hydrochlorothiazide, Hydrodiuril, Ezide, Hydro-Par, Microzide, and many combinations
Pharmacy Author:
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmDDr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99. Medical and Pharmacy Editor:
Jay W. Marks, MD
Jay W. Marks, MDJay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
GENERIC NAME: hydrochlorothiazideBRAND NAMES: Hydrodiuril, Ezide, Hydro-Par, Microzide, and many combinations with other drugsDRUG CLASS AND MECHANISM: Hydrochlorothiazide is a diuretic (water pill) used for treating high blood pressure (hypertension) and accumulation of fluid. It works by blocking salt and fluid reabsorption in the kidneys, causing increased urine output (diuresis). The mechanism of its action in lowering high blood pressure is not well understood. PRESCRIPTION: Yes GENERIC AVAILABLE: Yes PREPARATIONS: Tablets: 12.5, 25, 50, and 100 mg; Capsules: 12.5 mg STORAGE: Hydrochlorothiazide should be stored at room temperature, 15 to 30 C (59 to 86 F), 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 also is used alone or in conjunction with other blood pressure lowering medications to treat high blood pressure. Although hydrochlorothiazide is approved for treating edema in cirrhosis of the liver, it is rarely used because of the availability of more potent diuretics that are more effective. Hydrochlorothiazide can be used to treat calcium-containing kidney stones because it decreases the amount of calcium excreted by the kidneys in the urine and thus decreases the amount of calcium in urine to form stones. DOSING: Hydrochlorothiazide may be taken with or without food. The usual adult dose for hypertension is 12.5 to 50 mg once daily. The usual adult dose for treating edema is 25-100 mg once daily or in divided doses. DRUG INTERACTIONS: Hydrochlorothiazide reduces the elimination of lithium (Lithobid) by the kidneys and can lead to lithium toxicity. Nonsteroidal antiinflammatory drugs, for example, ibuprofen, may reduce the blood pressure effects of hydrochlorothiazide. Blood sugar levels can be elevated by hydrochlorothiazide, necessitating adjustment in the doses of medications that are used for treating diabetes. Combining hydrochlorothiazide with corticosteroids may increase the risk for low levels of blood potassium and other electrolytes. Low blood potassium can increase the toxicity of digoxin (Lanoxin). Cholestyramine (Questran, Questran Light) and colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by 43%-85%. PREGNANCY: There are no adequate studies of hydrochlorothiazide in pregnant women. NURSING MOTHERS: Hydrochlorothiazide is excreted in breast milk. There is some evidence that it may reduce production of breast milk. SIDE EFFECTS: Side effects of hydrochlorothiazide include weakness, low blood pressure, light sensitivity (rash caused by sunlight), impotence, nausea, abdominal pain, electrolyte disturbances, pancreatitis, jaundice, anaphylaxis, and rashes, both mild and severe. Patients allergic to sulfa may also be allergic to hydrochlorothiazide because of the similarity in the chemical structure of the medications.
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Congestive Heart Failure
- Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
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Kidney Failure
- Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
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High Blood Pressure
- High blood pressure, also known as hypertension, is a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
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Edema
- Edema is the swelling of tissues as a result of excess water accumulations. Peripheral edema occurs in the feet and legs. There are two types of edema, non-pitting edema and pitting edema. Causes of pitting edema is caused by systemic diseases, most commonly involving the heart, liver, and kidneys. Local conditions that cause edema are thrombophlebitis and varicose veins. Edema is generally treated with medication.
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High Blood Pressure Treatment
- High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
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