, colorful circles around lights (vision halos)

Severe Allergic Reactions. Triamterene/hydrochlorothiazide may cause allergic reactions, which can be serious. Stop using triamterene/hydrochlorothiazide and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Severe Skin Reactions. Triamterene/hydrochlorothiazide can cause severe skin reactions called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) that can lead to death if not treated. If you develop a rash, stop triamterene/hydrochlorothiazide and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.

Painful red or purple skin that looks burned and peels off
Flat red rash or blisters on your skin, mouth, nose, and genitals
Red, painful, watery eyes

Sensitivity to Sunlight. Your skin may be very sensitive to light from the sun and devices that give off similar light, such as sunlamps and tanning beds, while you are taking certain drugs, including triamterene/hydrochlorothiazide. This is called photosensitivity. Use sunscreen and wear a hat and clothes that cover your skin if you need to be in the sunlight. Exposing your skin to this kind of light, even for a short time, can cause your skin to be severely sunburned, blistered, or swollen. Tell your healthcare provider right away if any of these happen.

Inflammation of the Pancreas (Pancreatitis). Triamterene/hydrochlorothiazide may cause inflammation of the pancreas, which is called pancreatitis. Stop taking triamterene/hydrochlorothiazide and call your healthcare provider right away if you have symptoms of pancreatitis including vomiting or severe pain in the upper part of your belly that travels to your back.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking triamterene/hydrochlorothiazide. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

Nausea or vomiting
Stomach or belly pain
Fever
Weakness or unusual tiredness
Itching
Loss of appetite
Light-colored poop
Dark-colored urine
Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severely Low Platelet Levels. Triamterene/hydrochlorothiazide can cause you to have a severely low number of platelets in your blood, also called thrombocytopenia. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Tell your healthcare provider if you have any of the following symptoms of low platelet levels.

Easy bruising or bleeding
Bleeding that does not stop
Nosebleeds

Anemia. Triamterene/hydrochlorothiazide may cause anemia, which is a condition that causes low levels of red blood cells. Tell your healthcare provider if you have any of the following symptoms of anemia.

Unusual weakness or tiredness
Cold hands and feet
Fast or abnormal heartbeat
Pale or yellowish skin
Dizziness, lightheadedness, or feeling like you are about to pass out
Shortness of breath

Warnings & Precautions

Who should not use triamterene/hydrochlorothiazide?

Allergies to Ingredients. People who are allergic to any of the following should not use triamterene/hydrochlorothiazide.

Hydrochlorothiazide
Triamterene
Dyazide
Maxzide
Maxzide-25
Any other medicine known as a sulfonamide (sulfa drug)
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific triamterene/hydrochlorothiazide products they stock.

No Urine Production. Do not take triamterene/hydrochlorothiazide if you are making very little to no pee. This condition is also called anuria.

Very Low Electrolytes. If you have low electrolytes, including low sodium or potassium, triamterene/hydrochlorothiazide may not be safe to use. Your healthcare provider may measure your electrolytes before starting triamterene/hydrochlorothiazide. Low electrolytes are not usually something you can feel, so it is important to make it to your scheduled blood work appointments.

High Potassium Level (Hyperkalemia). Triamterene/hydrochlorothiazide should not be used if your blood potassium level is too high. Your healthcare provider should measure your potassium level before starting, and during treatment with, triamterene/hydrochlorothiazide. It is very important to make it to all appointments where your blood potassium levels will be measured.

Metabolic or Respiratory Acidosis. Triamterene/hydrochlorothiazide should not be used if you are at risk for metabolic or respiratory acidosis. These are conditions in which you have too much acid in your blood. They can occur if you have certain breathing problems or are severely ill. Talk to your healthcare provider to determine if you are at risk for acidosis.

Kidney Problems. Triamterene/hydrochlorothiazide should not be used if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your healthcare provider may do tests to determine if they are working well enough to take this medicine.

Liver Problems. Triamterene/hydrochlorothiazide should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.

Salt Substitutes or Potassium Supplements. Salt substitutes containing potassium, or potassium supplements, should not be used while taking triamterene/hydrochlorothiazide.

Drug Interactions. Triamterene/hydrochlorothiazide should not be taken while you are using certain other medicines. Before taking triamterene/hydrochlorothiazide, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about triamterene/hydrochlorothiazide before using it?

Do not take triamterene/hydrochlorothiazide unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share triamterene/hydrochlorothiazide with other people, even if they have the same condition as you. It may harm them.

Keep triamterene/hydrochlorothiazide out of the reach of children.

Triamterene/hydrochlorothiazide can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how hydrochlorothiazide affects you.

People who are age 65 or older can be at greater risk for some side effects from triamterene/hydrochlorothiazide. Talk to your healthcare provider about your risks if you are in this age group.

Your skin may be very sensitive to light from the sun and devices that give off similar light, such as sunlamps and tanning beds, while you are taking certain drugs, including triamterene/hydrochlorothiazide. This is called photosensitivity. Use sunscreen and wear a hat and clothes that cover your skin if you need to be in the sunlight. Talk to your healthcare provider about checkups for skin cancer.

Triamterene/hydrochlorothiazide can affect your electrolyte levels, especially potassium and sodium. It is important to discuss your intake of electrolytes with your healthcare provider, including potassium in food, drinks, or supplements.

Triamterene/hydrochlorothiazide can be taken after meals to help with an upset stomach.

If the need to pee at night is disrupting your sleep, talk to your healthcare provider about the best time to take triamterene/hydrochlorothiazide.

What should I tell my healthcare provider before using triamterene/hydrochlorothiazide?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if triamterene/hydrochlorothiazide is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Heart failure
Liver problems
Kidney problems, including kidney stones
Persistent or severe diarrhea or vomiting, which can lead to dehydration
Electrolyte issues, including high or low potassium, or low sodium
Abnormal heart rhythm (arrhythmias)
Diabetes
Gout
Prostate problems
A reduced need to pee

Systemic Lupus Erythematosus. Triamterene/hydrochlorothiazide may activate or worsen systemic lupus erythematosus. Tell your healthcare provider if you develop or have worsening rash, joint pain, fever, or unusual tiredness.

Sulfa Allergy. Some people who have a sulfa allergy may also be allergic to triamterene/hydrochlorothiazide. A sulfa allergy is a rash or more serious reaction to sulfa, or sulfonamide, medicines. Sulfa medicines include sulfamethoxazole, sulfadiazine silver, or sulfasalazine. Tell your healthcare provider if you have any allergies to medicines.

Salt Substitutes or Potassium Supplements. Tell your healthcare provider if you use any salt substitutes or low-salt milk, which often contain potassium, or if you take any potassium supplements. This information is important for your healthcare provider to determine if triamterene/hydrochlorothiazide is safe for you to use.

Pregnancy. It is not known if or how triamterene/hydrochlorothiazide could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take triamterene/hydrochlorothiazide while you are pregnant or trying to get pregnant.

Breastfeeding. Triamterene/hydrochlorothiazide passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop triamterene/hydrochlorothiazide.

Interactions

Does triamterene/hydrochlorothiazide interact with foods or drinks?

Triamterene/hydrochlorothiazide interacts with salt substitutes containing potassium and high potassium diets, which may increase the risk of high potassium in your blood (hyperkalemia). It is important to discuss your intake of electrolytes, including sodium and potassium, with your healthcare provider.

It is unknown if drinking alcohol will affect triamterene/hydrochlorothiazide. The risk of dizziness may be increased if you drink alcohol while taking triamterene/hydrochlorothiazide. It is best to limit the amount of alcohol you drink.

Does triamterene/hydrochlorothiazide interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using triamterene/hydrochlorothiazide.

A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of pain
A medicine for diabetes
A medicine for high blood pressure
An angiotensin-converting enzyme (ACE) inhibitor, which is a medicine for high blood pressure, heart failure, and certain kidney problems
An angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and other heart conditions
Aliskiren (Tekturna), which is a medicine for high blood pressure
Any potassium-containing medicine, such as penicillin G potassium or potassium chloride
Cholestyramine or colestipol, which are sometimes used to lower cholesterol
A corticosteroid, such as prednisone, methylprednisolone, or dexamethasone, which is a medicine for certain inflammatory conditions
Lithium, which is a medicine used for certain mental health conditions
A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure

This may not be a complete list of medicines that can interact with triamterene/hydrochlorothiazide. Always check with your healthcare provider.

Does Triamterene/Hydrochlorothiazide interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much triamterene/hydrochlorothiazide?

If you or someone else has used too much triamterene/hydrochlorothiazide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of triamterene/hydrochlorothiazide?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.