Precautions and Warnings With Triamterene-HCTZ
Understanding precautions and warnings with triamterene-HCTZ can help ensure a safe treatment process. This includes being aware of potential side effects, such as low blood pressure and high potassium levels. Women who are pregnant or breastfeeding should talk with their healthcare providers before taking the drug. Precautions and warnings with triamterene-HCTZ also extend to people with certain allergies, such as to sulfa drugs.
You should talk with your healthcare provider prior to taking triamterene-HCTZ (Dyazide®, Maxzide®) if you have:
- Liver disease, including cirrhosis
- Kidney disease or kidney failure
- A history of kidney stones
- Systemic lupus erythematosus (lupus or SLE)
- Fluid or electrolyte problems
- Any allergies, including allergies to sulfa drugs, foods, dyes, or preservatives.
Also let your healthcare provider know if you are:
- Pregnant or trying to become pregnant
You should also make sure to tell your healthcare provider about all of the medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
- The medication can cause low potassium levels (hypokalemia) or, more commonly, high potassium levels (hyperkalemia). Your healthcare provider should monitor your potassium levels regularly (using a blood test) during treatment with triamterene-HCTZ. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include:
- Dry mouth
- Muscle pain or muscle cramps
- Low blood pressure (hypotension)
- Decreased urination
- A rapid heart rate (tachycardia) or irregular heart rhythm (arrhythmia)
- Nausea or vomiting.
- Triamterene-HCTZ should be started cautiously in people with liver disease. In general, the medication should be started in the hospital for these people so that they can be monitored closely.
- Do not use salt substitutes while taking triamterene-HCTZ. Salt substitutes usually contain potassium, and combining them with triamterene-HCTZ can increase the risk of high potassium levels in your blood (hyperkalemia). Herb-type salt substitutes that do not contain potassium are okay to use.
- There are a number of medicines that triamterene-HCTZ can potentially interact with (see Drug Interactions With Triamterene-HCTZ).
- The medication has been reported to cause kidney stones in some people. Talk with your healthcare provider before taking triamterene-HCTZ if you have had kidney stones in the past.
- Triamterene-HCTZ may cause extreme low blood pressure in some people. This is more likely to happen when the medicine is first started or the dosage is changed. It is also more likely to happen in people who sweat a lot; people who are on dialysis; and people who have congestive heart failure, diarrhea, or vomiting. This is why it is important to drink fluids regularly while taking the drug. If you have any possible symptoms of low blood pressure -- such as dizziness, lightheadedness, or fainting -- contact your healthcare provider. If you have fainted, stop taking triamterene-HCTZ until you have talked with your healthcare provider.
- Make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness until you know how triamterene-HCTZ affects you.
- Triamterene-HCTZ is known to make gout worse.
- You may be more likely to be allergic to triamterene-HCTZ if you have asthma. Talk with your healthcare provider before taking the drug if you have asthma.
- Drugs that contain hydrochlorothiazide, including this medication, can sometimes cause a potentially dangerous eye reaction (a particularly dangerous type of glaucoma). This reaction usually occurs within days to weeks of starting the drug. Because this reaction can permanently damage vision, let your healthcare provider know right away if you develop vision changes and/or eye pain. The main treatment for this reaction is to stop taking this medication, although other treatment, including surgery, may sometimes be necessary.
- Triamterene-HCTZ may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, may even cause diabetes in people without a history of the condition.
- Triamterene-HCTZ is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using the drug while pregnant (see Dyazide and Pregnancy or Maxzide and Pregnancy).
- Triamterene-HCTZ passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider before using the drug (see Dyazide and Breastfeeding or Maxzide and Breastfeeding).