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Any chloride deficit during thiazide therapy is generally mild and usually does not require any specific treatment except under extraordinary circumstancesas in liver disease or renal diseaseDilutional hyponatremia may occur in edematous patients in hot weatherappropriate therapy is water restrictionrather than administration of saltexcept in rare instances when the hyponatremia is life threateningIn actual salt depletionappropriate replacement is the therapy of choice.

Triamterene is a potassium-conservingantikaliureticdiuretic with relatively weak natriuretic propertiesIt exerts its diuretic effect on the distal renal tubule to inhibit the reabsorption of sodium in exchange for potassium and hydrogenWith this actiontriamterene increases sodium excretion and reduces the excessive loss of potassium and hydrogen associated with hydrochlorothiazideTriamterene is not a competitive antagonist of the mineralocorticoids and its potassium-conserving effect is observed in patients with Addison’s diseasei.ewithout aldosteroneTriamterene’s onset and duration of activity is similar to hydrochlorothiazideNo predictable antihypertensive effect has been demonstrated with triamterene.

MAXZIDE should be used with caution in patients with impaired hepatic function or progressive liver diseasesince minor alterations of fluid and electrolyte balance may precipitate hepatic coma.

Hypersensitivity to triamterene Anuriasevere liver diseaseand kidney failure Hyperkalemia Concomitant use with potassium sparing diureticor potassium supplementation.

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