Hydrochlorothiazide

Hydrochlorothiazide is a prototype drug of thiazide diuretics. Hydrochlorothiazide is antihypertensive agent. It increases the urination and reduces the amount of water and sodium retained by the body. The drugs in this class are formally called benzothiadiazide, usually shortened to thiazides. The nature of the hetrocyclic rings and the substitution on these ring may vary among the congeners but all of them retain a unsubstituted sulfonamide group. Development of thiazides and other modern diuretics began when a perceptive physician noticed that patients receiving sulfanilamide, an early antimicrobial agent, developed metabolic acidosis and a very alkaline urine. Careful study revealed that the drug was causing sodium bicarbonate diuresis. The realization that it could be useful diuretic led first to the development of acetazolamide and then to the thiazides.


Brands
CAPOZIDE DYAZIDE ZESTORETIC 20 HYZAAR MODURETIC ALDACTAZIDE ALDACTAZIDE CO-ZEAL CO-RENITEC CO-EZIDAY CO-EZIDAY XAVOR-DIU DOSURETIC CO-CARDIOTEC SPIRAZIDE SPIRAZIDE SPIRAZIDE SPIRAZIDE SPIRAZIDE SPIRAZIDE LOSASCOT PLUS BLAZE PLUS DIU-TANSIN FORTZAAR DIUZA OSRAN-TZ SARTAN-H CONSERVE TENOZIDE UROZIDE CO-DIOVAN CO-DIOVAN CO-DIOVAN NORMOZIDE LOSAR PLUS BEPSAR PLUS LOPEC-H CO AMOTAC ARTAZIDE LOSARTEC PLUS LOSAAN-H ZAMLO-H REVLOC REVLOC REVLOC PLUS GIOZAR-D ADVANTEC CO-TRUPRIL CORRECT LOTENSE-H SARCOL-H LOPLUS CARDAKTIN-H CARDACE-H CANTA-D RAPOSIN-D IRECON-H IRECON-H CO-APROVEL CO-APROVEL GLUTAN-DIU CARTEX-H CO-ACEARTIN CO-A2A CO-A2A LARSEN-T LOSAN PLUS DIASTOLIC H CANSAAR PLUS CO-TASMI CO-TASMI LAMORETIC MOUZIDE NORMISAR EXFORGE HCT EXFORGE HCT EXFORGE HCT EXFORGE HCT EXFORGE HCT XETA PLUS ANGIOTAN H LOSATEN-H CAZILA CO TELSAN CO TELSAN CO VALTEC CO VALTEC CO LOSARTAN ZEPOSE PLUS ZEPOSE PLUS SOPRAL PLUS SOPRAL PLUS CO-NOVATEC RENRID RENRID RENRID RENRID RENRID PLUS RENRID PLUS RENRID PLUS RENRID PLUS ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H ALLDAY-H JESPER PLUS CARAC-H CO-KIREN CO-KIREN CO-KIREN CO-KIREN CRESAR H CRESAR H CRESAR H CRESAR H CRESAR H ERIN ERIN ERIN ERIN GELFER LISTAN HT LOCOZAR LOSANTA DIU MALISARTAN -HT MALISARTAN -HT MALISARTAN -HT MECARDIS-H MECARDIS-H MECARDIS-H FORTE MECARDIS-H FORTE MECARDIS-H PLUS MECARDIS-H PLUS MISARTAN -H MISARTAN -H NUVAL -D NUVAL -D NUVAL -D NUVAL -D OSCORD DIU OSCORD DIU OSCORD DIU OSCORD DIU OSCORD DIU OSCORD DIU OSCORD DIU H-CORTISONE PROSARTAN-DU RAMY PLUS RAMY PLUS RAMY PLUS RAYCAN-H SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKIREN PLUS SKYGEN NEO SKYGEN NEO SKYGEN NEO SKYGEN NEO TELSARTA-D TELSARTA-D TELSARTA-D TELSITAN-H TELSITAN-H CAPTIL-H CAPTIL-H CAPTIL-H CO TELMAS CO TELMAS CO-CARDIOVASC CO-EZITAB CO-EZITAB CO-EZITAB CO-EZITAB CO-LISPRIL CO-LISPRIL CO-SARTAN CO-SARTAN CO-SARTAN HYPONORM-H. HYPONORM-H. MONITOR PLUS MONITOR PLUS SARTX DIU WOZIDE PLUS RENRID H RENRID H RENRID H RENRID H COCHEMZIDE COCHEMZIDE COLOSARTIN CO-OLESTA CO-OLESTA CORBIS-H CORBIS-H COZISCAR COZISCAR COZISCAR LOSAPREX-P OMSANA DIU OMSANA DIU OMSANA DIU ORION DIU SARUTAN PLUS TREATAN D VALTAN PLUS VALVOZID PLUS VALVOZID PLUS XAVOR-FORTE ZOSTAT-PLUS ZOSTAT-PLUS BENICAR-H CO-ARBISTA CO-ARBISTA FORTE CO-BARITEC CO-BARITEC CO-BARITEC CO-BARITEC CO-BARITEC CO-BARITEC CO-EXTOR CO-EXTOR CO-EXTOR CO-TELISARTAN CO-VALSETA KOSART DIU LOSAZID PLUS OLMIPRESS -H OLMIPRESS -H OLMIPRESS -H SAR-K PLUS TRI-VALSAN TRI-VALSAN TRI-VALSAN TRI-VALSAN TRI-VALSAN TRI-VALSAN VALAM-H VALAM-H VALAM-H VALAM-H VALAM-H NORMISAR PLUS ADYTUM-H LOPIZIDE AMODIP PLUS DE-NILE PLUS LOSERT TELMIS-H RASILEZ HCT RASILEZ HCT CO-TRITACE CO-TRITACE CORACE PLUS CORACE PLUS RAMIPACE D RAMIPACE D ARBI-D ARBI-D MISAR-H MISAR-H CO-VALID CO-VALID CO-VALID CO-VALSTAR VALKEN-H
Adult Dose
Dose: 25 to 100 mg
Single Dose: 62 (62.5)
Frequency: 24 hourly
Route: PO
Instructions: As Required
Neonatal
Dose: 1 mg/kg
Single Dose: 1 (1)
Frequency: 12 hourly
Route: Oral
Instructions:
Paedriatic
Dose: 2.5 mg/kg
Single Dose: 2.5 (2.5)
Frequency: 12 hourly
Route: Oral
Instructions:
Characteristics
. It is of Synthetic origin and belongs to Thiazide. It belongs to NaCl cotransport inhibitor pharmacological group on the basis of mechanism of action and also classified in Antihypertensive Agent, Combination pharmacological group.The Molecular Weight of Hydrochlorothiazide is 297.70. Its pKa is 7.9, 9.2.
Contraindications
Hydrochlorothiazide is contraindicated in conditions like Diabetes mellitus,Gout,Renal diseases,Anuria,Hyperlipidemia,Liver diseases,Ecg abnormalities.
Effects
The severe or irreversible adverse effects of Hydrochlorothiazide, which give rise to further complications include Pancreatitis, Stevens johnson syndrome, Stevens johnson syndrome, Systemic lupus erythematosus, Pneumonitis, Idiosyncratic hypersensitiviy reactions.Hydrochlorothiazide produces potentially life-threatening effects which include Hyponatremia, Metabolic disturbances, Hyponatremia, Idiosyncratic hypersensitivity reactions. which are responsible for the discontinuation of Hydrochlorothiazide therapy.The signs and symptoms that are produced after the acute overdosage of Hydrochlorothiazide include Coma, Volume depletion, Hypokalemia, Hypochloremic alkalosis, Hypersensitivity reactions, Electrolyte disturbances, Lethargy, Hemolytic anemia, Hyponatremia.The symptomatic adverse reactions produced by Hydrochlorothiazide are more or less tolerable and if they become severe, they can be treated symptomatically, these include Weakness, Thirst, Fatigue, Restlessness, Dry mouth, Lethargy, Allergic reactions, Cardiac arrhythmias, Hyperuricemia, Hypokalemia, Ectopic beats, Hypomagnesemia, Paralysis, UTI, Hyperlipidemia, Hyperglycemia, Dry mouth, parasthesia.
Indications
Hydrochlorothiazide is primarily indicated in conditions like Diabetes insipidus, Edema, Hypercalciuria, Hypertension, Nephrolithiasis, Nephrotic syndrome, Oedema, Proximal renal tubular acidosis, and can also be given in adjunctive therapy as an alternative drug of choice in Exercise induced hyperkalemia, Osteoporosis, Renal hypophosphatemic rickets.
Interactions
Hydrochlorothiazide is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlbuterolShould not use concurrently without doctors prescription.AlcoholAllopurinolconcomitant administeration can lead to impaired renal functionAmantadine (HCl)Amphotericin BIncreased risk of hypokalemia when amphotericin given with Hydrochlorothiazide.AstemizoleAzilisartan MedoxomilConcomitant administeration of Azilisartan and diuretics (e.g. hydrochlorothiazide) can lead to volume depletionCalciferolCarbamazepineIncreased risk of hyponatremia when Carbamazepine given with diuretics. Carbenoxolone (Na)Celiprolol (HCl)CholestyramineIt will reduce absorption of Hydrochlorothiazide from GIColestipol (HCl)DiazoxideEnhanced hypotensive effect when Diazoxide given with Hydrochlorothiaide.DiflunisalFluconazoleFosinopril (Na)Halofantrine (HCl)Indacaterolconcomitant therapy may increase risk of hypokalemiamonitor closelyInsulin Lispro ProtamineLithiumVolume depletion by Hydrochlorothiazide increases lithium absorption and causes Lithium toxicityMetformin (HCl)Thiazide (hydrochlorothiazide) antagonize the effect of metformin.MoxonidineConcomitant administration of moxonidine and hydrochlorothiazide is not indicated, as hypotensive effect of both drugs may be enhanced.Nebivolol (HCl)Concurrent use may decrease the extent of absorption of Nebivolol (HCl).PimozideConcomitant administeration can lead to prolong QT intervalPinacidil MonohydratePiroxicam-beta-cyclodextrinPiroxicam causes sodium,potassium and fluid retention and may interfere with natriuretic action of diuretic agents (e.g hydrochlorothiazide) and thus precipitate the heart failurePropranolol (HCl)Riboflavin (Vitamin B2)Hydrochlorothiazide, may cause you to excrete more riboflavin in your urine.Rutin (Vitamin P)Rutin may have additive effects when used in combination with Hydrochlorothiazide.Sodium PhosphateShould not be use concurrently without doctors prescription.Sotalol (HCl)TenoxicamNSAIDs may cause sodium, potassium and fluid retention and may interfere with the natriuretic action of diuretic agents, which can increase the risk of nephrotoxicity of NSAIDs.TerfenadineConcomitant administeration can lead to prolong QT intervalTetracycline (HCl)TrimethoprimTubocurarine (Cl) Warfarin (Na) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Periodic determination of serum electrolytes
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Kidney dysfunction, and patients suffering from Liver Malfunction.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Store in a well closed container, at room temperature. Protect from Moisture and Heat. Tab Store Below 40°C. Protect from Sunlight and Heat.
Warnings
Hydrochlorothiazide should be used with caution in patients with diabetes, kidney or liver disease or any drug allergy. Caution must be observed when eating large amounts of food high in potassium such as bananas, baked potatoes, raisins, cooked spinach and other foods. Alcoholic beverages may increase the effects of this drug, causing dizziness or lightheadedness, so limit alcohol intake. It should be used with caution while engaging in activities requiring alertness. This drug changes fluid balance, cause dizziness, if change from a lying to a standing position too rapidly, avoid this by sitting up a few minutes before rising. It should be used with caution during pregnancy or lactation. Use with caution in certain pateints with 4% gout. Photosensensiation can occur exacerbation or actiration. Use with caution with moderate or high cholestraheacone.
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