💊 Hydrochlorothiazide (Hydrochlorothiazide)

🏷️ Brand names & manufacturers

Hydrochlorothiazide🏭 Aurobindo Pharma LimitedDailyMed

Hydrochlorothiazide🏭 ScieGen Pharmaceuticals, Inc.DailyMed

Hydrochlorothiazide🏭 Westminster Pharmaceuticals, LLCDailyMed

✅ What it is used for

• Adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy
• Edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure
• Management of hypertension, alone or to enhance the effectiveness of other antihypertensive drugs in more severe forms
• Edema during pregnancy when due to pathologic causes (not routine use in normal pregnancy)

🧪 Active ingredient

Hydrochlorothiazide: acts on the distal renal tubule to increase excretion of sodium and chloride, producing diuresis. Some potassium and bicarbonate loss may accompany this.

🌿 Benefits

• Reduces swelling caused by fluid retention
• Lowers high blood pressure
• Diuresis begins within about 2 hours, peaks in about 4 hours, and lasts about 6 to 12 hours

📝 How to use

• Tablets are taken by mouth
• Your doctor or pharmacist sets the dose according to your response, using the smallest dose needed
• For edema, your doctor may prescribe daily or intermittent dosing (e.g., alternate days or 3 to 5 days a week)
• Do not change the dose or stop the medicine on your own

💊 Dosage forms

• Tablets of 12.5 mg, 25 mg and 50 mg (the product described here is a peach, round 12.5 mg tablet)

🔄 Drug interactions

• Lithium: generally should not be given with diuretics
• Other antihypertensive drugs: effect may be increased
• Alcohol, barbiturates, narcotics: may aggravate orthostatic hypotension
• Digitalis: hypokalemia may accentuate cardiac arrhythmias
• Tell your doctor or pharmacist about all medicines you take

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👨‍⚕️ For healthcare professionals

Mechanism of action

Affects the distal renal tubular mechanism of electrolyte reabsorption, increasing sodium and chloride excretion in approximately equivalent amounts; natriuresis may be accompanied by loss of potassium and bicarbonate. The mechanism of the antihypertensive effect is unknown, and it does not usually affect normal blood pressure. Not metabolized; eliminated rapidly by the kidney (at least 61% unchanged within 24 hours); plasma half-life 5.6 to 14.8 hours. Crosses the placenta but not the blood-brain barrier; excreted in breast milk.

Labeled dosing

Adults: edema 25–100 mg daily as a single or divided dose, with intermittent schedules possible. Hypertension: initial 25 mg daily, which may be increased to 50 mg daily as a single or two divided doses; doses above 50 mg are often associated with marked reductions in serum potassium. Therapy is individualized by response and the dose is set by the doctor/pharmacist.

• Children: 1–2 mg/kg/day in one or two doses, not exceeding 37.5 mg/day in infants up to 2 years or 100 mg/day in children 2–12 years; up to 3 mg/kg/day in two divided doses may be required in infants under 6 months
• Monitor electrolytes, especially at higher doses
• Intermittent dosing makes excessive response and electrolyte imbalance less likely
• In overdose: induce emesis or perform gastric lavage; correct dehydration, electrolyte imbalance, hepatic coma and hypotension; the degree of removal by hemodialysis has not been established

🎓 Key points for students

• Class: thiazide diuretic
• Increases Na+ and Cl- excretion with possible K+ and HCO3- loss
• Onset ~2 h, peak ~4 h, duration 6–12 h
• Not metabolized; renally eliminated
• Contraindications: anuria, sulfonamide hypersensitivity
• Warnings: acute myopia/angle-closure glaucoma, non-melanoma skin cancer, lupus, hepatic coma
• Lithium generally should not be given with diuretics