hydrochlorothiazide, (Hydrodiuril, Ezide, Hydro-Par [discontinued]), Microzide, and many others (cont.)

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Medical and Pharmacy Editor:

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, Eskalith) by the kidneys and can lead to lithium toxicity. Nonsteroidal antiinflammatory drugs (NSAIDs), for example, ibuprofen (Motrin), may reduce the blood pressure lowering 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 (hypokalemia) 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% to 85%.

PREGNANCY: There are no adequate studies of hydrochlorothiazide in pregnant women. Thiazides may increase the risk of fetal or neonatal jaundice, low platelet levels, and possibly other adverse reactions that have occurred in adults.

NURSING MOTHERS: Hydrochlorothiazide is excreted in breast milk. Intense diuresis using hydrochlorothiazide may reduce the production of breast milk. Otherwise hydrochlorothiazide is considered safe to use during nursing if required by the mother.

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 (a life-threatening allergic reaction), 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.

Medically Reviewed by a Doctor on 3/27/2013


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