A comparison of the effects of hydrochlorothiazide and hydrochlorothiazide in combination with triamterene on electrolyte balance

Abstract

A comparison of hydrochlorothiazide alone and a combination of triamterene and hydrochlorothiazide in a ratio of 2:1 was made in 9 nonedematous patients, with the use of a metabolic balance technique. The results indicated that the mixture produces a greater natriuretic effect than can be produced by hydrochlorothiazide alone. However, whereas doubling the doses of the combination of 100 mg. of triamterene and 50 mg. of hydrochlorothiazide per day had no greater natriuretic effect, the doubled quantities did result in a greater reduction of potassium loss. These findings are of value in defining the manner in which such agents exert their activity on distal tubular transport systems. The use of triameterene and hydrochlorothiazide in combination tends to eliminate the undesirable effects of each of these agents on potassium and acid-base balance. Finally, the use of the combination as the first test agent exaggerated the difference between the ensuing natriuretic response and that produced by hydrochlorothiazide. These results indicated the importance of the order of drug administration in comparing diuretic efficacy in a crossover investigation.

The saluretic effect of the thiazide diuretic bemetizide in relation to the glomerular filtration rate

“…Thiazides are, however, relatively K + wasting [9,11]. This risk can be avoided by comedication with antikaliuretics [23,29]. In patients with renal disease, thiazides are usually replaced by loop diuretics.…”