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Maxzide (Triamterene and Hydrochlorothiazide) Information

Maxzide is a combination medication containing two active ingredients: triamterene (a potassium-sparing diuretic) and hydrochlorothiazide (HCT) (a thiazide diuretic). It is indicated for the treatment of hypertension (high blood pressure) and edema (swelling or fluid retention) 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 simultaneously minimizing the risk of potassium loss (hypokalemia) often associated with HCT alone. Maxzide is administered orally, typically once or twice daily.

The mechanism of action involves the synergistic effects of the two components: Hydrochlorothiazide (HCT). This thiazide diuretic acts in the distal convoluted tubules of the kidney. It inhibits the Sodium-Chloride (Na/Cl) co-transporter system, 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 the retention of potassium, directly counteracting the potassium loss caused by HCT. By combining these two mechanisms, Maxzide provides adequate diuresis and blood pressure reduction while attempting to maintain a normal potassium balance.

Maxzide Side Effects

Maxzide combines the side-effect profiles of both triamterene and hydrochlorothiazide, primarily affecting fluid and electrolyte balance. Common side effects often reported include dizziness, headache, muscle cramps, nausea, and mild gastrointestinal disturbances specific to the triamterene component. However, a range of serious side effects can occur, leading to significant monitoring protocols. Suppose any of the following symptoms or laboratory findings are identified. In that case, 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 due to the diuretic components.
• 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 (HCT), including severe skin rashes or, rarely, acute angle-closure glaucoma.
• Hypotension (Symptomatic): Excessive lowering of blood pressure, which may lead to fainting (syncope).
• 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).

Maxzide Precautions

Due to the significant risk of severe hyperkalemia, Maxzide carries a Boxed Warning. It is contraindicated in patients with a history of hypersensitivity to triamterene, sulfonamide-derived drugs (HCT), or a history of anuria (inability to urinate). It is also contraindicated in patients with existing hyperkalemia or significant renal impairment. Serum potassium levels and renal function (serum creatinine and BUN) must be checked before starting treatment and frequently thereafter throughout the course of therapy. Patients should be cautioned against using potassium supplements or salt substitutes containing potassium while on Maxzide. 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 Maxzide?

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