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triamterene - hydrochlorothiazide
How does this medication work? What will it do for me?
This combination product contains 2 medications: triamterene and hydrochlorothiazide. Both these medications belong to the class of medications called diuretics ("water pills"). They are used in combination to treat edema (fluid retention) that occurs with congestive heart failure and liver or kidney disorders. It is also used to treat mild-to-moderate high blood pressure.
This medication works by making the body lose excess water and salt. Triamterene, called a potassium-sparing diuretic, helps the body to keep potassium in, while hydrochlorothiazide causes the body to lose potassium. Therefore, potassium supplements are usually not required with this medication.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Riva-Triazide is no longer being manufactured for sale in Canada. For brands that may still be available, search under triamterene – hydrochlorothiazide. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.
How should I use this medication?
Each triamterene – hydrochlorothiazide tablet contains 50 mg of triamterene and 25 mg of hydrochlorothiazide. The usual starting dose to treat edema (fluid retention) or high blood pressure is 1 tablet twice daily after meals. The maximum daily dose is 4 tablets divided into 2 doses.
Your doctor will increase, decrease, or leave the dose the same depending on your response to the medication. If more than 1 tablet per day is needed, it should be taken in 2 divided doses. If only one dose is needed, it should be taken in the morning after breakfast.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you:
- are allergic to hydrochlorothiazide, triamterene, or any ingredients of the medication
- are allergic to sulfa medications (e.g., sulfamethoxazole)
- are not producing urine or are producing very little urine
- have increased blood potassium levels
- have severe or progressive kidney disease
- have severe or progressive liver disease
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- decreased sexual interest or ability
- dizziness or lightheadedness when rising from a lying or sitting position
- dry mouth
- enlarged glands in the mouth
- increased sensitivity of skin to sunlight
- loss of appetite
- pins and needles sensation in hands, feet
- stomach cramps or upset stomach
Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- discoloured patches or lumps on the skin that change slowly over time
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of changes in potassium (e.g., confusion; drowsiness; dry mouth; increased thirst; irregular heartbeat; mood or mental changes; muscle cramps or pain; numbness or tingling in hands, feet, or lips; shortness of breath or difficulty breathing; unusual tiredness or weakness; weak pulse; weakness or heaviness of legs)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- signs of gout (e.g., hot, swollen, or painful joints)
- signs of infection (e.g., fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
- signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, change of urine colour, nausea, vomiting, swelling feet, ankles, hands)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
- vision changes
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
- signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergy: Some people who are allergic to sulfonamide antibiotics also experience allergic reactions to triamterene – hydrochlorothiazide because of the hydrochlorothiazide component. Before you take this medication, inform your doctor about any previous adverse reactions you have had to medications, especially sulfonamide (sulfa) antibiotics.
Contact your doctor at once if you experience signs of an allergic reaction such as skin rash, itching, difficulty breathing, or swelling of the face and throat.
Diabetes: People with diabetes may find that their blood sugar level is less controlled when taking triamterene – hydrochlorothiazide. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Driving and using machines: Triamterene – hydrochlorothiazide can cause dizziness or lightheadedness, which may affect your ability to perform tasks that require special attention, such as driving or operating machinery. Avoid performing any potentially hazardous tasks, including driving, until you have determined how this medication affects you.
Glaucoma: Hydrochlorothiazide may cause the symptoms of glaucoma (increased pressure in the eye) to suddenly occur. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking this medication.
Gout: This medication may cause a flare-up of gout symptoms. If you have gout or a history of gouty arthritis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney stones: Triamterene has been found in kidney stones. If you have kidney stones or a history of kidney stones, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: If you have decreased liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed
Potassium levels: Increased blood levels of potassium, though uncommon, are potentially the most severe side effect with this medication. This is more likely to occur if you are 60 years old or over.
Warning signs or symptoms of high potassium include numbness, muscular weakness, fatigue, paralysis of the extremities, and slow heart rate. If this condition occurs, stop taking the medication.
Potassium supplements: Potassium supplementation, either in the form of medication or as a potassium-rich diet, should not be used at the same time as triamterene – hydrochlorothiazide. Triamterene helps recycle potassium from the urine, back into the body. When it is combined with potassium supplements, high levels of potassium in the blood may result.
Low levels of potassium may also occur for some of the people taking this medication because of the potassium-lowering effect of hydrochlorothiazide.
Sensitivity to sunlight: This medication may increase the sensitivity of the skin to sunlight, increasing the risk of sunburn. Avoid exposure to sunlight for long periods of time, particularly between the hours of 10 am and 2 pm, while you are taking this medication and for 7 days after your last dose. Wear a broad-spectrum sunscreen and lip balm with an SPF of 30 or higher. If you notice any unusual skin rash or peeling, contact your doctor immediately.
Skin cancer: Recent studies of hydrochlorothiazide have connected long-term use of the medication with an increased risk of developing non-melanoma skin cancer. Check your skin regularly for unusual growths or discolouration and report any changes to your doctor as soon as possible.
Systemic lupus erythematosus: This medication can worsen or activate the symptoms of lupus. If you experience swollen and painful joints, fever, fatigue, or rash on the nose and cheeks while taking this medication, contact your doctor.
Pregnancy: Hydrochlorothiazide crosses the placenta and may affect an unborn baby. Triamterene – hydrochlorothiazide should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: Hydrochlorothiazide passes into breast milk, and triamterene may pass into breast milk. If you are a breast-feeding mother and are taking triamterene – hydrochlorothiazide, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
What other drugs could interact with this medication?
There may be an interaction between triamterene – hydrochlorothiazide and any of the following:
- alpha-agonists (e.g., clonidine, methyldopa)
- alpha-blockers (e.g., alfuzosin, doxazosin, tamsulosin)
- amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
- angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril, enalapril)
- angiotensin II receptor blockers (e.g., losartan, candesartan)
- antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
- beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
- beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
- calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
- calcium supplements (e.g., calcium carbonate, calcium citrate, calcium gluconate)
- inhaled corticosteroids (e.g., budesonide, ciclesonide, fluticasone)
- oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
- diabetes medications (e.g., chlorpropamide, glyburide, insulin, metformin, rosiglitazone)
- other diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
- low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
- multivitamin/mineral supplements
- nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
- narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
- nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., diclofenac, ibuprofen, ketorolac, naproxen)
- other potassium-sparing diuretics (e.g., amiloride, spironolactone)
- phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
- potassium supplements (e.g., potassium chloride, potassium gluconate, salt substitutes containing potassium)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
- sodium phosphates
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
- vitamin D analogues (e.g., alfacalcidol, calcitriol, cholecalciferol)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Riva-Zide