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Ditide (Triamterene and Benzthiazide) Information

Ditide is a combination medication containing two active ingredients: triamterene (a potassium-sparing diuretic) and benzthiazide (a thiazide diuretic). It is indicated for the treatment of edema (swelling) and hypertension (high blood pressure) in patients for whom combination therapy is appropriate. This fixed-dose combination is typically used when the goal is to enhance the diuretic and antihypertensive effects while minimizing the risk of potassium loss (hypokalemia) often associated with thiazide diuretics alone. Ditide is administered orally, typically once or twice daily.

The mechanism of action involves the synergistic effects of the two components: Benzthiazide is a thiazide diuretic that works in the distal convoluted tubules of the kidney. It inhibits the reabsorption of sodium and chloride, leading to increased excretion of salt and water, and a resulting reduction in blood volume and blood pressure. Triamterene is a potassium-sparing diuretic that works in the collecting ducts of the kidney. It directly blocks the epithelial sodium channels, inhibiting sodium reabsorption and thereby increasing sodium and water excretion. Crucially, this mechanism results in potassium retention, counteracting the potassium loss caused by benzthiazide. By combining these two mechanisms, Ditide provides adequate diuresis and blood pressure reduction while maintaining a more favourable potassium balance.

Ditide Side Effects

Ditide combines the side-effect profiles of both triamterene and benzthiazide, primarily affecting fluid and electrolyte balance. Common side effects often reported include dizziness, headache, muscle cramps, nausea, and mild gastrointestinal disturbances.

However, more serious side effects can occur, leading to significant monitoring protocols. If any of the following symptoms are experienced, the patient should stop taking the medication and seek immediate medical attention:

• Electrolyte Imbalances (Severe): Despite the potassium-sparing effect, severe imbalances in sodium (hyponatremia) or other electrolytes can occur.
• Hyperkalemia (Severe High Potassium) (Boxed Warning): The most serious risk is that significantly elevated serum potassium levels can cause dangerous, potentially fatal cardiac arrhythmias. This risk is highest in patients with renal impairment, diabetes, or those taking other potassium-sparing drugs.
• Hypersensitivity Reactions: Severe allergic reactions can occur to the sulfonamide-derived component (benzthiazide), including severe skin rashes or anaphylaxis.
• Renal Impairment/Failure: In patients with pre-existing renal disease, the combination may worsen kidney function. Triamterene, in particular, has been associated with the formation of kidney stones (nephrolithiasis).
• Symptomatic Hypotension: Excessive lowering of blood pressure, which may lead to fainting (syncope).

Ditide Precautions

Due to the risk of severe hyperkalemia, Ditide (or its components) carries a Boxed Warning in similar formulations. It is contraindicated in patients with a history of hypersensitivity to triamterene, sulfonamide-derived drugs (benzthiazide), or a history of anuria (inability to urinate). It is also contraindicated in patients with existing hyperkalemia (serum potassium greater than 5.5 mEq/L) or significant renal impairment. Serum potassium levels and renal function (serum creatinine) must be checked before starting treatment and frequently thereafter. Patients should be cautioned against using potassium supplements or salt substitutes containing potassium while on Ditide. Caution is necessary for patients with pre-existing liver disease, diabetes, or a history of gout, as the drug may exacerbate these conditions.

Do I need a prescription to order Ditide?

Yes, a prescription is required from your physician to order Ditide.