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What is triamterene-hctz. Triamterene-HCTZ: A Comprehensive Guide to Uses, Side Effects, and Precautions

by alexxlab

What are the primary uses of Triamterene-HCTZ. How does this medication work to treat high blood pressure. What are the potential side effects and precautions associated with Triamterene-HCTZ. How should patients take this medication for optimal effectiveness.

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Understanding Triamterene-HCTZ: A Dual-Action Diuretic

Triamterene-HCTZ is a combination medication that plays a crucial role in managing hypertension and fluid retention. This powerful drug combines two diuretics: triamterene and hydrochlorothiazide (HCTZ). Together, they work synergistically to help the body eliminate excess salt and water, effectively lowering blood pressure and reducing edema.

Why is this combination particularly effective? Triamterene helps retain potassium, while HCTZ tends to deplete it. By combining these two diuretics, the medication maintains a delicate balance of electrolytes in the body, making it especially useful for patients at risk of developing low potassium levels when using HCTZ alone.

The Science Behind Triamterene-HCTZ

How exactly does Triamterene-HCTZ work in the body? The hydrochlorothiazide component inhibits the reabsorption of sodium and chloride in the distal convoluted tubules of the kidneys. This action increases the excretion of sodium, chloride, and water. Meanwhile, triamterene blocks the sodium channels in the collecting duct, further enhancing sodium and water excretion while simultaneously reducing potassium loss.

This dual mechanism of action results in several beneficial effects:

  • Reduced blood volume
  • Decreased cardiac output
  • Lowered peripheral vascular resistance
  • Maintenance of potassium levels

Primary Uses and Benefits of Triamterene-HCTZ

Triamterene-HCTZ is primarily prescribed for the treatment of hypertension, or high blood pressure. By effectively lowering blood pressure, this medication plays a vital role in preventing serious health complications such as strokes, heart attacks, and kidney problems.

Are there other conditions that Triamterene-HCTZ can help manage? Indeed, this versatile medication is also used to reduce edema (fluid retention) associated with various conditions, including:

  • Heart failure
  • Liver disease
  • Kidney disease

By reducing excess fluid in the body, Triamterene-HCTZ can alleviate symptoms such as shortness of breath and swelling in the ankles or feet, significantly improving patients’ quality of life.

The Importance of Blood Pressure Control

Why is controlling blood pressure so crucial? Hypertension is often called the “silent killer” because it typically has no symptoms but can lead to severe health complications if left untreated. By effectively managing blood pressure, Triamterene-HCTZ helps reduce the risk of:

  1. Cardiovascular disease
  2. Stroke
  3. Kidney damage
  4. Vision problems
  5. Cognitive decline

Proper Administration and Dosage Guidelines

How should patients take Triamterene-HCTZ for optimal effectiveness? This medication is typically taken orally once daily, preferably in the morning. It can be taken with or without food, but consistency is key. Patients should aim to take the medication at the same time each day to maintain steady blood levels and maximize its therapeutic effects.

Is there a specific time frame to avoid taking Triamterene-HCTZ? Yes, it’s best to avoid taking this medication within 4 hours of bedtime to prevent nighttime urination, which could disrupt sleep patterns.

Special Considerations for Dosage

The dosage of Triamterene-HCTZ is not one-size-fits-all. It’s carefully determined based on several factors, including:

  • The patient’s medical condition
  • Response to treatment
  • Other medications being taken
  • Overall health status

Can patients adjust their dosage on their own? It’s crucial for patients to follow their doctor’s instructions precisely and not alter their dosage without medical supervision. Even if they feel well, continuing the medication as prescribed is essential for maintaining blood pressure control.

Potential Side Effects and Monitoring

While Triamterene-HCTZ is generally well-tolerated, like all medications, it can cause side effects. Common side effects may include:

  • Dizziness
  • Lightheadedness
  • Headache
  • Upset stomach

These effects often subside as the body adjusts to the medication. However, if they persist or worsen, patients should consult their healthcare provider.

Serious Side Effects to Watch For

While rare, some side effects of Triamterene-HCTZ require immediate medical attention. These include:

  • Muscle weakness
  • Slow or irregular heartbeat
  • Severe dizziness or fainting
  • Decrease in vision or eye pain
  • Signs of kidney problems (such as changes in urine output)

Why is monitoring potassium levels crucial when taking Triamterene-HCTZ? This medication can potentially raise the body’s potassium levels, especially in certain at-risk groups. High potassium levels (hyperkalemia) can lead to serious, potentially fatal side effects. Regular blood tests to monitor potassium levels are often recommended for patients on this medication.

Drug Interactions and Precautions

Triamterene-HCTZ can interact with various medications and substances, potentially altering its effectiveness or increasing the risk of side effects. Some notable interactions include:

  • Cholesterol-lowering drugs (bile acid-binding resins)
  • Potassium supplements
  • Certain pain relievers (NSAIDs)
  • Lithium
  • Alcohol

How can patients minimize the risk of drug interactions? It’s crucial for patients to inform their healthcare provider about all medications, supplements, and herbal products they’re taking. In some cases, dosage adjustments or alternative treatments may be necessary.

Special Precautions for Certain Groups

Some individuals may need extra caution or monitoring when taking Triamterene-HCTZ. These groups include:

  • People with diabetes
  • Individuals with kidney disease
  • Older adults
  • Those with a history of gout
  • Patients with liver disease
  • Individuals with lupus

Why is extra caution needed for these groups? These conditions can affect how the body processes and responds to the medication, potentially increasing the risk of side effects or complications.

Lifestyle Considerations While Taking Triamterene-HCTZ

While Triamterene-HCTZ is effective in managing hypertension and edema, it’s most beneficial when combined with healthy lifestyle choices. Patients can optimize their treatment by:

  • Maintaining a balanced, low-sodium diet
  • Engaging in regular physical activity
  • Managing stress effectively
  • Limiting alcohol consumption
  • Quitting smoking

Why is limiting sodium intake particularly important when taking Triamterene-HCTZ? This medication works by helping the body eliminate excess sodium and water. A high-sodium diet can counteract these effects, potentially reducing the medication’s effectiveness in controlling blood pressure.

Hydration and Electrolyte Balance

Proper hydration is crucial when taking Triamterene-HCTZ. While the medication helps eliminate excess fluid, it’s still important to maintain adequate hydration. Patients should be aware of signs of dehydration, such as:

  • Excessive thirst
  • Dry mouth
  • Decreased urine output
  • Dizziness or lightheadedness

How can patients ensure proper hydration without counteracting the medication’s effects? It’s about finding the right balance. Patients should drink when thirsty and pay attention to their body’s signals. In hot weather or during intense physical activity, extra fluid intake may be necessary.

Long-Term Management and Follow-Up Care

Successfully managing hypertension with Triamterene-HCTZ requires ongoing care and monitoring. Patients should:

  • Attend regular follow-up appointments with their healthcare provider
  • Have their blood pressure checked regularly
  • Undergo periodic blood tests to monitor electrolyte levels and kidney function
  • Report any new symptoms or side effects promptly

Why is consistent follow-up care so important? Blood pressure management is an ongoing process. Regular check-ups allow healthcare providers to assess the medication’s effectiveness, make necessary adjustments, and catch any potential issues early.

The Importance of Medication Adherence

Adhering to the prescribed Triamterene-HCTZ regimen is crucial for effective blood pressure control. Patients should:

  • Take the medication consistently as prescribed
  • Not skip doses, even if feeling well
  • Use reminders or pill organizers if needed
  • Communicate with their healthcare provider about any concerns or difficulties with the medication

What are the potential consequences of poor medication adherence? Inconsistent use of Triamterene-HCTZ can lead to fluctuations in blood pressure, potentially increasing the risk of complications associated with uncontrolled hypertension.

In conclusion, Triamterene-HCTZ is a powerful tool in managing hypertension and edema. By understanding its uses, proper administration, potential side effects, and necessary precautions, patients can maximize the benefits of this medication while minimizing risks. As with any medical treatment, open communication with healthcare providers and a commitment to overall health and wellness are key to achieving optimal results.

Triamterene-HCTZ Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

This medication can raise your body’s potassium levels. The risk for this is higher for people with diabetes or kidney disease, older adults, or during severe illness. High potassium levels can cause serious (rarely fatal) side effects. Tell your doctor right away if you have any of these serious side effects: muscle weakness, slow/irregular heartbeat.

Warnings:

This medication can raise your body’s potassium levels. The risk for this is higher for people with diabetes or kidney disease, older adults, or during severe illness. High potassium levels can cause serious (rarely fatal) side effects. Tell your doctor right away if you have any of these serious side effects: muscle weakness, slow/irregular heartbeat.

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Uses

This drug is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This medication is a combination of two “water pills” (diuretics): triamterene and hydrochlorothiazide. This combination is used by people who have developed or are at risk for having low potassium levels on hydrochlorothiazide. It causes you to make more urine, which helps your body get rid of extra salt and water.This medication also reduces extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, or kidney disease. This can lessen symptoms such as shortness of breath or swelling in your ankles or feet.

How to use Triamterene-HCTZ Capsule

Take this medication by mouth with or without food as directed by your doctor, usually once daily in the morning. It is best to avoid taking this medication within 4 hours of your bedtime to prevent having to get up to urinate.

If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take this product at least 4 hours before or at least 4 to 6 hours after these medications.

The dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings increase).

Side Effects

See also Warning section.

Dizziness, lightheadedness, headache, or upset stomach may occur as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This product may cause your body to lose too much water and salt (dehydration). Tell your doctor right away if you notice any symptoms of dehydration, such as unusual dry mouth/thirst, fast heartbeat, or dizziness/lightheadedness.

Tell your doctor right away if you have any serious side effects, including: fainting, muscle cramps/weakness, slow/fast/irregular heartbeat, decrease in vision, eye pain, signs of kidney problems (such as change in the amount of urine).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking this medication, tell your doctor or pharmacist if you are allergic to triamterene or hydrochlorothiazide; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, gout, high level of potassium in the blood, kidney disease (including kidney stones), liver disease, lupus, skin cancer.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Severe sweating, diarrhea, or vomiting can increase the risk for lightheadedness or dehydration. Report prolonged diarrhea or vomiting to your doctor. To prevent dehydration, drink plenty of fluids unless your doctor directs you otherwise.

If you have diabetes, this product may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This medication may affect your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

This medication may make you more sensitive to the sun. It may also increase your risk for skin cancer, especially if you take it for a long time. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned, have skin blisters/redness, or notice new or changed moles/skin lesions.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the effects of this drug, especially dizziness, or high blood potassium levels.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.

It is unknown if triamterene passes into breast milk. Hydrochlorothiazide passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Interactions

See also How to Use and Precautions sections.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: dofetilide, lithium, other drugs that may increase potassium levels (such as spironolactone, amiloride, cyclosporine).

Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

This medication may interfere with certain laboratory tests (including parathyroid function), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Does Triamterene-HCTZ Capsule interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

Do not share this medication with others.

Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Lab and/or medical tests (such as kidney function, potassium levels, skin exams) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure, and share the results with your doctor.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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Drug Survey

Are you currently using Triamterene-HCTZ Capsule?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Hydrochlorothiazide and Triamterene | Memorial Sloan Kettering Cancer Center

Adult Medication

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Dyazide [DSC]; Maxzide; Maxzide-25

Brand Names: Canada

APO-Triazide; TEVA-Triamterene/HCTZ

Warning

  • Sometimes, this drug may raise potassium levels in the blood. This can be deadly if it is not treated. The risk is highest in people with diabetes, kidney disease, severe illness, and in older adults. Your doctor will follow you closely to change the dose if needed.

What is this drug used for?

  • It is used to treat high blood pressure.
  • It is used to get rid of extra fluid.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have a sulfa allergy.
  • If you have any of these health problems: Diabetes, high potassium levels, kidney disease, or trouble passing urine.
  • If you are not able to pass urine.
  • If you are taking dofetilide.
  • If you are taking lithium.
  • If you are taking any of these drugs: Amiloride, spironolactone, or another drug that has triamterene in it.
  • If you are taking a salt substitute that has potassium in it, a potassium-sparing diuretic, or a potassium product, talk with your doctor.
  • If you are breast-feeding. Do not breast-feed while you take this drug.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
  • If you have high blood sugar (diabetes), talk with your doctor. This drug may raise blood sugar.
  • Check your blood sugar as you have been told by your doctor.
  • Tell your doctor if you have signs of high blood sugar like confusion, feeling sleepy, unusual thirst or hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
  • Check your blood pressure as you have been told.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • If you are on a low-salt or salt-free diet, talk with your doctor.
  • Talk with your doctor before you use alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
  • Watch for gout attacks.
  • If you have lupus, this drug can make your lupus active or get worse. Tell your doctor right away if you get any new or worse signs.
  • This drug may make you sunburn more easily. Use care if you will be in the sun. Tell your doctor if you sunburn easily while taking this drug.
  • Tell your doctor if you have too much sweat, fluid loss, throwing up, or loose stools. This may lead to low blood pressure.
  • Rarely, low blood cell counts have happened with this drug. Call your doctor right away if you have any unexplained bruising or bleeding; signs of infection like fever, chills, or sore throat; or feel very tired or weak.
  • This drug can cause certain eye problems. If left untreated, this can lead to lasting eyesight loss. If eye problems happen, signs like change in eyesight or eye pain most often happen within hours to weeks of starting this drug. Call your doctor right away if you have these signs.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this drug while you are pregnant.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of fluid and electrolyte problems like mood changes, confusion, muscle pain or weakness, fast or abnormal heartbeat, severe dizziness or passing out, increased thirst, seizures, feeling very tired or weak, decreased appetite, unable to pass urine or change in the amount of urine produced, dry mouth, dry eyes, or severe upset stomach or throwing up.
  • Signs of too much acid in the blood (acidosis) like confusion; fast breathing; fast heartbeat; a heartbeat that does not feel normal; very bad stomach pain, upset stomach, or throwing up; feeling very sleepy; shortness of breath; or feeling very tired or weak.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
  • Back pain, belly pain, or blood in the urine. May be signs of a kidney stone.
  • Dark urine or yellow skin or eyes.
  • A burning, numbness, or tingling feeling that is not normal.
  • Restlessness.
  • Shortness of breath.
  • Chest pain or pressure.
  • Fast or slow heartbeat.
  • Not able to get or keep an erection.
  • Mood changes.
  • Rarely, certain types of skin cancer have happened in people taking hydrochlorothiazide. Protect your skin from the sun, and have your skin checked as you have been told by your doctor. Call your doctor right away if you have a change in color or size of a mole, or any new or changing skin lump or growth.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Constipation, diarrhea, upset stomach, throwing up, or decreased appetite.
  • Headache.
  • Feeling dizzy, sleepy, tired, or weak.
  • Increased appetite.
  • Change in taste.
  • Stomach cramps.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • This drug may cause you to pass urine more often. To keep from having sleep problems, try not to take too close to bedtime.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

  • Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2020-09-21

Copyright

© 2023 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022

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