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- Why is hydrochlorothiazide prescribed to patients?
- Do I need a prescription for hydrochlorothiazide?
- What brand names are available for hydrochlorothiazide?
- Is hydrochlorothiazide available as a generic drug?
- What are the side effects of hydrochlorothiazide?
- What is the dosage for hydrochlorothiazide?
- Which drugs or supplements interact with hydrochlorothiazide?
- Is hydrochlorothiazide safe to use during pregnancy or while breastfeeding?
- What else should I know about hydrochlorothiazide?
Why is hydrochlorothiazide prescribed to patients?
- 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 other 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.
What brand names are available for hydrochlorothiazide?
Hydrodiuril, Ezide, Hydro-Par, and Microzid are brand names that are no longer available in the US.
What are the side effects of hydrochlorothiazide?
Side effects of hydrochlorothiazide include
- low blood pressure,
- light sensitivity (rash caused by sunlight),
- nausea, and
- abdominal pain.
More serious side effects include
- electrolyte disturbances,
- jaundice, and
- anaphylaxis (a life-threatening allergic reaction).
Patients allergic to sulfa may also be allergic to hydrochlorothiazide because of the similarity in the chemical structure of the medications.
Hydrochlorothiazide can aggravate kidney dysfunction and is used with caution in patients with kidney disease. Hydrochlorothiazide can lower blood potassium, sodium, and magnesium levels. Low potassium and magnesium levels can lead to abnormalities in heart rhythm, especially in patients already taking digoxin (Lanoxin). During hydrochlorothiazide treatment, supplementation with potassium is common to prevent low potassium levels.
Blood uric acid levels can increase during hydrochlorothiazide treatment, and this elevation may cause an episode of acute gout in some individuals. Thiazide diuretics may increase blood sugar (glucose) levels and precipitate diabetes.
What is the dosage for hydrochlorothiazide?
- 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.
Which drugs or supplements interact with hydrochlorothiazide?
- Hydrochlorothiazide reduces the elimination of lithium (Lithobid, Eskalith) by the kidneys and can lead to lithium toxicity.
- Nonsteroidal anti-inflammatory 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%.
Is hydrochlorothiazide safe to use during pregnancy or while breastfeeding?
- 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.
- 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.
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What else should I know about hydrochlorothiazide?
What preparations of hydrochlorothiazide are available?
- Tablets: 12.5, 25, 50 and 100 mg
- Capsules: 12.5 mg
How should I keep hydrochlorothiazide stored?
Hydrochlorothiazide should be stored at room temperature, 15 C to 30 C (59 F to 86 F), in a tight, light-resistant container.
How does hydrochlorothiazide work?
- Hydrochlorothiazide is a diuretic (water pill) used for treating high blood pressure (hypertension) and accumulation of fluid (edema). It works by blocking salt and fluid reabsorption from the urine in the kidneys, causing increased urine output (diuresis). Its mechanism of action in lowering high blood pressure is not well understood.
- Hydrochlorothiazide is used in combination with many other drugs
When was hydrochlorothiazide approved by the FDA?
- The FDA approved hydrochlorothiazide in February 1959.
Hydrochlorothiazide (Microzide, Hydrodiuril, Ezide, and Hydro-Par have been discontinued) is a diuretic drug prescribed to treat
- high blood pressure,
- edema caused by heart failure,
- chronic kidney failure,
- nephrotic syndrome, and
- corticosteroid medications.
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Kidney (Renal) Failure
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include 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.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin (jaundice), itching, and fatigue. The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
The First Signs of Kidney Stones (Nephrolithiasis)
Kidney stones are solid masses of crystalline material that form in the kidneys. Symptoms of kidney stones can include pain, nausea, vomiting, and even fever and chills. Kidney stones are diagnosed via CT scans and specialized X-rays. Treatment of kidney stones involves drinking lots of fluids and taking over-the-counter pain medications to medical intervention including prescription medications, lithotripsy, and sometimes even surgery.
Congestive Heart Failure (CHF)
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
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High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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