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If hyperkalemia is suspectedwarning signs include paresthesiasmuscular weaknessfatigueflaccid paralysis of the extremitiesbradycardia and shockan electrocardiogramECGshould be obtainedHoweverit is important to monitor serum potassium levels because mild hyperkalemia may not be associated with ECG changes.

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.

The exact mechanism of hydrochlorothiazide’s antihypertensive action is not known although it may relate to the excretion and redistribution of body sodium.

Dizzinesslightheadednesstirednessheadachestomach upsetor diarrhea may occurIf any of these effects last or get worsetell your doctor or pharmacist promptly.

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