Hydrochlorothiazide

Brand names: ATACAND HCT, Benazepril Hydrochloride and Hydrochlorothiazide, Diovan HCT, Enalapril Maleate and Hydrochlorothiazide, Lotensin HCT, Moexipril Hydrochloride and Hydrochlorothiazide, Valsartan and Hydrochlorothiazide, Ziac, benazepril hydrochloride and hydrochlorothiazide, bisoprolol fumarate and hydrochlorothiazide, Hydrochlorothiazide, HYDROCHLOROTHIAZIDE, hydrochlorothiazide, INZIRQO

Warnings

Key warnings include: - "Use with caution in severe renal disease" as thiazides may precipitate azotemia - Caution advised with impaired hepatic function due to risk of hepatic coma - Risk of systemic lupus erythematosus exacerbation reported - "Lithium generally should not be given with diuretics" due to toxicity risk - Potential electrolyte imbalances requiring monitoring (hypokalemia, hyponatremia, hypochloremic alkalosis)

Contraindications

CONTRAINDICATIONS Hydrochlorothiazide is contraindicated in patients with anuria. Hypersensitivity to this product or other sulfonamide derived drugs is also contraindicated.

Overdose

OVERDOSAGE The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias. In the event of overdosage, symptomatic and supportive measures should be employed. Emesis should be induced or gastric lavage performed. Correct dehydration, electrolyte imbalance, hepatic coma and hypotension by established procedures. If required, give oxygen or artificial respiration for respiratory impairment. The degree to which hydrochlorothiazide is removed by hemodialysis has not been established. The oral LD 50 of hydrochlorothiazide is greater than 10 g/kg in the mouse and rat.

Drug interactions

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 hydrochlorothiazide capsules. 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 hydrochlorothiazide capsules 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 (see PRECAUTIONS , General ).

Uses

Hydrochlorothiazide is indicated for edema management associated with congestive heart failure, hepatic cirrhosis, and corticosteroid/estrogen therapy, as well as edema from renal dysfunction. It's also used to manage hypertension "either as the sole therapeutic agent or to enhance the effectiveness of other antihypertensive drugs."

Dosage forms & strengths

Tablet Tablet, Film Coated TABLET POWDER CAPSULE CAPSULE, GELATIN COATED POWDER, FOR SUSPENSION SOLUTION

BENAZEPRIL HYDROCHLORIDE 10 mg HYDROCHLOROTHIAZIDE 12.5 mg BENAZEPRIL HYDROCHLORIDE 20 mg HYDROCHLOROTHIAZIDE 25 mg BISOPROLOL FUMARATE 5 mg HYDROCHLOROTHIAZIDE 6.25 mg CANDESARTAN CILEXETIL 32 mg ENALAPRIL MALEATE 5 mg hydrochlorothiazide 12.5 mg HYDROCHLOROTHIAZIDE 50 mg BISOPROLOL FUMARATE 2.5 mg MOEXIPRIL HYDROCHLORIDE 15 mg VALSARTAN 160 mg VALSARTAN 320 mg VALSARTAN 80 mg HYDROCHLOROTHIAZIDE 12.5 mg/1 HYDROCHLOROTHIAZIDE 25 mg/1 HYDROCHLOROTHIAZIDE 1 kg/kg HYDROCHLOROTHIAZIDE 50 mg/1 HYDROCHLOROTHIAZIDE 25 kg/25kg HYDROCHLOROTHIAZIDE 10 mg/mL HYDROCHLOROTHIAZIDE 50 mg/5mL HYDROCHLOROTHIAZIDE 100 kg/100kg HYDROCHLOROTHIAZIDE 1 g/g HYDROCHLOROTHIAZIDE 50 kg/50kg

DOSAGE AND ADMINISTRATION For Control of Hypertension: The adult initial dose of hydrochlorothiazide capsules, USP is one capsule given once daily whether given alone or in combination with other antihypertensives. Total daily doses greater than 50 mg are not recommended.