Maxzide (Triamterene and Hydrochlorothiazide) – Oral

Warning:

Increased potassium levels in the blood can occur while taking potassium-sparing diuretic combinations, including Maxzide (triamterene and hydrochlorothiazide). High potassium levels in the blood are more likely to happen in people with poor kidney function, diabetes, and in people who are older than 65 years or are severely ill.

High potassium levels that are not corrected can be fatal. Therefore, potassium levels in the blood must be checked frequently, especially when first receiving Maxzide, when the dosage is changed, or with any illness that can affect how the kidneys work.  



What Is Maxzide?

Maxzide (triamterene and hydrochlorothiazide) is an oral prescription tablet used to treat high blood pressure or excess fluid in people who develop low potassium while taking hydrochlorothiazide alone. Maxzide is also approved for use in those who require a diuretic and for whom the development of low potassium cannot be risked.

Hydrochlorothiazide is a thiazide diuretic, sometimes called a “water pill,” commonly used for treating high blood pressure. Triamterene is a potassium-sparing diuretic that helps prevent the body from losing too much potassium.

Triamterene and hydrochlorothiazide act on different parts of the kidneys to decrease how much sodium (salt) and water are reabsorbed. Using both of these medications together minimizes the risk of low potassium levels in the blood that may be experienced when using hydrochlorothiazide on its own.

This medication is available in tablet form to be taken by mouth.

Drug Facts

Generic Name: Triamterene and hydrochlorothiazide

Brand Name(s): Maxzide, Maxzide-25

Administration Route: Oral

Drug Availability: Prescription

Therapeutic Classification: Thiazide diuretic combination

Available Generically: Yes

Controlled Substance: N/A

Active Ingredients: Triamterene and hydrochlorothiazide

Dosage Form(s): Tablet

What Is Maxzide Used For?

The Food and Drug Administration (FDA) approved Maxzide for:

  • Treatment of high blood pressure or excess fluids in people who develop low potassium levels in the blood while taking hydrochlorothiazide alone
  • Those who require a thiazide diuretic and in whom the development of low potassium cannot be risked

How to Take Maxzide

Always follow the directions given to you by your healthcare provider or pharmacist on how to take Maxzide.

The usual dose of Maxzide is one tablet daily with or without food. If you are prescribed Maxzide-25, you may take one or two tablets daily.

As with other blood-pressure-lowering medications, stick to your treatment regimen even if you are feeling well. High blood pressure is often regarded as the "silent killer," since you may not have any symptoms. Even if you are feeling healthy, you may still have high blood pressure and be at risk for further complications like a heart attack or stroke.

Storage

Store Maxzide in a cool, dry place at room temperature (between 68 and 77 degrees F). Keep it away from heat, humidity, and light exposure. Do not store it in your bathroom or kitchen. These environments can impact how well medications work.

It is also important to ensure this medication is kept out of reach of children and pets to prevent accidental consumption.

How Long Does Maxzide Take to Work?

You should expect Maxzide to start working within two hours of your dose, with its effects lasting between six and 12 hours.

What Are the Side Effects of Maxzide?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Maxzide may include:

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Dial 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hyperkalemia: Numbness and tingling, decreased reflexes, muscle weakness, gas and bloating, and nausea
  • Gout: Sudden and severe joint pain, joint swelling, joint stiffness, and mild fever
  • Hyponatremia: Personality changes, fatigue, convulsions or seizures, weakness, loss of consciousness, low blood pressure, and nausea or vomiting
  • Kidney stones: Severe pain in the side and back just below the ribs, pain that radiates in the lower stomach and groin, or pain or burning with urination

Long-Term Side Effects

Taking Maxzide long term can cause electrolyte imbalances due to how this medication works. Your healthcare provider will frequently monitor common electrolytes.

Report Side Effects

Maxzide may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Maxzide Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For hypertension or edema:
      • Adults—One or two capsules once a day. Each capsule contains 25 milligrams (mg) hydrochlorothiazide and 37.5 mg triamterene.
      • Children—Use and dose must be determined by your doctor.

Modifications

Maxzide carries a boxed warning about the risk of developing high potassium in the blood. This risk is higher in people with kidney problems, diabetes, and those who are 65 and older or severely ill. If any of these apply to you, extra monitoring of potassium levels or a dosage change may be needed. Talk to your healthcare provider before starting your treatment.

Maxzide is not recommended to take if you have a creatinine clearance less than 30 milliliters per minute (mL/min) which would indicate that the kidneys are not working well.

The use of the individual components of Maxzide (hydrochlorothiazide and triamterene) has been shown to not cause harm to a fetus. Therefore, this medication is safe to use if you are pregnant.

For breastfeeding people, this medication can be present in breast milk but no negative side effects have been observed in nursing infants. Talk with your healthcare provider about the risks and benefits of being on this medication while nursing.

Missed Dose

If you miss a dose of Maxzide, take it as soon as you remember. If the time you remember happens to be closer to the next scheduled dose than the missed dose, take just the scheduled dose. You should not take more than one dose at a time. Missing one dose of this medication is not harmful, but it is important to take it daily to control your blood pressure.

Overdose: What Happens If I Take Too Much Maxzide?

No specific data are available for taking too much Maxzide in humans and no specific antidote is available. The most probable side effect of taking too much Maxzide would be electrolyte imbalances and dehydration.

An overdose of triamterene may cause:

  • High potassium levels in the blood
  • Dehydration
  • Nausea or vomiting
  • Weakness
  • Low blood pressure

Overdosing with hydrochlorothiazide may cause:

  • Low potassium levels in the blood
  • Low chloride levels in the blood
  • Low sodium levels in the blood
  • Dehydration

In case of an overdose, seek medical help immediately and contact poison control for the latest recommendations.

What Happens If I Overdose on Maxzide?

If you think you or someone else may have overdosed on Maxzide, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Maxzide, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Make sure your doctor knows if you are also taking potassium supplements or salt substitutes containing potassium, or certain diuretics such as amiloride (Midamor®, Moduretic®), spironolactone (Aldactazide®, Aldactone®), or other products containing triamterene. Using these medicines together may cause serious problems.

This medicine may increase the amount of potassium in your blood (hyperkalemia). Check with your doctor right away if you have stomach pain, confusion, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, trouble breathing, or weakness or heaviness of the legs.

Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may affect blood sugar levels. Check with your doctor if you notice a change in the results of your blood or urine sugar tests.

This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. Dizziness may be worse if you lose too much water from your body. You can lose water by sweating, having diarrhea, or vomiting. Tell your doctor if this medicine makes you feel lightheaded or dizzy after you have been vomiting or had diarrhea.

Check with your doctor right away if you experience drowsiness, fainting, confusion, muscle pain, weakness, and/or a fast heartbeat. Use extra care if you exercise or if the weather is hot. Heavy sweating can cause dehydration (loss of too much water) or electrolyte imbalances (loss of sodium, potassium, or magnesium in the body).

This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

This medicine may cause serious kidney problems, including kidney stones. Check with your doctor right away if you have lower back or side pain, decreased frequency or amount of urine, bloody urine, increased thirst, loss of appetite, nausea, vomiting, unusual tiredness or weakness, swelling of the face, fingers, or lower legs, weight gain, or trouble breathing.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

What Are Reasons I Shouldn’t Take Maxzide?

This medication should not be used in someone with high potassium levels in the blood. If a person develops high potassium levels while taking this drug, the drug should be stopped, and hydrochlorothiazide or a thiazide alone should be used.

This medication should also not be prescribed for people with poor kidney function or those whose kidneys produce little to no urine.

Do not take Maxzide if you are hypersensitive to triamterene, hydrochlorothiazide, or other sulfonamide-derived drugs.

What Other Medications Interact With Maxzide?

Maxzide has several drug interactions to be aware of. Before starting treatment, tell your healthcare provider of all your over-the-counter (OTC), nonprescription medications, vitamins, herbal supplements, or prescription drugs.

Lithium is a medication that should not be given with Maxzide. It can increase the risk of lithium toxicity.

Acute kidney failure has been reported for a few people who have taken indomethacin, a type of nonsteroidal anti-inflammatory drug (NSAID), and the individual components of Maxzide together. Be cautious when taking an NSAID with Maxzide, and talk to your healthcare provider before considering the use of an NSAID.

Examples of common NSAIDs include:

Maxzide may add to or increase the effects of other blood pressure medications. This can occur if taking Maxzide with a type of blood pressure drug known as angiotensin-converting enzyme (ACE) inhibitors. Both ACE inhibitors and triamterene can cause potassium levels in the body to increase and lower blood pressure. Taking them at the same time can increase the risk of hyperkalemia.

Some examples of ACE inhibitors include:

Maxzide should under no circumstances be used with the following medications:

Used Maxzide with dofetilide can damage the heart muscle. High potassium levels can occur if using Maxzide in combination with spironolactone, eplerenone, or amiloride.

What Medications Are Similar?

Maxzide is a combination medication with a potassium-sparing agent and a thiazide diuretic used to treat high blood pressure in people at risk of developing low potassium levels.

Other diuretic medications include:

This is a list of medications that are also classified as diuretics. It is NOT a list recommended to take with Maxzide. Taking these drugs together can increase the risk of side effects. Talk to your healthcare provider or pharmacist if you have any questions. 

Frequently Asked Questions

  • How does Maxzide work?

    To understand how Maxzide works, it is important to understand how its components work.

    Hydrochlorothiazide works by blocking the reabsorption of sodium (salt) and chloride ions in the kidneys, which helps get rid of excess water. Its exact action in lowering high blood pressure is not fully known. However, it is believed to help lower blood pressure by eliminating excess salt in the body and preventing it from being absorbed back into the body.

    Triamterene works similarly but acts on a different part of the kidneys to block sodium reabsorption. Throughout the body, different types of proteins called channels are responsible for many bodily functions. By acting on this channel, triamterene causes a loss in sodium ions in exchange for a reduced loss of potassium and hydrogen ions. Triamterene is used to minimize how much potassium is lost from hydrochlorothiazide.

    Potassium is an important ion in the body that regulates many functions. Having too little potassium in the body, also known as hypokalemia, can cause serious life-threatening problems, like abnormal heart rhythms. 

  • How long does it take for Maxzide to work?

    Maxzide is a relatively quick-acting medication that takes about two hours after a dose to take effect.

  • How expensive is Maxzide? Is there a way I can get help paying for it?

    Maxzide is a moderately priced medication. It also has a generic equivalent that is both widely available and cheaper. Maxzide is covered by most insurance. How much you pay out of pocket may depend on your health insurance plan and pharmacy.

How Can I Stay Healthy While Taking Maxzide?

To stay healthy while taking Maxzide, use your medication exactly as directed by your healthcare provider. While it may be difficult to remember to take your doses, it's important to take them regularly to keep your blood pressure under control.

Additionally, check your blood pressure regularly. You can do this at a healthcare provider's office or at home. Your local pharmacies might also offer blood pressure testing. Keep track of your numbers to inform your healthcare provider if it continues to be too high.

Along with taking medication, make an effort to eat a healthier diet and work regular exercise into your routine. Consult your healthcare provider about the right eating and exercise plan for you. Often, lifestyle changes can make a difference in maintaining healthy blood pressure.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

The author would like to acknowledge and thank Cody Ryan Thomas for contributing to this article.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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