From the Guidelines
Maxzide should be used with caution if you have gout, as it contains hydrochlorothiazide which can worsen gout symptoms. This medication, which combines triamterene and hydrochlorothiazide, is primarily used to treat high blood pressure and fluid retention. The hydrochlorothiazide component can increase uric acid levels in the blood, potentially triggering or exacerbating gout attacks 1.
Key Considerations
- If you have gout and need blood pressure medication, your doctor might recommend alternative medications that don't affect uric acid levels, such as ACE inhibitors, ARBs, or calcium channel blockers 1.
- According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline, thiazide or thiazide-type diuretics, such as hydrochlorothiazide, should be used with caution in patients with a history of acute gout unless the patient is on uric acid–lowering therapy 1.
- The EULAR evidence-based recommendations for gout suggest stopping diuretics if possible and considering alternative antihypertensive treatment without diuretics, such as losartan, which has a uricosuric action 1.
Management Options
- If Maxzide is deemed necessary for your condition, your doctor may prescribe additional medications to control your uric acid levels, such as allopurinol or febuxostat.
- Always inform your healthcare provider about your gout history before starting any new medication, and report any increased joint pain or swelling while taking Maxzide.
- It is essential to weigh the benefits and risks of using Maxzide in patients with gout and to closely monitor their condition to minimize the risk of exacerbating gout symptoms 1.
From the Research
Gout and Maxzide Interaction
- Maxzide is a combination of triamterene and hydrochlorothiazide, which is a thiazide diuretic.
- Thiazide diuretics can increase uric acid levels, which may worsen gout symptoms 2.
- The use of loop and thiazide diuretics can increase the risk of gout flares by increasing uric acid levels 2.
- There is no direct evidence that Maxzide is contraindicated in patients with gout, but caution should be exercised when using thiazide diuretics in patients with gout due to the potential for increased uric acid levels.
Alternative Treatment Options
- Patients with gout should be treated with medications that reduce uric acid levels, such as allopurinol or febuxostat, to prevent recurrent flares 2, 3.
- Nonsteroidal anti-inflammatory drugs, corticosteroids, or colchicine can be used to relieve pain in adults with acute gout episodes 4, 5.
- Comprehensive patient education and counseling, as well as regular laboratory follow-up, are important components of gout treatment 4.
Safety Considerations
- Clinicians should be aware of the safety concerns of medications used to treat acute and chronic gout, particularly in patients with comorbidities such as chronic kidney disease or cardiovascular disease 6.
- The benefits of gout medications usually outweigh their safety concerns, but studies are needed to better understand the safety issues associated with gout treatment in patients with comorbidities 6.