Hydrochlorothiazide is a diuretic agent intended for the treatment of diseases of the cardiovascular system.
Release form and composition
Hydrochlorothiazide is produced in the form of round white tablets, in blisters of 10 pieces.
One tablet contains 25 or 100 mg of hydrochlorothiazide.
Indications for use
Hydrochlorothiazide is used to control polyuria mainly in nephrogenic diabetes insipidus, treatment of edematous syndrome of various origins, as well as in the following cases:
- Preventing the formation of stones in the urinary tract.
The use of Hydrochlorothiazide is contraindicated in cases of hypersensitivity to the components included in its composition. The drug is not prescribed for diabetes, chronic renal failure, anuria, Addison's disease, hyponatremia, severe liver failure, hypercalcemia, refractory hypokalemia and children under 3 years of age.
Also, hydrochlorothiazide is contraindicated in the first trimester of pregnancy and during the breastfeeding period.
With caution, the drug is prescribed to patients with ischemic heart disease, hypokalemia, hyponatremia, hypercalcemia, gout, mild and moderate hepatic insufficiency and in the following cases:
- Cirrhosis of the liver;
- Simultaneous administration of cardiac glycosides;
- Pregnancy (second and third trimester);
- Progressive liver disease.
Hydrochlorothiazide is also prescribed with caution in elderly patients.
Dosing and Administration
The drug is taken orally with a small amount of water after meals. The dosage of hydrochlorothiazide for lowering blood pressure is 1-2 tablets (25 mg) per day for 21-28 days.
In cases of edema syndrome, 1-4 tablets are prescribed per day, taken once (preferably in the morning) or 1 time in 2 days. Further, depending on the clinical response, the dose is reduced to 1-2 tablets 1 time per day or 2 days.
The dose of hydrochlorothiazide with premenstrual syndrome is 1 tablet per day. The remedy is taken from the onset of symptoms to the onset of menstruation. To prevent the formation of stones, patients take 2 tablets twice a day.
Elderly patients are prescribed half a tablet (12.5 mg) once or twice a day. For children aged three years and older, the dose is calculated on the basis of a proportion of 1-2 mg of an agent per 1 kg of body weight per day, or 30-60 mg of the preparation per 1 sq. M. body surface once a day.
In cases of nephrogenic diabetes insipidus, the daily dose of the drug is 50-150 mg, divided into several doses. Tablets are taken until a therapeutic effect is achieved (reduction of polyuria and thirst), then the dose of hydrochlorothiazide can be reduced.
The instructions for hydrochlorothiazide indicate that the drug can cause hypercalcemia, electrolyte imbalance, hypomagnesemia, hypochloremic alkalosis, hypokalemia, and also:
- Stevens-Johnson Syndrome;
- Respiratory Distress Syndrome;
- Anaphylactic reactions (up to shock);
- Hemolytic and aplastic anemia;
- Allergic reactions;
- Necrotizing vasculitis.
During therapy with hydrochlorothiazide, cholestatic jaundice, hyperuricemia, pancreatitis, anorexia, constipation, cholecystitis, diarrhea, dizziness, glycosuria, headache, sialadenitis, photosensitization, interstitial nephritis and arrhythmias can occur.
Symptoms of a drug overdose include blood pressure reduction, hypochloremia, hypokalemia, drowsiness, oliguria or anuria, hyponatremia, tachycardia, shock, confusion, weakness, polyuria, nausea and vomiting. In such cases, gastric lavage, induction of vomiting, the appointment of activated carbon, potassium-containing drugs and potassium-sparing diuretics, as well as infusion of electrolyte solutions are required.
With prolonged use of Hydrochlorothiazide is recommended in patients with diseases of the cardiovascular system and impaired liver function to carefully monitor the clinical symptoms of water and electrolyte imbalance.
The instructions for the drug indicated that it is possible to avoid the development of hypokalemia by using potassium-containing agents and foods rich in K +.
Due to the fact that hydrochlorothiazide increases the excretion of magnesium in the urine, it is possible the development of hypomagnesemia.
When prescribing the drug to patients with chronic renal insufficiency, periodic monitoring of QC is necessary, since Hydrochlorothiazide may accumulate and cause the development of azotemia. In cases of development of oliguria, it is recommended to consider the abolition of the drug.
It is established that the drug can reduce the amount of iodine that binds to serum proteins. In this case, the patient may not experience signs of dysfunction of the thyroid gland.
In the initial stage of therapy with Hydrochlorothiazide, patients are advised to refrain from driving vehicles and complex mechanisms. In the future, in the conduct of potentially hazardous activities requiring increased attention, care must be taken.
Synonyms of the drug are Dichlothiazide and Hypothiazide. Analogous to hydrochlorothiazide is cyclomethiazide.
Terms and conditions of storage
The instructions for hydrochlorothiazide indicate that the drug should be stored in a well-ventilated, dry, out of reach of children and protected from light, at a temperature not exceeding 25 ° C.
From pharmacies, the drug is released on prescription. The shelf life of tablets, subject to the recommendations of the manufacturer, is five years.