Abnormal elevation of serum potassium levels (greater than or equal to 5.5 mEq/liter) can occur with all potassium-sparing diuretic combinations, including triamterene and hydrochlorothiazide. Hyperkalemia is more likely to occur in patients with renal impairment and diabetes (even without evidence of renal impairment), and in the elderly or severely ill. Since uncorrected hyperkalemia may be fatal, serum potassium levels must be monitored at frequent intervals especially in patients first receiving triamterene and hydrochlorothiazide, when dosages are changed or with any illness that may influence renal function.
Triamterene is an antikaliuretic agent and hydrochlorothiazide is a diuretic/antihypertensive agent. At 50°C, triamterene is practically insoluble in water (less than 0.1%). It is soluble in formic acid, sparingly soluble in methoxyethanol and very slightly soluble in alcohol.
This fixed combination drug is not indicated for the initial therapy of edema or hypertension except in individuals in whom the development of hypokalemia cannot be risked.
Triamterene/hydrochlorothiazide capsules are indicated for the treatment of hypertension or edema in patients who develop hypokalemia on hydrochlorothiazide alone.
Triamterene/hydrochlorothiazide capsules are also indicated for those patients who require a thiazide diuretic and in whom the development of hypokalemia cannot be risked.
Triamterene/hydrochlorothiazide capsules may be used alone or as an adjunct to other antihypertensive drugs, such as beta-blockers. Since triamterene/hydrochlorothiazide capsules may enhance the action of these agents, dosage adjustments may be necessary.
Usage in Pregnancy: The routine use of diuretics in an otherwise healthy woman is inappropriate and exposes mother and fetus to unnecessary hazard. Diuretics do not prevent development of toxemia of pregnancy, and there is no satisfactory evidence that they are useful in the treatment of developed toxemia.
Edema during pregnancy may arise from pathological causes or from the physiologic and mechanical consequences of pregnancy. Diuretics are indicated in pregnancy when edema is due to pathologic causes, just as they are in the absence of pregnancy. Dependent edema in pregnancy resulting from restriction of venous return by the expanded uterus is properly treated through elevation of the lower extremities and use of support hose; use of diuretics to lower intravascular volume in this case is illogical and unnecessary. There is hypervolemia during normal pregnancy which is harmful to neither the fetus nor the mother (in the absence of cardiovascular disease), but which is associated with edema, including generalized edema in the majority of pregnant women. If this edema produces discomfort, increased recumbency will often provide relief. In rare instances this edema may cause extreme discomfort which is not relieved by rest. In these cases a short course of diuretics may provide relief and may be appropriate.
Published Studies Related to Triamterene and Hydrochlorothiazide (Triamterene / Hydrochlorothiazide)
Bioequivalence evaluation of a triamterene-hydrochlorothiazide generic product: a new bioequivalence index for fixed-dose combinations. [2011.02]
In this study, an open, double-blind, randomized, two-period, two-group crossover design was conducted in 14 healthy volunteers to study the bioequivalence of a fixed-dose generic product. After administration of test or reference products to each volunteer, both active ingredients were determined simultaneously in plasma samples using a developed and validated HPLC-UV method, and pharmacokinetic parameters, including C(max), T(max), AUC(0-t) , AUC(0infinity), terminal elimination rate constant (lambdaz), volume of distribution in steady state (Vd(ss)), mean residence time (MRT), clearance (Cl), terminal elimination rate constant (Kel) were determined in each subject using the standard non-compartmental approach...
Clinical Trials Related to Triamterene and Hydrochlorothiazide (Triamterene / Hydrochlorothiazide)
Diuretics, Hypertension, and Arrhythmias Clinical Trial [Completed]
To determine whether hypertensive patients with ECG abnormalities and receiving
hydrochlorothiazide diuretics were at increased risk of sudden death.
Hemodialysis Without Anticoagulation in Intensive Care Unit [Recruiting]
The purpose of this study is to determine the safety and operative efficacy of intermittent
hemodialysis without anticoagulation with saline flushes or Nephral 400ST in patients at high
risk of bleeding
Renin-Guided Therapeutics in the Management of Untreated, Uncontrolled, or Complicated Hypertension [Completed]
Plasma renin values determine whether volume or vasoconstrictor (renin) factors predominate
in elevating blood pressure and are useful in selecting effective antihypertensive
The researchers hypothesize that:
1. Plasma renin-guided therapeutics will improve systolic and diastolic blood pressure
control in patients with untreated hypertension as well as in patients with treatment
refractory or resistant hypertension that are managed by Clinical Hypertension
2. Renin-guided therapeutics will reduce the number of medications required to maintain
blood pressure control to <140/90 mmHg in hypertensive patients receiving 3 or more
medications, while under the care of a Clinical Hypertension Specialist.
3. Renin-guided therapeutics selection will reduce the total cost of antihypertensive care
provided by Clinical Hypertension Specialists.
Chronic Hemodialysis Without Systemic Heparinization : a Randomized Study [Recruiting]
Conventional hemodialysis requires transient systemic anticoagulation to prevent blot
clotting after contact with the extracorporeal circuit. However, low molecular weight heparin
(LMWH) or unfractioned heparin are contra-indicated in dialysis patients at risk for
hemorrhagic complications. In this setting, several procedures theoretically allow dialysis
without systemic heparinization, but randomized studies to compare them are lacking. The
gold standard is the use of iterative rises of the extra corporeal circuit with isotonic
saline (« rises »). Two emerging procedures are increasingly used : continuous pre-dilution
of the arterial line (« pre-dilution ») and the use of a specific dialysis membrane (NEPHRAL
400 ST) coated with heparin immediately before use (« heparin adsorption »).
Reports of Suspected Triamterene and Hydrochlorothiazide (Triamterene / Hydrochlorothiazide) Side Effects
Completed Suicide (23),
Respiratory Arrest (11),
Cardiac Arrest (11),
Drug Ineffective (8),
Cardio-Respiratory Arrest (6),
Toxicity TO Various Agents (5),
Nephrolithiasis (4), more >>
Page last updated: 2011-12-09