From the Guidelines
Dyazide, a combination of hydrochlorothiazide and triamterene, is a suitable treatment option for patients with hypertension and fluid retention, as evidenced by its inclusion in the list of combination drugs for hypertension 1. When considering the use of Dyazide, it's essential to weigh the potential benefits against the risks, including adverse metabolic effects and the potential for thiazide-induced hypokalemia, which could contribute to increased ventricular ectopy and possible sudden death, particularly with high doses of thiazides in the absence of a potassium-sparing agent 1. Key points to consider when prescribing Dyazide include:
- Monitoring potassium levels to avoid hypokalemia
- Staying hydrated to prevent dehydration
- Avoiding excessive sun exposure due to the increased risk of sunburn
- Being aware of potential side effects like dizziness, headache, or electrolyte imbalances The typical dosage of Dyazide is 1-2 capsules daily, with each capsule containing 37.5 mg triamterene and 25 mg hydrochlorothiazide, as listed in the combination drugs for hypertension table 1. It's crucial to consult with a healthcare provider for personalized advice on using Dyazide, as treatment duration and specific patient conditions can vary greatly. In terms of morbidity, mortality, and quality of life, the use of Dyazide as part of a comprehensive treatment plan for hypertension can help reduce the risk of cardiovascular events and improve overall patient outcomes, as seen in studies like ALLHAT, which compared the effects of different antihypertensive medications on cardiovascular outcomes 1.
From the Research
Dyazide Menderes
- Dyazide is a combination formulation of triamterene and hydrochlorothiazide, used to treat patients with mild to moderate hypertension 2.
- The absorption and disposition of Dyazide have been compared to another combination formulation, Maxzide, in patients with essential hypertension, showing marked impairment in the absorption of hydrochlorothiazide and triamterene from Dyazide 3.
- Studies have shown that triamterene enhances the blood pressure lowering effect of hydrochlorothiazide in patients with hypertension, with a mean systolic BP reduction of 3.8 mmHg 4.
- A comparison of the anti-hypertensive effectiveness of Maxzide and Dyazide found no difference in blood pressures at any time during the study between the two agents, despite the difference in bioavailability of the hydrochlorothiazide component 5.
Key Findings
- The new combination formulation of triamterene and hydrochlorothiazide (Maxzide) maintained normal serum electrolyte values, including potassium, with no or minor changes in the levels of uric acid, creatinine, and blood urea nitrogen 2.
- The absorption of hydrochlorothiazide and triamterene from Dyazide is impaired compared to Maxzide, with approximately two-thirds and half as bioavailable, respectively 3.
- Triamterene's ability to lower blood pressure should be considered in addition to its potassium-sparing action 4.
- The difference in bioavailability of the hydrochlorothiazide component between Maxzide and Dyazide did not translate into enhanced hypotensive efficacy 5.