GENERIC NAME: hydrochlorothiazide

BRAND NAMES: Hydrodiuril, and multiple combinations with other drugs.

DRUG CLASS AND MECHANISM: Hydrochlorothiazide is a diuretic (water pill). It works by blocking salt and fluid reabsorption in the kidneys, causing increased urine output (diuresis). It has also been used in treating mild high blood pressure, even though the mechanism of blood pressure lowering is not well understood.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Tablets: 25mg, 50mg, 100mg.

STORAGE: Should be stored at room temperature in a tight, light resistant container.

PRESCRIBED FOR: Hydrochlorothiazide is used to treat excessive fluid accumulation and swelling (edema) of the body caused by heart failure, cirrhosis, chronic kidney failure, corticosteroid medications, and nephrotic syndrome. It is sometimes used alone or in conjunction with other blood pressure pills to treat high blood pressure. Hydrochlorothiazide can be used to treat calcium containing kidney stones by decreasing the amount of calcium excreted in the urine.

DOSING: May be taken with or without food.

DRUG INTERACTIONS: Hydrochlorothiazide is eliminated rapidly by the kidneys and the dosage may have to be reduced in kidney dysfunction. It should be used with caution in patients with liver disease because of fluid and electrolyte problems.

Patients allergic to sulfa may also be allergic to hydrochlorothiazide because of a similarity in the chemical structure of the medications. Hydrochlorothiazide can aggravate kidney dysfunction, and is used with caution in patients with kidney disease. Even though hydrochlorothiazide is important in treating excess fluid accumulation in patients with cirrhosis, loss of fluid and electrolytes in these patients can worsen kidney function and even cause the patient to go into a coma. Hydrochlorothiazide can cause lowering of blood potassium, sodium, and magnesium levels. Low potassium and magnesium levels can lead to heart rhythm abnormalities, especially in patients already taking digoxin (Lanoxin). Please visit digoxin (Lanoxin) site for further information. Potassium supplementation is common during hydrochlorothiazide treatment.

Blood uric acid levels can increase during hydrochlorothiazide treatment, but precipitation of acute gout is rare. Hydrochlorothiazide reduces the kidney excretion of lithium and can lead to lithium toxicity. Blood sugar levels can be elevated, necessitating adjustment in the doses of oral diabetic medications and insulin. Periodic blood tests are performed to monitor kidney function and electrolytes during treatment with hydrochlorothiazide. Safe use in children has not been established.

PREGNANCY: Safe use in pregnancy has not established.

SIDE EFFECTS: Side effects include weakness, low blood pressure, rash, light sensitivity, impotence, nausea, abdominal pain, electrolyte disturbances, pancreatitis, jaundice, anaphylaxis, and severe rashes.

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Last Editorial Review: 12/31/1997