Triamterene 75mg/ HCTZ 50mg Tablets

Hydrochlorothiazide (HCTZ) is a thiazide diuretic that inhibits the reabsorption of sodium and chloride ions in the distal convoluted tubule, leading to increased excretion of sodium, chloride, and water. It also increases potassium and bicarbonate excretion and decreases calcium excretion. Triamterene is a potassium-sparing diuretic that inhibits sodium reabsorption in the distal convoluted tubule and collecting duct by blocking epithelial sodium channels (ENaC), thereby reducing potassium and hydrogen ion secretion.

Serious Side Effects: Seek Medical Attention Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:

Allergic reactions: Rash, hives, itching, red, swollen, blistered, or peeling skin with or without fever, wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Fluid and electrolyte problems: Mood changes, confusion, muscle pain or weakness, fast or abnormal heartbeat, severe dizziness or passing out, increased thirst, seizures, feeling very tired or weak, decreased appetite, unable to pass urine or change in the amount of urine produced, dry mouth, dry eyes, or severe upset stomach or vomiting.
Acidosis (too much acid in the blood): Confusion, fast breathing, fast heartbeat, irregular heartbeat, severe stomach pain, upset stomach, or vomiting, feeling very sleepy, shortness of breath, or feeling very tired or weak.
Kidney problems: Unable to pass urine, change in urine output, blood in the urine, or sudden weight gain.
Pancreatitis (pancreas problem): Severe stomach pain, severe back pain, or severe upset stomach or vomiting.
High blood sugar: Confusion, feeling sleepy, unusual thirst or hunger, frequent urination, flushing, fast breathing, or fruity-smelling breath.
Kidney stone symptoms: Back pain, belly pain, or blood in the urine.
Liver problems: Dark urine, yellow skin, or yellow eyes.
Nerve problems: Burning, numbness, or tingling sensations that are not normal.
Respiratory problems: Shortness of breath, restlessness.
Cardiovascular problems: Chest pain or pressure, fast, slow, or irregular heartbeat.
Erectile dysfunction: Difficulty getting or maintaining an erection.
Mood changes: Changes in mood or emotional state.

Rare but Serious Side Effects

Low blood cell counts: Unexplained bruising or bleeding, signs of infection (fever, chills, sore throat), or feeling very tired or weak.
Eye problems: Changes in vision, eye pain, or lasting eyesight loss (if left untreated). If you experience any eye problems, contact your doctor right away, as these symptoms usually occur within hours to weeks of starting this medication.
Skin cancer: Rarely, people taking hydrochlorothiazide have developed certain types of skin cancer. Protect your skin from the sun and have your skin checked regularly by your doctor. Contact your doctor immediately if you notice any changes in the color or size of a mole, or any new or changing skin lump or growth.

Other Side Effects

Most people do not experience serious side effects, and many have no side effects or only minor ones. However, if you experience any of the following side effects and they bother you or do not go away, contact your doctor or seek medical help:

Constipation, diarrhea, upset stomach, vomiting, or decreased appetite.
Headache.
Dizziness, drowsiness, tiredness, or weakness.
Increased appetite.
Changes in taste.
Stomach cramps.

Reporting Side Effects

This is not a comprehensive list of all possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances. Describe the allergic reaction you experienced, including the symptoms that occurred.
A known sulfa allergy.
Certain health conditions, such as:
+ Diabetes
+ High potassium levels
+ Kidney disease
+ Urination problems
Inability to pass urine.
Current medications, including:
+ Dofetilide
+ Lithium
+ Amiloride
+ Spironolactone
+ Other medications containing triamterene
Use of salt substitutes containing potassium, potassium-sparing diuretics, or potassium products.
* Breast-feeding: Do not breast-feed while taking this medication, as it may pose risks to your baby.

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your existing treatments and health status. Never start, stop, or adjust the dose of any medication without consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, be cautious when driving or performing tasks that require alertness, as it may affect your ability to do so. To minimize the risk of dizziness or fainting, stand up slowly after sitting or lying down, and exercise caution when climbing stairs.

If you have diabetes (high blood sugar), consult your doctor, as this medication may increase your blood sugar levels. Monitor your blood sugar levels as instructed by your doctor. Additionally, check your blood pressure and undergo blood work and other laboratory tests as directed by your doctor. Be aware that this medication may interfere with certain lab tests, so inform all your healthcare providers and laboratory personnel that you are taking this medication.

If you follow a low-sodium or salt-free diet, discuss this with your doctor. Before consuming alcohol, marijuana, or other forms of cannabis, or taking prescription or over-the-counter medications that may cause drowsiness, consult your doctor.

Be aware of the potential for gout attacks, and if you have lupus, this medication may exacerbate your condition or trigger a flare-up. Immediately report any new or worsening symptoms to your doctor.

This medication may increase your susceptibility to sunburn, so take precautions when exposed to sunlight. If you experience excessive sunburn, inform your doctor. Also, notify your doctor if you experience excessive sweating, fluid loss, vomiting, or diarrhea, as these may lead to low blood pressure.

If you are 65 years or older, use this medication with caution, as you may be more prone to side effects. If you are pregnant or planning to become pregnant, discuss the benefits and risks of using this medication with your doctor.

• Potassium supplements
• Potassium-sparing diuretics (e.g., spironolactone, amiloride)
• Eplerenone
• Patients with anuria or significant renal impairment (CrCl < 30 mL/min)

• ACE inhibitors (e.g., lisinopril, enalapril) - increased risk of hyperkalemia and hypotension
• Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan) - increased risk of hyperkalemia and hypotension
• NSAIDs (e.g., ibuprofen, naproxen) - reduced diuretic/antihypertensive effect, increased risk of renal dysfunction and hyperkalemia
• Lithium - reduced renal clearance of lithium, leading to increased lithium levels and toxicity
• Digoxin - hypokalemia from HCTZ can increase digoxin toxicity
• Corticosteroids - increased risk of hypokalemia (from HCTZ)
• Antidiabetic agents (insulin, oral hypoglycemics) - HCTZ may decrease glucose tolerance, requiring dose adjustment
• Cholestyramine, Colestipol - may reduce absorption of HCTZ

• Alcohol, barbiturates, narcotics - may potentiate orthostatic hypotension
• Pressor amines (e.g., norepinephrine) - decreased arterial responsiveness to pressor amines
• Skeletal muscle relaxants, non-depolarizing (e.g., tubocurarine) - potentiated effect
• Allopurinol - increased risk of hypersensitivity reactions to allopurinol
• Amantadine - increased risk of amantadine toxicity
• Cytotoxic agents (e.g., cyclophosphamide, methotrexate) - increased bone marrow suppression

• Calcium salts - increased risk of hypercalcemia
• Vitamin D - increased risk of hypercalcemia

• Signs of hyperkalemia (muscle weakness, fatigue, bradycardia, paresthesias)
• Signs of hypokalemia (muscle cramps, weakness, irregular heartbeat)
• Signs of hyponatremia (nausea, headache, confusion, seizures)
• Signs of dehydration (dry mouth, thirst, decreased urination, dizziness)
• Orthostatic hypotension (dizziness upon standing)
• Symptoms of gout (joint pain, swelling)
• Symptoms of kidney stones (flank pain, hematuria) - rare with triamterene

Category D. Should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Thiazides can cross the placental barrier and may cause fetal or neonatal jaundice, thrombocytopenia, and other adverse reactions. Triamterene may interfere with folic acid metabolism and has been associated with birth defects in animal studies.

Both hydrochlorothiazide and triamterene are excreted in breast milk. HCTZ can reduce milk production. Due to the potential for serious adverse reactions in the nursing infant (e.g., electrolyte disturbances, inhibition of lactation), a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Safety and effectiveness have not been established in pediatric patients. Use is generally not recommended.

Elderly patients may be more sensitive to the effects of diuretics, including orthostatic hypotension and electrolyte imbalances (especially hyperkalemia due to age-related decline in renal function). Initiate therapy with caution and monitor renal function and electrolytes closely.

• Always check serum potassium levels before initiating therapy and regularly thereafter, especially in patients with renal impairment, diabetes, or those on ACE inhibitors/ARBs.
• Advise patients to take the medication in the morning to prevent nocturia.
• Educate patients on symptoms of hyperkalemia (muscle weakness, fatigue, bradycardia) and hypokalemia (muscle cramps, irregular heartbeat).
• Avoid concomitant use with potassium supplements or other potassium-sparing agents.
• This combination is particularly useful for patients who develop hypokalemia on thiazide monotherapy.
• Patients should be advised to avoid excessive heat exposure and maintain adequate hydration to prevent dehydration and electrolyte imbalances.

• Other thiazide diuretics (e.g., Chlorthalidone, Indapamide)
• Loop diuretics (e.g., Furosemide, Torsemide) for more potent diuresis
• ACE inhibitors (e.g., Lisinopril)
• Angiotensin Receptor Blockers (e.g., Valsartan)
• Calcium Channel Blockers (e.g., Amlodipine)
• Beta-blockers (e.g., Metoprolol)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.