Hydrochlorothiazide + Triamterene

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Generic Name of Hydrochlorothiazide + Triamterene - Learn More

Hydrochlorothiazide + Triamterene Precaution - What You Need to Know

- Special Populations: Hydrochlorothiazide + Triamterene should be used with caution in pregnant women, as thiazide diuretics can cross the placenta and may lead to fetal electrolyte imbalances, thrombocytopenia, or neonatal jaundice. It is generally avoided unless absolutely necessary. Breastfeeding mothers should be cautious, as both components may be excreted in breast milk and affect the infant. Elderly patients may be more sensitive to its effects, particularly hypotension and electrolyte disturbances, necessitating close monitoring. Patients with a history of gout should be cautious, as Triamterene may increase uric acid levels.
- Monitoring Parameters: Regular monitoring of serum potassium, sodium, creatinine, and blood pressure is crucial. Patients with preexisting kidney or liver disease should undergo frequent renal and hepatic function assessments. Electrolyte imbalances should be corrected promptly to avoid complications such as arrhythmias.
- Potential Misuse: As a potassium-sparing diuretic combination, improper use or overdose may result in hyperkalemia, leading to fatal cardiac complications. Patients with heart failure or on concurrent ACE inhibitors or potassium supplements require extra caution.

Hydrochlorothiazide + Triamterene Indication - Uses and Benefits

- Primary Use: Hydrochlorothiazide + Triamterene is primarily indicated for the management of hypertension and edema associated with congestive heart failure, liver cirrhosis, nephrotic syndrome, or corticosteroid therapy. The combination works to reduce blood pressure while minimizing potassium loss, a common issue with thiazide diuretics alone.
- Guidelines: According to clinical guidelines, this combination is most beneficial in patients who experience hypokalemia from thiazide diuretics alone. It is not a first-line antihypertensive but is often used as an adjunct when monotherapy is insufficient.
- Off-Label Uses: Occasionally, it is used for conditions such as lithium-induced polyuria and idiopathic hyperaldosteronism, although evidence for these uses remains limited.

Hydrochlorothiazide + Triamterene Contraindications - Important Warnings

- Absolute Contraindications:
- Anuria (severe renal impairment where urine production is minimal or absent)
- Hyperkalemia (due to Triamterene’s potassium-sparing effects)
- Severe hepatic disease (risk of hepatic encephalopathy)
- Hypersensitivity to sulfonamides (due to Hydrochlorothiazide)
- Relative Contraindications:
- Pregnancy, particularly in the second and third trimesters
- Concurrent use with potassium supplements or potassium-sparing drugs
- Patients with a history of kidney stones due to Triamterene’s crystalluria risk
- Age restrictions: Not typically recommended in pediatric populations due to insufficient safety data

Hydrochlorothiazide + Triamterene Side Effects - What to Expect

- Common:
- Dizziness, headache, fatigue
- Nausea, vomiting, dry mouth
- Increased urination (especially at the start of treatment)
- Serious:
- Hyperkalemia (potentially fatal arrhythmias)
- Hyponatremia and dehydration
- Kidney dysfunction (increased creatinine levels)
- Thrombocytopenia or leukopenia (rare but serious)
- Mitigation:
- Regular electrolyte monitoring
- Maintaining adequate hydration
- Immediate medical attention for signs of severe potassium imbalance (muscle weakness, palpitations, confusion)

Hydrochlorothiazide + Triamterene Pregnancy Category ID - Safety Information

3

Hydrochlorothiazide + Triamterene Mode of Action - How It Works

- Hydrochlorothiazide (HCTZ): A thiazide diuretic that inhibits sodium-chloride symporters in the distal convoluted tubule, reducing sodium and water reabsorption, leading to diuresis and lower blood pressure.
- Triamterene: A potassium-sparing diuretic that blocks epithelial sodium channels (ENaCs) in the distal nephron, reducing sodium reabsorption while preserving potassium levels.
- Synergistic Effect: The combination enhances diuresis and blood pressure control while mitigating potassium loss, making it more effective than monotherapy with either drug.

Hydrochlorothiazide + Triamterene Drug Interactions - What to Avoid

- Drug-Drug Interactions:
- ACE inhibitors (e.g., Lisinopril, Ramipril): Increased risk of severe hyperkalemia
- NSAIDs (e.g., Ibuprofen, Naproxen): May reduce the diuretic and antihypertensive effects, increasing renal impairment risk
- Lithium: Increased lithium toxicity risk due to reduced renal clearance
- Corticosteroids: May enhance potassium loss, leading to severe hypokalemia
- Food & Lifestyle Interactions:
- High potassium diets and supplements should be avoided to prevent hyperkalemia.
- Alcohol may potentiate orthostatic hypotension, leading to dizziness or fainting.
- Salt substitutes containing potassium chloride should be avoided.

Hydrochlorothiazide + Triamterene Adult Dose - Recommended Dosage

- Hypertension & Edema:
- Initial: 1 tablet (25 mg HCTZ / 37.5 mg Triamterene) once daily
- Maintenance: 1–2 tablets once daily
- Maximum: 2 tablets per day
- Administration: Oral, preferably in the morning to avoid nocturnal urination

Hydrochlorothiazide + Triamterene Child Dose - Dosage for Children

- Pediatric Use: Not typically recommended due to lack of sufficient studies and potential risk of severe electrolyte imbalance
- Adolescent Use (≥12 years, if deemed necessary):
- Initial: 12.5 mg HCTZ / 18.75 mg Triamterene once daily
- Maximum: 25 mg HCTZ / 37.5 mg Triamterene per day
- Monitoring: Close observation for dehydration, hypotension, and electrolyte disturbances

Hydrochlorothiazide + Triamterene Renal Dose - Dosage for Kidney Conditions

- Mild Renal Impairment (CrCl 30–50 mL/min): Use with caution, monitor potassium levels closely
- Moderate to Severe Renal Impairment (CrCl <30 mL/min): Contraindicated due to hyperkalemia risk
- End-Stage Renal Disease (ESRD): Not recommended
- Monitoring: Serum creatinine and electrolytes should be assessed frequently