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Does Microzide (hydrochlorothiazide) cause side effects?
Microzide (hydrochlorothiazide) is a diuretic 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.
Microzide 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. Although Microzide 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.
Common side effects of Microzide include
- low blood pressure,
- light sensitivity (rash caused by sunlight),
- nausea, and
- abdominal pain.
Serious side effects of Microzide include
- electrolyte disturbances,
- yellowing skin and eyes (jaundice), and
- life-threatening allergic reaction (anaphylaxis).
- Nonsteroidal anti-inflammatory drugs (NSAIDs), for example, ibuprofen, may reduce the blood pressure lowering effects of Microzide.
- Blood sugar levels can be elevated by Microzide, necessitating adjustment in the doses of medications that are used for treating diabetes.
- Combining Microzide 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. Cholestyramine and colestipol bind to Microzide and reduce its absorption from the gastrointestinal tract by 43% to 85%.
There are no adequate studies of Microzide in pregnant women. Thiazide diuretics may increase the risk of fetal or neonatal jaundice, low platelet levels, and possibly other adverse reactions that have occurred in adults.
Microzide is excreted in breast milk. Intense diuresis using Microzide may reduce the production of breast milk. Otherwise Microzide is considered safe to use during breastfeeding if required by the mother. Consult your doctor before breastfeeding.
What are the important side effects of Microzide (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.
Microzide (hydrochlorothiazide) side effects list for healthcare professionals
The adverse reactions associated with hydrochlorothiazide have been shown to be dose related. In controlled clinical trials, the adverse events reported with doses of 12.5 mg hydrochlorothiazide once daily were comparable to placebo. The following adverse reactions have been reported for doses of hydrochlorothiazide 25 mg and greater and, within each category, are listed in the order of decreasing severity.
- Body as a whole: Weakness.
- Cardiovascular: Hypotension including orthostatic hypotension (may be aggravated by alcohol, barbiturates, narcotics or antihypertensive drugs).
- Digestive: Pancreatitis, jaundice (intrahepatic cholestatic jaundice), diarrhea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia.
- Hematologic: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia.
- Hypersensitivity: Anaphylactic reactions, necrotizing angiitis (vasculitis and cutaneous vasculitis), respiratory distress including pneumonitis and pulmonary edema, photosensitivity, fever, urticaria, rash, purpura.
- Metabolic: Electrolyte imbalance (see PRECAUTIONS), hyperglycemia, glycosuria, hyperuricemia.
- Musculoskeletal: Muscle spasm.
- Nervous System/Psychiatric: Vertigo, paresthesia, dizziness, headache, restlessness.
- Renal: Renal failure, renal dysfunction, interstitial nephritis (see WARNINGS).
- Skin: Erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis, alopecia.
- Special Senses: Transient blurred vision, xanthopsia.
- Urogenital: Impotence.
Whenever adverse reactions are moderate or severe, thiazide dosage should be reduced or therapy withdrawn.
What drugs interact with Microzide (hydrochlorothiazide)?
When given concurrently the following drugs may interact with thiazide diuretics:
- Alcohol, barbiturates, or narcotics: potentiation of orthostatic hypotension may occur.
- Antidiabetic drugs: (oral agents and insulin) dosage adjustment of the antidiabetic drug may be required.
- Other antihypertensive drugs: additive effect or potentiation.
- Cholestyramine and colestipol resins: Cholestyramine and colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively.
- Corticosteroid, ACTH: intensified electrolyte depletion, particularly hypokalemia.
- Pressor amines (e.g., norepinephrine): possible decreased response to pressor amines but not sufficient to preclude their use.
- Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): possible increased responsiveness to the muscle relaxant.
- Lithium: generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and greatly increase the risk of lithium toxicity. Refer to the package insert for lithium preparations before use of such preparations with MICROZIDE (hydrochlorothiazide capsule) .
- Non-steroidal anti-inflammatory drugs: In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. When MICROZIDE (hydrochlorothiazide capsule) and non-steroidal anti-inflammatory agents are used concomitantly, the patients should be observed closely to determine if the desired effect of the diuretic is obtained.
Drug/Laboratory Test Interactions
- Thiazides should be discontinued before carrying out tests for parathyroid function.
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Related Disease Conditions
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.
High Blood Pressure (Hypertension)
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.
Primary Biliary Cirrhosis (PBC)
Primary Biliary Cirrhosis (PBS) is a liver disease in which bile building up in the organ damages bile ducts. Ultimately, this can cause liver failure. A number of drugs are available to treat this disease of unknown cause, but the only ultimate cure is a liver transplant.
Portal hypertension is most commonly caused by cirrhosis, a disease that results from scarring of the liver. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from the liver to the heart, and a parasitic infection called schistosomiasis. Symptoms of portal hypertension include varices (enlarged veins), vomiting blood, blood in the stool, black and tarry stool, ascites (abnormal fluid collection within the peritoneum, the sac that contains the intestines within the abdominal cavity), confusion and lethargy, splenomegaly or enlargement of the spleen, and decreased white blood cell counts.
Pulmonary hypertension is elevated pressure in the pulmonary arteries that carry blood from the lungs to the heart. The most common symptoms are fatigue and difficulty breathing. If the condition goes undiagnosed, more severe symptoms may occur. As pulmonary hypertension worsens, some people with the condition have difficulty performing any activities that require physical exertion. While there is no cure for pulmonary hypertension, it can be managed and treated with medications and supplemental oxygen to increase blood oxygen levels.
Second Source article from Government
Hypertension-Related Kidney Disease
Second Source WebMD Medical Reference
Hypertensive Kidney Disease
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
Is There a Cure for Cirrhosis of the Liver?
Liver cirrhosis results from disease- or chemical-induced injury to the liver over a sustained period. The injury kills liver cells, and your body attempts to rebuild the damage. In the process, the existing cells are inflamed and scar tissue results, compromising the structure of the liver and hampering its function.
Primary Biliary Cirrhosis (PBC) Treatment
Primary biliary cirrhosis (PBC) is thought to be an autoimmune disorder that involves the deterioration of the liver's small bile ducts. These ducts are crucial to transport bile to the small intestine, digesting fats and removing wastes. Symptoms of PBC are edema, itching, elevated cholesterol, malabsorption of fat, liver cancer, gallstones, urinary tract infections (UTIs), and hypothyroidism. Treatments include ursodeoxycholic acid (UDCA); colchicine (Colcrys); and immunosuppressive medications, such as corticosteroids; obeticholic acid (Ocaliva); and medications that treat PBC symptoms. For PBC that is associated with cirrhosis of the liver, liver transplantation may be indicated in extreme cases.
Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)
Pseudotumor Cerebri (intracranial hypertension) is a condition where there is an increase in pressure of fluid surrounding the brain and spinal cord (cerebrospinal fluid or CSF) mimicing a brain tumor. The cause is unknown. The most common symptom is headache but also include eye-pain, vision loss and double vision. Pseudotumor cerebri is diagnosed with MRI or CAT scans and treated by discontinuing offending medications (if applicable), weight loss and diuretic medications. The condition can also be helped by repeated drainage of spinal fluid using the lumbar puncture.
Preeclampsia (Pregnancy Induced Hypertension)
Preeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
Hypertension-Induced Chronic Kidney Disease
Hypertension-induced chronic kidney disease (CKD) is a long-standing kidney condition that develops over time due to persistent or uncontrolled high blood pressure (hypertension).
What Is High Blood Pressure (Hypertension)?
High blood pressure or hypertension is when the blood pressure readings consistently range from 140 or higher for systolic or 90 or higher for diastolic. Blood pressure readings above 180/120 mmHg are dangerously high and require immediate medical attention.
Treatment & Diagnosis
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