Triamterene/ Hydrochlorothiazide

Registered South African indications:

• Oedema
• Hypertension

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Severe renal impairment
• Severe hepatic impairment
• Hyperkalaemia
• Hypercalcaemia
• Diabetic ketoacidosis
• Addison's disease
• Coadministration with agents that increase serum potassium 

Cautions

• Pregnancy
• Breastfeeding
• Gout
• Diabetes mellitus
• Pancreatitis

Forms avail. in SA and covered in this monograph: tab

Oedema

Triamterene 50mg/Hydrochlorothiazide 25mg

• Oral (tab): Initial: 1 tab, 12hrly; Maintenance: 1-3 tabs, dly, in divided doses OR 2 tabs, on alternate days; Max: 4 tabs/24hrs

Hypertension

Triamterene 50mg/Hydrochlorothiazide 25mg

• Oral (tab): 1 tab, 12-24hrly

Not established for use in children

Pregnancy

• FDA Pregnancy Category C  

Breastfeeding

• Caution; not recommended

Renal Impairment

• Severe: Contraindicated

Hepatic Impairment

• Severe: Contraindicated

Elderly

• No dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Prohibited - At all times

Central Nervous System Disorders

• Weakness
• Dizziness
• Headache

Cardiovascular Disorders

• Hypotension

Respiratory Disorders

• Interstitial pneumonitis
• Pulmonary oedema

Gastrointestinal Disorders

• Nausea and vomiting
• Diarrhoea

Genitourinary Disorders

• Renal failure
• Renal stones

Endocrine and Metabolic Disorders

• Hyperglycaemia
• Hypercalcaemia

Skin and Subcutaneous Tissue Disorders

• Photosensitivity
• Systemic lupus erythematosus

Immune, Blood and Lymphatic System Disorders

• Anaphylaxis
• Thrombocytopaenic purpura
• Megaloblastic anaemia
• Agranulocytosis
• Thrombocytopaenia
• Leucopaenia

Sensory Disorders

• Thirst
• Dry mouth

• Folate antagonists
• Non-steriodal anti-inflammatory drugs
• Anion exchange resins
• Antidepressants
• Antidiabetic agents
• Antifungals
• Antihypertensives
• Antipsychotics
• Calcium salts
• Digoxin
• Antiarrhythmic drugs
• Ciclosporin
• Agents that increase serum potassium
• Cytotoxics
• Lithium
• Muscle relaxants
• Oral contraceptives
• Sympathomimetics
• Theophylline
• Carbenoxolone
• Vitamin D

None routine. Specific cases may require

• Electrolytes
• Renal function

Triamterene is a potassium conserving diuretic thought to act by inhibiting the exchange of sodium for potassium and hydrogen in the distal renal tubule. Hydrochlorothiazide acts primarily in the distal convoluted tubule where it inhibits sodium chloride transport. It competes for the chloride site and affects the electrolyte reabsorption by increasing sodium and chloride excretion. This reduces plasma volume indirectly and increases plasma renin activity, aldosterone secretion and urinary potassium loss.

COMBINATION PREPARATIONS

Triamterene/ Hydrochlorothiazide

Tablet 50mg/25mg 

• Dyazide (Pharmafrica) (Discontinued: 21/06/19)
• Renezide (Litha)