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The development of hyperkalemia associated with potassium-sparing diuretics is accentuated in the presence of renal impairmentsee CONTRAINDICATIONSPatients with mild renal functional impairment should not receive this drug without frequent and continuing monitoring of serum electrolytesCumulative drug effects may be observed in patients with impaired renal functionThe renal clearances of hydrochlorothiazide and the pharmacologically active metabolite of triamterenethe sulfate ester of hydroxytriamterenehave been shown to be reduced and the plasma levels increased following MAXZIDEtriamterene and hydrochlorothiazideadministration to elderly patients and patients with impaired renal function.

MAXZIDE should not be given to patients receiving other potassium-conserving agents such as spironolactoneamiloride hydrochloride or other formulations containing triamtereneConcomitant potassium supplementation in the form of medicationpotassium-containing salt substitute or potassium-enriched diets should also not be used.

Lithium generally should not be given with diuretics because they reduce its renal clearance and add a high risk of lithium toxicityRefer to the package insert on lithium before use of such concomitant therapy.

Before using this medicationtell your doctor or pharmacist your medical historyespecially ofkidney problemssuch as kidney stonesliver diseasemineral imbalancesuch as high potassium blood levellow sodium blood levelloss of too much body waterdehydrationgoutconditions causing low folic acid blood levelssuch as alcoholic cirrhosispregnancy

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