Hydrochlorothiazide Tablets

Hydrochlorothiazide is a drug with a pronounced saluretic effect.

Like other saluretics, it has a diuretic effect, while acting throughout the ascending section of the loop of Henle (part of the renal tubule, going in the direction of the center of the kidney and surrounded by a branched network of capillaries that absorb water and throw soluble substances back into the bloodstream). It helps to increase the excretion of various salts, water and certain chemicals from the body.

On this page you will find all information about Hydrochlorothiazide: the full instruction on the application for this medicine, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used hydrochlorothiazide. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Thiazide diuretic.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is hydrochlorothiazide? The average price in pharmacies is at the level of60 rubles.

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Form of issue and composition

Tablets are white or almost white, flat-cylindrical, with a bevel.

Each tablet contains the active substance - hydrochlorothiazide - 25 mg; auxiliary substances: lactose monohydrate, talc, gelatin, calcium stearate, potato starch.

Pharmacological effect

Hydrochlorothiazide is a diuretic and saluretic. It blocks the reabsorption of sodium, chlorine and water ions in the distal tubules of the nephron. Increases the excretion of potassium, magnesium, bicarbonate ions; reduces the excretion of calcium in the urine as a result of direct action on the distal tubules, which can prevent the formation of calcium renal calculi.

The drug helps to reduce high blood pressure, causes a decrease in polyuria in patients with diabetes insipidus (the mechanism of action is finally unclear). In some cases, the drug lowers the intraocular pressure in glaucoma.

Indications for use

Hydrochlorothiazide is recommended for use in both complex and monotherapy patients:

Suffering from manifestations of hypertension;
With heart failure, accompanied by the development of edema;
With central diabetes insipidus;
With diabetes of a nephrogenic type;
Passing treatment with hormonal drugs (in particular, drugs containing estrogens and corticosteroids);
With cirrhosis of the liver accompanied by ascites;
In disorders of kidney function, including nephrotic syndrome, renal failure in chronic form, as well as acute form of glomerulonephritis;
With a subcompensated form of glaucoma.

Also, hydrochlorothiazide can be prescribed as a preventive agent that prevents the formation of calcium calculus in the kidneys in idiopathic hypercalciuria.

Contraindications

According to the instructions, hydrochlorothiazide is contraindicated in patients with hypersensitivity to sulfonamides and at the age of 3 years. The drug can also not be used in the following conditions:

Anuria;
Refractory hypokalemia, hyponatremia and hypercalcemia;
Severe hepatic impairment;
Severe renal dysfunction;
Severe forms of diabetes mellitus (difficult to control) and gout;
Addison's disease.

The use of hydrochlorothiazide is contraindicated in the first trimester of pregnancy and during breastfeeding.

Additional contraindications for medicinal forms that contain lactose are rare hereditary diseases, among which deficiency of lactase, lactose intolerance and glucose-galactose malabsorption.

Caution should be applied to the drug under the following conditions:

Progressive liver disease (increases the likelihood of developing a hepatic coma);
Hepatic insufficiency in mild and mild forms;
IHD;
Hypercalcemia;
Hypokalemia;
Hyponatremia;
Gout;
Cirrhosis of the liver (high probability of hypomagnesemia development);
Elderly age;
Combination with the use of cardiac glycosides;
The second and third trimesters of pregnancy.

Application in pregnancy and lactation

The use of hydrochlorothiazide tablets in the first trimester of pregnancy is strictly forbidden, as during this period the formation of organs and systems of the fetus occurs, and drugs can disrupt this process.

The use of the drug in the 2nd and 3rd trimesters of pregnancy is possible only after a thorough assessment of the benefit / risk indicators and under the strict supervision of the doctor.

The use of the drug in the period of breastfeeding is prohibited, because the active ingredients of the medicine can penetrate into breast milk, and then into the body of the child with food. If treatment with hydrochlorothiazide is necessary, lactation should be discontinued!

Instructions for use

The instructions for use indicate that hydrochlorothiazide is taken orally.

To reduce blood pressure, the drug is prescribed in a daily dose of 25-50 mg. As a rule, insignificant natriuresis and diuresis are noted on the first day of therapy. The drug is used continuously at the same time as other antihypertensive drugs: inhibitors angiotensin-converting enzyme (ACE), vasodilators, beta-blockers, sympatholytics. When the dose is increased from 25 to 100 mg, a proportional increase in natriuresis, diuresis and a decrease in blood pressure is usually observed. When taking hydrochlorothiazide in a single dose of more than 100 mg, further lowering of blood pressure and an increase in diuresis insignificant, with a disproportionate increase in the loss of electrolytes, especially Mg2 + and K +. An increase in the dose to 200 mg or more is not advisable, as there is no increase in diuresis.

With edematic syndrome, hydrochlorothiazide is prescribed in doses determined by the patient's condition and response to therapy. The daily dose can vary from 25 to 100 mg. The drug is taken once in the morning or in the morning in 2 divided doses. Elderly patients usually take 1-2 times a day for 12.5 mg.

Children from 2 months to 14 years of age, hydrochlorothiazide is prescribed at a rate of 1 mg / kg per day.

The maximum daily doses are determined by age:

Children under 6 months of age - 3.5 mg / kg;
Children under 2 years of age - 1, -3, mg;
Children 3-12 years old - 100 mg.

The daily dose is taken in 2-3 divided doses.

After 3-5 days of therapy, it is recommended to take a break for 3-5 days. As maintenance therapy in this dose, hydrochlorothiazide is prescribed 2 times a week. When using intermittent course of treatment with taking the drug after 1-3 days or for 2-3 days followed by break, side effects develop less often and a decrease in effectiveness is less pronounced.

To reduce intraocular pressure, hydrochlorothiazide is usually prescribed once every 1-6 days for 25 mg. As a rule, the effect develops after 1-2 days.

In diabetes insipidus, tablets should be taken 1-2 times a day for 25 mg with a gradual increase in the dose to 100 mg (until the therapeutic effect - reducing polyuria and thirst). In the future, a dose reduction is possible.

Side effects

When taking "hydrochlorothiazide" you need to be prepared for the possible development of side effects. Patients may experience the following problems.

The digestive tract. Vomiting, nausea, diarrhea, in rare cases - pancreatitis.
The hematopoiesis system. In rare cases, thrombocytopenia and neutropenia develop.
The cardiovascular system. Development of tachycardia, orthostatic hypotension.
Vision. Very rarely there are problems with vision: there is vagueness.
Nervous system. The appearance of weakness, dizziness, fatigue, paresthesia.
Endocrine system. The appearance of hyperglycemia due to the action of thiazides: they reduce the level of glucose tolerance, manifested latent diabetes.
System of metabolism. Lack of potassium, magnesium, sodium, the appearance of which indicates the appearance of dry mouth, nausea, as well as changes in heart rate, confusion, increased excitability.

In rare cases, when taking hydrochlorothiazide, allergic dermatitis occurs.

Overdose

Symptoms: hypokalemia (adynamia, paralysis, constipation, arrhythmia), drowsiness, lowering of blood pressure, tachycardia, shock, weakness, confusion, nausea, vomiting, thirst, polyuria, oliguria or anuria, hyponatremia, hypochloraemia, alkalosis, elevated blood urea nitrogen concentrations (especially in patients with chronic renal insufficiency).

Treatment: there is no specific antidote; induction of vomiting, gastric lavage, intake of activated carbon, infusion electrolyte solutions; compensation of K + deficiency (appointment of K + and potassium-sparing diuretics).

special instructions

Due to the fact that hydrochlorothiazide increases the excretion of magnesium in the urine, hypomagnesemia may develop.
It is established that the drug can reduce the amount of iodine binding to whey proteins. In this case, the patient may not show signs of impaired thyroid function.
In the instructions to the drug it is indicated that it is possible to avoid the development of hypokalemia by using potassium-containing agents and foods rich in K +.
When prescribing a drug for patients with chronic renal failure, periodic monitoring of the CC is required, since hydrochlorothiazide can accumulate and cause the development of azotemia. In cases of development of oliguria, it is recommended to consider the question of withdrawal of a medicinal product.
With prolonged use of hydrochlorothiazide is recommended in patients with diseases of the cardiovascular system and violations of liver function carefully monitor the clinical symptoms of disturbance of the water-electrolyte balance.
In the initial stage of therapy with hydrochlorothiazide, patients are advised to refrain from managing motor vehicles and complex mechanisms. Care should be taken in future when conducting potentially hazardous activities requiring increased attention.

Drug Interactions

With the simultaneous use of barbiturates, diazepam, ethanol, the risk of developing orthostatic hypotension increases.
With the simultaneous use of antihypertensive agents, nondepolarizing muscle relaxants, their effect is enhanced.
When used simultaneously with ACE inhibitors (including captopril, enalapril), the antihypertensive effect is enhanced.
With simultaneous application to the SCS, there is a risk of hypokalemia, as well as orthostatic hypotension.
Increased risk of impaired renal function. Development of hypokalemia is not ruled out.
With the simultaneous use of oral hypoglycemic drugs, their effectiveness decreases.
With simultaneous use with carbamazepine there are reports of the development of hyponatremia.
When used simultaneously with colestipol, colestyramin, the absorption and diuretic effect of hydrochlorothiazide decreases.
With simultaneous application of lithium carbonate, it is possible to increase the concentration of lithium salts in the blood to a toxic level
With simultaneous application with allopurinol, the risk of allergic reactions increases, especially in patients with impaired renal function.
With simultaneous use with digoxin, an increased risk of developing glycosidic intoxication is possible.
With simultaneous use with indomethacin, piroxicam, naproxen, phenylbutazone, a slight decrease in the hypotensive effect is possible.
With simultaneous application with irbesartan possible development of additive hypotensive effect.
With simultaneous application with orlistat diminishes the effectiveness of hydrochlorothiazide, which can lead to a significant increase in blood pressure and the development of hypertensive crisis.
Possible severe arterial hypotension, especially after taking the first dose of hydrochlorothiazide, apparently, due to hypovolemia, which leads to a transient enhancement of the hypotensive effect of the ACE inhibitor.
With the simultaneous use of calcium and / or vitamin D in high doses, hypercalcemia and the risk of developing metabolic acidosis due to a delay in the excretion of calcium in the urine under the influence of thiazide diuretics.
With simultaneous application with sotalol, hypokalemia and the development of ventricular arrhythmia such as "pirouette" are possible.

Reviews

Analyzing the feedback of patients using hydrochlorothiazide, one can come to the conclusion that the drug is used not only as a diuretic, but also as an antihypertensive drug.

Most women use the drug for edema caused by premenstrual syndrome - one tablet in the morning several days before menstruation.

As an antihypertensive drug, it is listed in the combination preparations: Enap N, Aritel plus, Capozid, Co-Diroton, Amprilan NL. The action is mutually reinforced; the dose of a diuretic is small, constant reception, recommended for hypertension, does not cause side effects.