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Dyrenium triamterene should not be used in patients with pre-existing elevated serum potassium, as is sometimes seen in patients with impaired renal function or azotemia, or in patients who develop hyperkalemia while on the drug.
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pTriamterene inhibits the epithelial sodium channels on principal cells in the late distal convoluted tubule and collecting tubulewhich are responsible for 1-2of total sodium reabsorptionAs sodium reabsorption is inhibitedthis increases the osmolarity in the nephron lumen and decreases the osmolarity of the interstitiumSince sodium concentration is the main driving force for water reabsorptiontriamterene can achieve a modest amount of diuresis by decreasing the osmotic gradient necessary for water reabsorption from lumen to interstitiumTriamterene also has a potassium-sparing effectNormallythe process of potassium excretion is driven by the electrochemical gradient produced by sodium reabsorptionAs sodium is reabsorbedit leaves a negative potential in the lumenwhile producing a positive potential in the principal cellThis potential promotes potassium excretion through apical potassium channelsBy inhibiting sodium reabsorptiontriamterene also inhibits potassium excretion./ppTriamterene and quinidine have similar fluorescence spectrathus MAXZIDEtriamterene and hydrochlorothiazidemay interfere with the measurement of quinidine./ppTriamterene comes as a capsule to take by mouthIt usually is taken once a day in the morning after breakfast or twice a day after breakfast and lunchIt is best to take triamterene earlier in the day so that frequent trips to the bathroom do not interfere with nighttime sleepTake triamterene at around the same time(severy dayFollow the directions on your prescription label carefullyand ask your doctor or pharmacist to explain any part you do not understandTake triamterene exactly as directedDo not take more or less of it or take it more often than prescribed by your doctor./ppTell your doctor right away if you have any serious side effectsincludingnausea/vomiting that doesn’t stopstomach/abdominal painyellowing eyes/skindark urinesigns of infectionsuch as sore throat that doesn’t go awayfeverchillscoughsigns of kidney problemssuch as pain in the side/back/abdomenpainful urinationblood in the urinechange in the amount of urinejoint painsuch as big toe paineasy bruising/bleeding./ppPatients receiving MAXZIDEtriamterene and hydrochlorothiazideshould be carefully monitored for fluid or electrolyte imbalancesi.ehyponatremiahypochloremic alkalosishypokalemia and hypomagnesemiaDetermination of serum electrolytes to detect possible electrolyte imbalance should be performed at appropriate intervalsSerum and urine electrolyte determinations are especially important and should be frequently performed when the patient is vomiting or receiving parenteral fluidsWarning signs or symptoms of fluid and electrolyte imbalance includedryness of mouththirstweaknesslethargydrowsinessrestlessnessmuscle pains or crampsmuscular fatiguehypotensionoliguriatachycardia and gastrointestinal disturbances such as nausea and vomiting./p

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studies of the mutagenic potential of maxzide, the triamterene hydrochlorothiazide combination, have not been performed.