hydrochlorothiazide
enUKhy·dro·chlo·ro·thi·a·zide
H0343750 (hī′drə-klôr′ə-thī′ə-zīd′)| Noun | 1. | hydrochlorothiazide - a diuretic drug (trade name Microzide, Esidrix, and HydroDIURIL) used in the treatment of hypertension |
hydrochlorothiazide
enUKhydrochlorothiazide
[hi″dro-klor″o-thi´ah-zīd]hydrochlorothiazide
Pharmacologic class: Thiazide diuretic
Therapeutic class: Diuretic, antihypertensive
Pregnancy risk category B
Action
Increases sodium and water excretion by inhibiting sodium reabsorption in distal tubules; promotes excretion of chloride, potassium, magnesium, and bicarbonate. Also may produce arteriolar dilation, reducing blood pressure.
Availability
Capsules: 12.5 mg
Oral solution: 10 mg/ml, 100 mg/ml
Tablets: 12.5 mg, 25 mg, 50 mg, 100 mg
Indications and dosages
➣ Edema caused by heart failure, renal dysfunction, cirrhosis, corticosteroid therapy, or estrogen therapy
Adults: 25 to 100 mg P.O. daily as a single dose or in divided doses. Maximum dosage is 200 mg/day.
➣ Mild to moderate hypertension
Adults: Initially, 12.5 mg daily P.O.; then, based on blood pressure response, may give 12.5 to 50 mg/day P.O. Higher dosages may be given in refractory cases.
Children ages 2 to 12: 1 to 2 mg/kg/day P.O. in single dose or two divided doses, not to exceed 100 mg/day
Children younger than age 2: 1 to 2 mg/kg P.O. as single dose or divided doses, not to exceed 37.5 mg/day; infants less than age 6 months may require dosage of 3 mg/kg/day in two divided doses.
Off-label uses
• Hypercalcemia
• Ménière's disease
Contraindications
• Hypersensitivity to drug, other thiazides, sulfonamides, or tartrazine
• Renal decompensation or anuria
Precautions
Use cautiously in:
• renal or severe hepatic impairment, fluid or electrolyte imbalances, gout, systemic lupus erythematosus, hyperparathyroidism, glucose tolerance abnormalities, bipolar disorder
• elderly patients
• pregnant or breastfeeding patients.
Administration
• Give with food or milk if GI upset occurs.
• Administer early in day so diuretic effect doesn't disturb sleep.
Adverse reactions
CNS: dizziness, drowsiness, lethargy, headache, insomnia, nervousness, vertigo, asthenia, asterixis, paresthesias, confusion, fatigue, encephalopathy
CV: chest pain, orthostatic hypotension, ECG changes, thrombophlebitis, arrhythmias
EENT: nystagmus
GI: nausea, vomiting, epigastric distress, anorexia, pancreatitis
GU: polyuria, nocturia, erectile dysfunction, loss of libido, renal failure
Hematologic: anemia, hemolytic anemia, agranulocytosis, leukopenia, thrombocytopenia
Hepatic: jaundice, hepatitis
Metabolic: dehydration, gout, hyperglycemia, hypokalemia, hypocalcemia, hypovolemia, hypomagnesemia, hyponatremia, hypophosphatemia, hyperuricemia, hypochloremic alkalosis
Musculoskeletal: muscle cramps
Skin: photosensitivity, urticaria, rash, dermatitis, purpura, alopecia, flushing
Other: fever, weight loss, anaphylaxis
Interactions
Drug-drug. Adrenocorticotropic hormone, corticosteroids: increased risk of intensified electrolyte depletion, particularly hypokalemia
Allopurinol: increased risk of hypersensitivity reaction
Amphotericin B, corticosteroids, digoxin, mezlocillin, piperacillin, ticarcillin: increased risk of hypokalemia
Antihypertensives, barbiturates, nitrates, opioids: increased hypotension
Cholestyramine, colestipol: decreased hydrochlorothiazide absorption
Digoxin: increased risk of hypokalemia
Insulin, oral hypoglycemics: possible decreased hypoglycemic effect
Lithium: decreased excretion and increased blood level of lithium
Nondepolarizing skeletal muscle relaxants (such as tubocurarine): increased skeletal muscle relaxant effect
Nonsteroidal anti-inflammatory drugs: decreased hydrochlorothiazide efficacy
Vasopressors: decreased pressor effect
Drug-diagnostic tests. Bilirubin, blood and urine glucose (in diabetic patients), calcium, creatinine, uric acid: increased levels
Cholesterol, low-density lipoproteins, magnesium, potassium, protein-bound iodine, sodium, triglycerides, urinary calcium: decreased levels
Drug-herbs. Dandelion: interference with diuretic activity
Ginkgo: decreased antihypertensive effect
Licorice, stimulant laxative herbs (aloe, cascara sagrada, senna): increased risk of hypokalemia
Drug-behaviors. Alcohol use: increased hypotension
Sun exposure: increased risk of photo-sensitivity
Patient monitoring
• Monitor blood pressure, fluid intake and output, and daily weight.
• Assess electrolyte levels, especially potassium. Monitor for signs and symptoms of hypokalemia.
• Monitor blood urea nitrogen and creatinine levels.
• Check blood glucose level in diabetic patients.
• Assess for signs and symptoms of gout attacks in patients with gouty arthritis.
Patient teaching
• Advise patient to take with food or milk if GI upset occurs.
• Tell patient to take early in day to avoid nighttime urination.
• Instruct patient to track intermittent doses on calendar.
• Tell patient to weigh himself daily, at same time on same scale and wearing same clothes.
See Instruct patient to report decreased urination, swelling, unusual bleeding or bruising, dizziness, fatigue, numbness, and muscle weakness or cramping.
• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.
hy·dro·chlo·ro·thi·a·zide
(hī'drō-klōr'ō-thī'ă-zīd),hydrochlorothiazide
(hī′drə-klôr′ə-thī′ə-zīd′)hy·dro·chlo·ro·thi·a·zide
(hī'drō-klōr'ō-thī'ă-zīd)hydrochlorothiazide
A drug used to increase the output of urine so as to relieve the body of surplus water. A thiazide DIURETIC drug. The drug is on the WHO official list. A brand name is Hydrosaluric. Hydrochlorothiazide is formulated in conjunction with a variety of drugs. It is available with potassium under the brand name Amil-Co; with another diuretic as Dyazide, Moduret 25, Moduretic, Triam-Co; with ANGIOTENSIN CONVERTING ENZYME inhibitor drugs as Accuretic, Acezide, Capozide, Carace 10 Plus, Innozide and Zestoretic 20; with BETA BLOCKER drugs as Co-Betaloc, Kalten, Moducren and Monozide 10; and with an angiotensin II antagonist drug as Cozaar-Comp.hy·dro·chlo·ro·thi·a·zide
(hī'drō-klōr'ō-thī'ă-zīd)hydrochlorothiazide
enUK- noun
Synonyms for hydrochlorothiazide
noun a diuretic drug (trade name Microzide, Esidrix, and HydroDIURIL) used in the treatment of hypertension
Synonyms
- Esidrix
- HydroDIURIL
- Microzide
Related Words
- Maxzide
- thiazide