Minor although the exact mechanism is uncertain, midodrine may be excreted by the same base-secreting pathway of the kidneys responsible for secretion of other basic drugs like triamterene.
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Abnormal elevation of serum potassium levelsgreater than or equal to 5.5 mEq/litercan occur with all potassium-conserving diuretic combinationsincluding MAXZIDEHyperkalemia is more likely to occur in patients with renal impairmentdiabeteseven without evidence of renal impairmentor elderly or severely ill patientsSince uncorrected hyperkalemia may be fatalserum potassium levels must be monitored at frequent intervals especially in patients first receiving MAXZIDEwhen dosages are changed or with any illness that may influence renal function.
Keep all appointments with your doctor and the laboratoryYour doctor will order certain lab tests to check your body’s response to triamterene.
MAXZIDEtriamterene and hydrochlorothiazidemay produce an elevated blood urea nitrogen levelBUNcreatinine level or bothThis is probably not the result of renal toxicity but is secondary to a reversible reduction of the glomerular filtration rate or a depletion of the intravascular fluid volumeElevations in BUN and creatinine levels may be more frequent in patients receiving divided dose diuretic therapyPeriodic BUN and creatinine determinations should be made especially in elderly patientspatients with suspected or confirmed hepatic disease or renal insufficienciesIf azotemia increasesMAXZIDEtriamterene and hydrochlorothiazideshould be discontinued.
Thiazides and triamterene have been shown to cross the placental barrier and appear in cord bloodThe use of thiazides and triamterene in pregnant women requires that the anticipated benefits be weighed against possible hazards to the fetusThese hazards include fetal or neonatal jaundicepancreatitisthrombocytopeniaand possibly other adverse reactions that have occurred in the adult.
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