What is the effect of Dayzide (Triamterene and Hydrochlorothiazide)?

From the Guidelines

Dayazide is a suitable treatment option for patients with high blood pressure and edema, particularly those at risk of hypokalemia, as it combines hydrochlorothiazide and triamterene to maintain potassium balance while reducing fluid volume. The typical dosage is one or two tablets daily, with each tablet containing 25mg hydrochlorothiazide and 37.5mg or 50mg triamterene 1. This medication works by increasing urine output to reduce fluid volume while maintaining potassium balance. Patients should take Dayazide in the morning to avoid nighttime urination disrupting sleep. Common side effects include dizziness, headache, and gastrointestinal disturbances. It's essential to monitor potassium levels while taking this medication since it affects electrolyte balance. Patients should stay well-hydrated but avoid excessive potassium intake from supplements or salt substitutes. Those with kidney disease, liver problems, or diabetes should use this medication with caution and under close medical supervision. Regular blood pressure monitoring and follow-up appointments are crucial to ensure the medication is working effectively.

Some key considerations when using Dayazide include:

• Monitoring potassium levels to avoid hyperkalemia or hypokalemia
• Avoiding excessive potassium intake from supplements or salt substitutes
• Using caution in patients with kidney disease, liver problems, or diabetes
• Regular blood pressure monitoring and follow-up appointments to ensure the medication is working effectively
• Being aware of potential side effects, such as dizziness, headache, and gastrointestinal disturbances

According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline, thiazide diuretics like hydrochlorothiazide are preferred for their prolonged half-life and proven trial reduction of cardiovascular disease 1. However, it's essential to consider the potential risks and benefits of using Dayazide, particularly in patients with multiple metabolic risk factors, and to weigh these against the benefits of other treatment options. The European guidelines on cardiovascular disease prevention in clinical practice also support the use of thiazide diuretics, but recommend caution in patients with multiple metabolic risk factors due to their dyslipidaemic and diabetogenic effects 1. Overall, Dayazide can be a valuable treatment option for patients with high blood pressure and edema, but its use should be carefully considered and monitored by a healthcare professional.

From the FDA Drug Label

Triamterene can cause mild nitrogen retention, which is reversible upon withdrawal of the drug, and is seldom observed with intermittent (every-other-day) therapy. INFORMATION FOR PATIENTS To help avoid stomach upset, it is recommended that the drug be taken after meals If a single daily dose is prescribed, it may be preferable to take it in the morning to minimize the effect of increased frequency of urination on nighttime sleep.

The drug name is Dayazide, but based on the provided information, it seems that Dayazide is another name for Triamterene.

• Indication: The provided text does not specify the indication for Dayazide.
• Dosage: The text does not provide a specific dosage for Dayazide, but it does mention that if a single daily dose is prescribed, it may be preferable to take it in the morning.
• Administration: It is recommended to take the drug after meals to help avoid stomach upset 2.
• Side effects: Possible side effects include mild nitrogen retention, nausea, vomiting, and other G.I. disturbances 2 2.

From the Research

Dayazide Overview

• Dayazide is a combination of potassium-sparing diuretics with hydrochlorothiazide, commonly used by hypertensive patients 3.
• The formulation contains 50 mg triamterene and 25 mg hydrochlorothiazide, but its absorption is markedly reduced, which may affect its effectiveness 3.

Efficacy and Safety

• Studies have shown that triamterene enhances the blood pressure lowering effect of hydrochlorothiazide in patients with hypertension 4.
• The combination of triamterene and hydrochlorothiazide has been found to be effective in reducing blood pressure in patients with mild systemic hypertension 5.
• However, the efficacy of triamterene in hospitalized patients with heart failure and diuretic resistance is still unclear, with one study showing no significant improvement in outcomes 6.

Mechanism of Action

• Triamterene works by inhibiting the epithelial sodium channel (ENaC) in the cortical collecting duct, reducing potassium secretion and the risk of hypokalemia 4.
• Hydrochlorothiazide and triamterene have been found to have modulatory effects on resistant hypertension patients, reversing changes in pressure-natriuresis curves and improving important indices such as plasma aldosterone and renin activity 7.

Comparison with Other Formulations

• Maxzide tablets, containing 75 mg triamterene and 50 mg hydrochlorothiazide, have been found to have enhanced bioavailability compared to Dyazide capsules 3.
• The safety of Maxzide tablets has been evaluated in hypertensive patients, with no clinically significant changes in blood urea nitrogen, creatinine, or uric acid levels 3.