৳ 5/unit
Pack: ৳ 50
৳ 5/unit
Pack: ৳ 50
At a glance
Hydrochlorothiazide + Triamterene combination is used for the treatment of hypertension or edema in patients who develop hypokalemia on hydrochlorothiazide alone or in whom the development of hypokalemia cannot be risked.
Indications
- Hypertension (high blood pressure)
- Edema - especially in patients who develop hypokalemia on hydrochlorothiazide alone
- In patients in whom the development of hypokalemia cannot be risked
Pharmacology
Triamterene directly inhibits the exchange of Na for K and hydrogen in the distal renal tubule. Hydrochlorothiazide inhibits Na+/Cl- reabsorption in the distal convoluted tubule, increasing sodium and chloride excretion, which reduces plasma volume. Triamterene reduces the kaliuretic effects of other diuretics and adds to the natriuretic effect. It is structurally similar to folate and has anti-folate activity.
Dosage
Adult Dose (Oral):
- Hypertension and Edema: 1-2 tablets/capsules (37.5-50 mg triamterene + 25 mg HCTZ) once daily
- Or 1 tablet (75 mg triamterene + 50 mg HCTZ) once daily
- Monitor serum potassium
Child Dose: Safety and efficacy not established
Side effects
Triamterene: Jaundice, weakness, headache, azotemia, dizziness, fatigue, xerostomia, photosensitivity, rash, diarrhea, nausea, vomiting, hyperuricemia, hyper/hypokalemia, interstitial nephritis
Hydrochlorothiazide: Anorexia, epigastric distress, hypotension, orthostatic hypotension, anaphylaxis, anemia, confusion, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, dizziness, hypokalemia, hypomagnesemia, hyperuricemia
Others: Arrhythmia, diabetes mellitus, acidosis, hypercalcemia, hyperglycemia, glycosuria, pancreatitis, acute renal failure, leukopenia, thrombocytopenia, muscle cramps, dry mouth, impotence
Use in pregnancy
Use in Pregnancy: Routine use of diuretics in otherwise healthy woman is inappropriate and exposes mother and fetus to unnecessary hazard; diuretics do not prevent toxemia of pregnancy; indicated when edema is due to pathologic causes.
Precautions & warnings
Precautions:
- Caution in renal and hepatic impairment, cirrhosis, diabetes, hyponatremia, hyperuricemia, history of nephrolithiasis, depleted folic acid stores
- Monitor electrolyte concentrations closely, especially potassium levels
- Observe for signs of liver damage, blood dyscrasias or other idiosyncratic reactions
- Discontinue treatment if urinary calculus is passed
- Pregnancy and elderly: caution
- Lactation: Not recommended; discontinue drug or do not nurse
- Caution in diabetes; thiazides may cause hyperglycemia, glycosuria, and alter insulin requirements
- Caution in hepatic impairment; may precipitate hepatic coma
- Monitor for electrolyte imbalance
Overdose effects
Overdose: Electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration; hyperkalemia may occur; symptomatic and supportive treatment; gastric lavage should be considered.
Storage conditions
Store at controlled room temperature 20° to 25°C; excursions permitted to 15° to 30°C; protect from light; dispense in a tight, light-resistant container.