Hydrochlorothiazide

5
Hydrochlorothiazide
Brands

DEA Class; Rx

Common Brand Names; Microzide, HydroDiuril, Hydro, Esidrix, HCTZ, Oretic

  • Diuretics, Thiazide

Thiazide diuretic
Used to treat edema and hypertension
Often used in combination with other agents

Indicated for the treatment of hypertension.

For use as an adjunctive agent to treat peripheral edema associated with congestive heart failure, hepatic cirrhosis (ascites), corticosteroid therapy, or estrogen therapy; or to treat edema associated with renal dysfunction including nephrotic syndrome, acute glomerulonephritis, and chronic renal failure.
For the treatment of nephrogenic or central diabetes insipidus.
For the prevention of nephrolithiasis (calcium-containing renal calculus) due to hypercalciuria.
For the treatment of symptoms of bloating and weight gain associated with premenstrual syndrome (PMS).

Documented hypersensitivity to hydrochlorothiazide or sulfonamides

Anuria

  • Anaphylaxis
  • Anorexia
  • Confusion
  • Disorder of hematopoietic structure
  • Dizziness
  • Epigastric distress
  • Fatigue
  • Headache
  • Hepatotoxicity
  • Hypercalcemia
  • Hypercholesterolemia
  • Hyperglycemia
  • Hyperlipidemia
  • Hyperuricemia
  • Hypokalemia
  • Hypomagnesemia
  • Hypotension
  • Interstitial nephritis
  • Metabolic acidosis
  • Muscle weakness or cramps
  • Nausea
  • Necrotizing angiitis
  • Pancreatitis
  • Phototoxicity
  • Pneumonitis
  • Pulmonary edema
  • Purpura
  • Rash
  • Respiratory distress
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • Vertigo
  • Vomiting
  • Xanthopsia

Use with caution in diabetes mellitus, fluid or electrolyte imbalance, hypercholesterolemia, hyperuricemia or gout, hypercalcemia, hypotension, systemic lupus erythematosus, liver or renal disease, hypokalemia, parathyroid disease

May aggravate digitalis toxicity

Sensitivity reactions may occur with or without history of allergy or asthma

Avoid concurrent use with lithium (reduction of lithium dosage by 50% may be necessary)

Risk of male sexual dysfunction

Causes systemic lupus exacerbation or activation

Azotemia may occur with severe renal disease

Acute transient myopia and acute angle-closure glaucoma have been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is sulfonamide)

FDA-approved product labeling for many medications have included a broad contraindication in patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely to occur

Photosensitization may occur; instruct patients to protect skin from sun and undergo regular skin cancer screening

Electrolyte disturbances (eg, hypokalemia, hyponatremia, hypochloremic alkalosis) may occur

Pregnancy category: B

Lactation: Drug excreted in breast milk; use with caution (American Academy of Pediatrics states that it is “compatible with nursing”)

Adults

50 mg/day PO for hypertension; 100 mg/day PO for edema.

Geriatric

50 mg/day PO for hypertension; 100 mg/day PO for edema.

Adolescents

50 mg/day PO for hypertension; 100 mg/day PO for edema.

Children

2—12 years: 2 mg/kg/day PO, not to exceed 100 mg/day.
1—< 2 years: 2 mg/kg/day PO, not to exceed 37.5 mg/day.

Infants

>= 6 months: 2 mg/kg/day PO, not to exceed 37.5 mg/day.
< 6 months: 3 mg/kg/day PO per the manufacturer; up to 3.3 mg/kg/day PO is recommended by some experts for hypertension.

Neonates

3 mg/kg/day PO per the manufacturer; up to 3.3 mg/kg/day PO is recommended by some experts for hypertension.

Hydrochlorothiazide

tablet/capsule

  • 12.5mg
  • 25mg
  • 50mg
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