Triamterene Hydrochlorothiazid

Drug

Triamterene-Hydrochlorothiazid

Pronounced

"HI-dro-klor-oh-THIGH-uh-zide/try-AM-ter-een"

Drug Interactions

See also How to Use and Precautions sections.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: dofetilide, lithium, other drugs that may increase potassium levels (such as spironolactone, amiloride, cyclosporine).

Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

This medication may interfere with certain lab tests (such as parathyroid function), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

  • Negative Interactions

    10
    • Triamterene

      Dandelion

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Herbs that have a diuretic effect should be avoided when taking diuretic medications, as they may increase the effect of these drugs and lead to possible cardiovascular side effects. These herbs include dandelion, uva ursi, juniper, buchu, cleavers, horsetail, and gravel root.
      Dandelion
      Triamterene
      ×
      1. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102-3.
    • Hydrochlorothiazide

      Dandelion

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Herbs that have a diuretic effect should be avoided when taking diuretic medications, as they may increase the effect of these drugs and lead to possible cardiovascular side effects. These herbs include dandelion, uva ursi, juniper, buchu, cleavers, horsetail, and gravel root.
      Dandelion
      Hydrochlorothiazide
      ×
      1. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102-3.
    • Triamterene-Hydrochlorothiazide

      Dandelion

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Herbs that have a diuretic effect should be avoided when taking diuretic medications, as they may increase the effect of these drugs and lead to possible cardiovascular side effects. These herbs include dandelion, uva ursi, juniper, buchu, cleavers, horsetail, and gravel root.
      Dandelion
      Triamterene-Hydrochlorothiazide
      ×
      1. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102-3.
    • Hydrochlorothiazide

      Digitalis

      Potential Negative Interaction

      Digitalis (Digitalis purpurea) refers to a family of plants commonly called foxglove, which contains digitalis glycosides, chemicals with actions and toxicities similar to the prescription drug digoxin. Thiazide diuretics can increase the risk of digitalis-induced heart disturbances. Thiazide diuretics and digitalis-containing products should be used only under the direct supervision of a doctor trained in their use.

      Digitalis
      Hydrochlorothiazide
      ×
      1. Threlkeld DS, ed. Diuretics and Cardiovasculars, Thiazides and Related Diuretics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1993, 135a-7c.
    • Triamterene

      Diuretic Herbs

      Potential Negative Interaction

      Herbs that have a diuretic effect should be avoided when taking diuretic medications, as they may enhance the effect of these drugs and lead to possible cardiovascular side effects. These herbs include dandelion, uva ursi, juniper, buchu, cleavers, horsetail, and gravel root.

      Use buckthorn (Rhamnus catartica, Rhamnus frangula, Frangula alnus) or alder buckthorn for more than ten days consecutively may cause a loss of electrolytes (especially the mineral potassium). Medications that also cause potassium loss, such as some diuretics, should be used with caution when taking buckthorn or alder buckthorn.

      Diuretic Herbs
      Triamterene
      ×
      1. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102-3.
      2. European Scientific Cooperative on Phytotherapy (ESCOP). Frangulae cortex, frangula bark. Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: University of Exeter, Centre for Complementary Health Studies, 1997.
    • Hydrochlorothiazide

      Diuretic Herbs

      Potential Negative Interaction

      Herbs that have a diuretic effect should be avoided when taking diuretic medications, as they may enhance the effect of these drugs and lead to possible cardiovascular side effects. These herbs include dandelion, uva ursi, juniper, buchu, cleavers, horsetail, and gravel root.

      Use buckthorn (Rhamnus catartica, Rhamnus frangula, Frangula alnus) or alder buckthorn for more than ten days consecutively may cause a loss of electrolytes (especially the mineral potassium). Medications that also cause potassium loss, such as some diuretics, should be used with caution when taking buckthorn or alder buckthorn.

      Diuretic Herbs
      Hydrochlorothiazide
      ×
      1. Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997, 102-3.
      2. European Scientific Cooperative on Phytotherapy (ESCOP). Frangulae cortex, frangula bark. Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: University of Exeter, Centre for Complementary Health Studies, 1997.
    • Hydrochlorothiazide

      Ginkgo

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Ginkgo
      Hydrochlorothiazide
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Hydrochlorothiazide

      Licorice

      Potential Negative Interaction

      Licorice (Glycyrrhiza glabra) may increase the side effects of potassium-depleting diuretics, including thiazide diuretics. Thiazide diuretics and licorice should be used together only under careful medical supervision. At the time of this writing, no evidence was found of interactions between deglycyrrhizinated licorice (DGL) and any diuretic was found in the medical literature.

      Licorice
      Hydrochlorothiazide
      ×
      1. Shintani S, Murase H, Tsukagoshi H, Shiigai T. Glycyrrhizin (licorice)-induced hypokalemic myopathy. Report of two cases and review of the literature. Eur Neurol 1992;32:44-51.
    • Triamterene

      Magnesium

      Potential Negative Interaction

      Preliminary research in animals suggests that triamterene may inhibit the urinary excretion of magnesium. It is unknown if this same effect would occur in humans. Persons taking more than 300 mg of magnesium per day and triamterene should consult with a doctor as this combination may lead to potentially dangerous increases in the level of magnesium in the body. The combination of triamterene and hydrochlorothiazide would likely eliminate this problem, as hydrochlorothiazide may deplete magnesium.

      Magnesium
      Triamterene
      ×
      1. Devane J, Ryan MP. The effects of amiloride and triamterene on urinary magnesium excretion in conscious saline-loaded rats. Br J Pharmacol 1981;72:285-9.
    • Triamterene

      Potassium

      Potential Negative Interaction

      As a potassium-sparing drug, triamterene reduces urinary loss of potassium, which can lead to elevated potassium levels. People taking triamterene should avoid potassium supplements, potassium-containing salt substitutes (Morton Salt Substitute, No Salt, Lite Salt, and others) and even high-potassium foods (primarily fruit). Doctors should monitor potassium blood levels in patients taking triamterene to prevent problems associated with elevated potassium levels.

      However, some medications (for example, Dyazide, Maxzide) contain the combination of the potassium-sparing drug triamterene and the potassium-depleting drug hydrochlorothiazide. With the use of these combination medications, potassium excess and potassium depletion are both possible. People taking these drugs should have their potassium levels monitored by a doctor to determine whether their potassium intake should be increased, reduced, or kept the same.

      Potassium
      Triamterene
      ×
      1. Jackson PR, Ramsay LE, Wakefield V. Relative potency of spironolactone, triamterene and potassium chloride in thiazide-induced hypokalaemia. Br J Clin Pharmacol 1982;14:257-63.
  • Supportive Interactions

    6
    • Triamterene

      Calcium

      Replenish Depleted Nutrients

      A review of the research literature indicates that triamterene may increase calcium loss. The importance of this information is unclear.

      Calcium
      Triamterene
      ×
      1. Werbach WR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 246 [review].
    • Triamterene

      Folic Acid

      Replenish Depleted Nutrients

      Triamterene is a weak folic acid antagonist that has been associated with folic acid-deficiency anemia in people already at risk for folic acid deficiency. However, people treated long term with triamterene, without additional risk for folic acid deficiency, were found to have normal folic acid levels and no signs of folic acid deficiency. The use of multivitamin supplements containing folic acid appears to diminish the occurrence of birth defects associated with triamterene. According to one study,pregnant women who took folic acid–containing multivitamin supplements in addition to their prescription drugs had fewer babies with heart defects and deformities of the upper lip and mouth.

      One study showed that people taking diuretics for more than six months had dramatically lower blood levels of folic acid and higher levels of homocysteine compared with individuals not taking diuretics. Homocysteine, a toxic amino acid byproduct, has been associated with atherosclerosis. Until further information is available, people taking diuretics for longer than six months should probably supplement with folic acid.

      Folic Acid
      Triamterene
      ×
      1. Jackson EK. Diuretics. In Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th ed. New York: McGraw Hill, 1996, 706.
      2. Mason JB, Zimmerman J, Otradovec CL, et al. Chronic diuretic therapy with moderate doses of triamterene is not associated with folate deficiency. J Lab Clin Med 1991;117:365-9.
      3. Hernández-Díaz S, Werler MM, Walker AM, Mitchell AA. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 2000;343:1608-14.
      4. Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866-70.
    • Triamterene-Hydrochlorothiazide

      Folic Acid

      Replenish Depleted Nutrients

      One study showed that people taking diuretics for more than six months had dramatically lower blood levels of folic acid and higher levels of homocysteine compared with individuals not taking diuretics. Homocysteine, a toxic amino acid byproduct, has been associated with atherosclerosis. Until further information is available, people taking diuretics for longer than six months should probably supplement with folic acid.

      Folic Acid
      Triamterene-Hydrochlorothiazide
      ×
      1. Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866-70.
    • Hydrochlorothiazide

      Folic Acid

      Replenish Depleted Nutrients

      One study showed that people taking diuretics for more than six months had dramatically lower blood levels of folic acid and higher levels of homocysteine compared with individuals not taking diuretics. Homocysteine, a toxic amino acid byproduct, has been associated with atherosclerosis. Until further information is available, people taking diuretics for longer than six months should probably supplement with folic acid.

      Folic Acid
      Hydrochlorothiazide
      ×
      1. Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866-70.
    • Hydrochlorothiazide

      Magnesium and Potassium

      Replenish Depleted Nutrients

      Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion, although this deficiency may not be reflected by a low blood level of magnesium. Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.

      People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels. A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death. Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

      Magnesium supplementation for people taking thiazide diuretics is typically 300–600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides. Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.

      Magnesium and Potassium
      Hydrochlorothiazide
      ×
      1. Martin B, Milligan K. Diuretic-associated hypomagnesiumia in the elderly. Arch Intern Med 1987;147:1768-71.
      2. Kroenke K, Wood DR, Hanley JF. The value of serum magnesium determination in hypertensive patients receiving diuretics. Arch Intern Med 1987;147:1553-6.
      3. Whang R, Whang DD, Ryan MP. Refractory potassium repletion. A consequence of magnesium deficiency. Arch Intern Med 1992;152:40-5.
      4. Wahr JA, Parks R, Boisvert D, et al. Preoperative serum potassium levels and perioperative outcomes in cardiac surgery patients. JAMA 1999;281:2203-10.
      5. Franse LV, Pahor M, Di Bari M, et al. Hypokalemia associated with diuretic use and cardiovascular events in the Systolic Hypertension in the Elderly Program. Hypertension 2000;35:1025-30.
      6. Ruml LA, Gonzalez G, Taylor R, et al. Effect of varying doses of potassium-magnesium citrate on thiazide-induced hypokalemia and magnesium loss. Am J Ther 1999;6:45-50.
      7. Ruml LA, Pak CYO. Effect of potassium magnesium citrate on thiazide-induced hypokalemia and magnesium loss. Am J Kidney Dis 1999;34:107-13.
    • Hydrochlorothiazide

      Zinc

      Replenish Depleted Nutrients

      Thiazide diuretics can increase urinary zinc loss.

      Zinc
      Hydrochlorothiazide
      ×
      1. Reyes AJ, Leary WP, Lockett CJ, et al. Diuretics and zinc. S Afr Med J 1982;62:373-5.
  • Explanation Required

    7
    • Triamterene-Hydrochlorothiazide

      Alder Buckthorn

      Needs Explanation

      Use buckthorn (Rhamnus catartica, Rhamnus frangula, Frangula alnus) or alder buckthorn for more than ten days consecutively may cause a loss of electrolytes (especially the mineral potassium). Medications that also cause potassium loss, such as some diuretics, should be used with caution when taking buckthorn or alder buckthorn.

      Alder Buckthorn
      Triamterene-Hydrochlorothiazide
      ×
      1. European Scientific Cooperative on Phytotherapy (ESCOP). Frangulae cortex, frangula bark. Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: University of Exeter, Centre for Complementary Health Studies, 1997.
    • Triamterene-Hydrochlorothiazide

      Buckthorn

      Needs Explanation

      Use buckthorn (Rhamnus catartica, Rhamnus frangula, Frangula alnus) or alder buckthorn for more than ten days consecutively may cause a loss of electrolytes (especially the mineral potassium). Medications that also cause potassium loss, such as some diuretics, should be used with caution when taking buckthorn or alder buckthorn.

      Buckthorn
      Triamterene-Hydrochlorothiazide
      ×
      1. European Scientific Cooperative on Phytotherapy (ESCOP). Frangulae cortex, frangula bark. Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: University of Exeter, Centre for Complementary Health Studies, 1997.
    • Hydrochlorothiazide

      Calcium

      Needs Explanation

      Thiazide diuretics decrease calcium loss in the urine due to actions on the kidneys. As a result, it may be less important for some people taking thiazide diuretics to supplement calcium than it is for other people.

      Calcium
      Hydrochlorothiazide
      ×
      1. Threlkeld DS, ed. Diuretics and Cardiovasculars, Thiazides and Related Diuretics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jul 1993, 135a-7c.
    • Hydrochlorothiazide

      Hibiscus

      Needs Explanation
      In experimental animals, co-administration of hibiscus (Hibiscus sabdariffa L.) extract and hydrochlorothiazide increased blood levels of hydrochlorothiazide and decreased the rate at which the body cleared the drug. Therefore, treatment with hibiscus could increase both the efficacy and the adverse effects of hydrochlorothiazide. People taking hydrochlorothiazide should not take hibiscus without medical supervision.
      Hibiscus
      Hydrochlorothiazide
      ×
      1. Ndu OO, Nworu CS, Ehiemere CO, et al. Herb-drug interaction between the extract of Hibiscus sabdariffa L. and hydrochlorothiazide in experimental animals. J Med Food 2011;14:640-4.
    • Triamterene

      Sodium

      Needs Explanation

      Diuretics, including triamterene, cause increased loss of sodium in the urine. By removing sodium from the body, diuretics also cause water to leave the body. This reduction of body water is the purpose of taking diuretics. Therefore, there is usually no reason to replace lost sodium, although strict limitation of salt intake in combination with the actions of diuretics can sometimes cause excessive sodium depletion. On the other hand, people who restrict sodium intake and in the process reduce blood pressure may need to have their dose of diuretics lowered. People taking triamterene should talk with their prescribing doctor before severely restricting salt.

    • Hydrochlorothiazide

      Sodium

      Needs Explanation

      Diuretics, including thiazide diuretics, cause increased loss of sodium in the urine. By removing sodium from the body, diuretics also cause water to leave the body. This reduction of body water is the purpose of taking diuretics. Therefore, there is usually no reason to replace lost sodium, although strict limitation of salt intake in combination with the actions of diuretics can sometimes cause excessive sodium depletion. On the other hand, people who restrict sodium intake, and in the process reduce blood pressure, may need to have their dose of diuretics lowered.

    • Hydrochlorothiazide

      Vitamin D

      Needs Explanation

      The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

      Vitamin D
      Hydrochlorothiazide
      ×
      1. Riis B, Christiansen C. Actions of thiazide on vitamin D metabolism: A controlled therapeutic trial in normal women early in the postmenopause. Metabolism 1985;34:421-4.

Copyright © 2024 TraceGains, Inc. All rights reserved.

RxAnswers™ is a copyrighted combined product from TraceGains and First DataBank, Inc.

Drug information is selected from data included with permission and copyrighted by First DataBank, Inc. This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional. Always seek the advice of your healthcare professional if you have any questions about this product or your medical condition. This information is not intended as individual medical advice and does not substitute for the knowledge and judgment of your healthcare professional. This information does not contain any assurances that this product is safe, effective or appropriate for you.

This information is intended only for residents of the United States. Products sold under the same brand names in other countries may contain different ingredients.

Learn more about First DataBank

There are some limitations on the information provided in “Nutrient Interactions.” Do NOT rely solely on the information in this article. Please read the disclaimer

Learn more about TraceGains, the company.

TraceGains and/or its suppliers make no warranties or representations as to the accuracy or completeness of this content herein or that of any organization referred or linked to within this content and will not be liable for any damages arising out of your access to or use of any information found herein or that of any organization referred to within this content.

Information expires December 2024.

Log In

You need to log into the site to use this feature

Create A Free Account To Use Medicine Chest

This feature requires registration. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier.

Benefits Include:

Store & manage your medication list
Medication pricing updates
Import medication from your pharmacy
Medication information
Pill & refill reminders
Medication journal & mood log

Sign up to use Medicine Chest

Create A Free Account To Use this feature

This feature requires registration. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier.

Benefits Include:

Store & manage your medication list
Medication pricing updates
Import medication from your pharmacy
Medication information
Pill & refill reminders
Medication journal & mood log

Sign up to use this feature

You will be redirected to your program in 5 seconds.

Hi there.

Our Terms and Conditions and Privacy Policy have recently been updated.

Learn More


I Accept

By declining you will be logged out of your account

;