What is this medicine?
HYDROCHLOROTHIAZIDE; TRIAMTERENE (hye droe klor oh THYE a zide; trye AM ter een) is a diuretic. It helps you make more urine and lose the extra water from your body. This medicine is used to treat high blood pressure and edema or swelling from excess water.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions such as skin rash or itching, hives, swelling of the lips, mouth, tongue, or throat
• fast or irregular heartbeat, chest pain
• feeling faint or dizzy
• gout attack
• muscle pain or cramps
• numbness or tingling in hands, feet, or lips
• pain or difficulty when passing urine
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• shortness of breath
• unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• blurred vision
• decreased sexual function
• dry mouth
• headache
• stomach upset

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I use this medicine?
Take this medicine by mouth with a glass of water. Follow the directions on your prescription label. You may take this medicine with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed.

Remember that you will need to pass urine frequently after taking this medicine. Do not take your doses at a time of day that will cause you problems. Do not take at bedtime.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?
Do not take this medicine with any of the following medications:

• eplerenone

This medicine may also interact with the following medications:

• cyclosporine
• heart medicines like ACE inhibitors, digoxin, dofetilide, eplerenone, angiotensin II antagonists, and medicines for blood pressure
• lithium
• medicines for diabetes
• medicines for inflammation like indomethacin
• medicines that relax muscles for surgery
• other diuretics
• potassium
• sotalol
• tacrolimus

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?
Visit your doctor or health care professional for regular check ups. You will need lab work done before you start this medicine and regularly while you are taking it. Check your blood pressure regularly. Ask your health care professional what your blood pressure should be, and when you should contact them. If you are a diabetic, check your blood sugar as directed. Do not stop taking your medicine unless your doctor tells you to.

You may need to be on a special diet while taking this medicine. Ask your doctor. Also, ask how many glasses of fluid you need to drink a day. You must not get dehydrated.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid or limit alcoholic drinks.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:

• diabetes
• immune system problems, like lupus
• kidney disease or stones
• liver disease
• small amount of urine or difficulty passing urine
• an unusual or allergic reaction to triamterene, hydrochlorothiazide, sulfa drugs, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

Can I stop taking the medication if I feel better?
Even though you may feel better you should not stop taking your high blood pressure medication without first checking with your healthcare provider.

I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.