Hydrochlorothiazide
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from 30 rubles.
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Hydrochlorothiazide is a drug with a diuretic effect.
Release form and composition
Hydrochlorothiazide is available in the form of tablets (10 pcs. In blisters, 2 packages in a cardboard box).
The active ingredient is a part of 1 tablet: hydrochlorothiazide - 25 or 100 mg.
Indications for use
- Arterial hypertension (as monotherapy or simultaneously with other antihypertensive drugs);
- Control of polyuria (most often in nephrogenic diabetes insipidus);
- Edema syndrome of various origins (nephrotic syndrome, chronic heart failure, acute glomerulonephritis, premenstrual syndrome, portal hypertension, chronic renal failure, corticosteroid treatment).
Also, hydrochlorothiazide is indicated for the prevention of stones in the genitourinary tract in predisposed patients (to reduce hypercalciuria).
Contraindications
- Anuria;
- Difficult to control diabetes mellitus;
- Hepatic or severe renal (creatinine clearance less than 30 ml per minute) failure;
- Gout;
- Addison's disease;
- Hypercalcemia, hypokalemia, hyponatremia;
- First trimester of pregnancy and lactation;
- Age up to 3 years;
- Hypersensitivity to the components of the drug, as well as to other sulfonamides.
Caution should be exercised when using hydrochlorothiazide in women in the II-III trimesters of pregnancy.
Method of administration and dosage
Hydrochlorothiazide is taken by mouth.
To lower blood pressure, the drug is prescribed in a daily dose of 25-50 mg. As a rule, minor natriuresis and diuresis are noted on the first day of therapy. The drug is used for a long time simultaneously with other antihypertensive drugs: angiotensin-converting enzyme (ACE) inhibitors, 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, a further decrease in blood pressure and an increase in urine output are insignificant, while there is a disproportionate increase in the loss of electrolytes, especially Mg2 + and K +. Increasing the dose to 200 mg or more is impractical, since there is no increase in diuresis.
In edematous syndrome, hydrochlorothiazide is prescribed in doses determined by the patient's condition and response to therapy. The daily dose can range from 25 mg to 100 mg. The drug is taken once in the morning or in the morning in 2 divided doses. Elderly patients usually take 12.5 mg 1-2 times a day.
For children from 2 months to 14 years old, hydrochlorothiazide is prescribed at the rate of 1 mg / kg per day.
Maximum daily doses are age dependent:
- Children under 6 months - 3.5 mg / kg;
- Children under 2 years of age - 12.5-37.5 mg;
- Children 3-12 years old - 100 mg.
The daily dose is taken in 2-3 doses.
After 3-5 days of therapy, it is recommended to take a break for 3-5 days. As a maintenance therapy in the indicated dose, hydrochlorothiazide is prescribed 2 times a week. When using an intermittent course of treatment with taking the drug after 1-3 days or within 2-3 days with a subsequent break, side effects develop less often and the decrease in effectiveness is less pronounced.
To reduce intraocular pressure, hydrochlorothiazide is usually prescribed 1 time in 1-6 days, 25 mg. As a rule, the effect develops in 1-2 days.
With diabetes insipidus, tablets should be taken 1-2 times a day at 25 mg with a gradual increase in the dose to 100 mg (until the therapeutic effect is achieved - reducing polyuria and thirst). In the future, the dose may be reduced.
Side effects
- Organs of the gastrointestinal tract: pancreatitis or cholecystitis, constipation, cholestatic jaundice, sialadenitis, diarrhea, anorexia;
- Nervous system and sensory organs: blurry vision (temporarily), dizziness, paresthesia, headache;
- Cardiovascular system and blood (hemostasis, hematopoiesis): vasculitis, orthostatic hypotension, arrhythmias; very rarely - agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia, aplastic anemia;
- Electrolyte imbalance: hyponatremia (convulsions, confusion, slow thinking, lethargy, irritability, fatigue, muscle cramps); hypomagnesemia, hypokalemia, hypercalcemia (thirst, dry mouth, changes in psyche or mood, irregular heart rate, cramps and muscle pain, vomiting, nausea, unusual weakness or fatigue), in addition, hypochloremic alkalosis can cause hepatic coma or hepatic encephalopathy;
- Metabolic phenomena: glucosuria, hyperglycemia, hyperuricemia with the development of a gout attack. Thiazide therapy may decrease glucose tolerance, and latent diabetes mellitus may manifest. With the use of high doses of hydrochlorothiazide, an increase in serum lipids is possible;
- Hypersensitivity reactions: purpura, urticaria, Stevens-Johnson syndrome, necrotizing vasculitis, photosensitivity, respiratory distress syndrome (including noncardiogenic pulmonary edema and pneumonitis), anaphylactic reactions up to shock;
- Others: impaired renal function, decreased potency, interstitial nephritis.
special instructions
With long-term course treatment, it is necessary to carefully monitor the clinical signs of a violation of the water-electrolyte balance, primarily in patients at high risk. These include patients with impaired liver function and diseases of the cardiovascular system, as well as patients who have developed severe vomiting or signs of imbalance in water and electrolyte balance, such as thirst, dry mouth, weakness, drowsiness, lethargy, anxiety, seizures or muscle pain, tachycardia, muscle weakness, oliguria, hypotension, gastrointestinal complaints.
The development of hypokalemia, especially with increased potassium loss (prolonged treatment, increased diuresis) or with simultaneous treatment with digitalis glycosides or corticosteroid drugs, can be avoided by taking potassium-containing drugs or potassium-rich foods (fruits, vegetables). Thiazides increase the excretion of magnesium in the urine, this can lead to the development of hypomagnesemia.
With reduced renal function, creatinine clearance must be monitored. In patients with impaired renal function, hydrochlorothiazide may cause azotemia. The development of cumulative effects is also possible. In case of obvious impairment of renal function in the event of oliguria, it is recommended to consider the possibility of discontinuing therapy.
In severe cerebral and coronary sclerosis, the appointment of hydrochlorothiazide requires special care.
Hydrochlorothiazide should be used with caution in patients with impaired function or progressive liver disease, since small changes in serum ammonium levels, as well as water-electrolyte balance, can lead to the development of hepatic coma.
The use of hydrochlorothiazide may impair glucose tolerance. During a long course of therapy with latent or manifest diabetes mellitus, it is necessary to systematically monitor the metabolism of carbohydrates.
Barbiturates, alcohol and narcotic analgesics can enhance the orthostatic hypotensive effect of hydrochlorothiazide.
With prolonged treatment, in rare cases, there was a pathological change in the parathyroid glands, accompanied by hypophosphatemia and hypercalcemia.
In patients with lactose intolerance, gastrointestinal complaints may occur, which is associated with the presence of lactose in the tablets.
At the beginning of therapy (the duration of this period is determined individually), driving and performing work requiring increased attention is prohibited.
Drug interactions
Drugs that strongly bind to proteins (clofibrate, indirect anticoagulants, nonsteroidal anti-inflammatory drugs) enhance the diuretic effect of hydrochlorothiazide.
The antihypertensive effect of the drug is enhanced by vasodilators, tricyclic antidepressants, beta-blockers, phenothiazines, barbiturates, ethanol.
Hydrochlorothiazide enhances the neurotoxicity of salicylates; reduces the excretion of quinidine and the effect of oral contraceptives; weakens the effect of oral hypoglycemic drugs, epinephrine, norepinephrine and anti-gout drugs; enhances the side effects of cardiac glycosides, neurotoxic and cardiotoxic effects of Li + drugs, the effect of peripheral muscle relaxants.
With the simultaneous administration of hydrochlorothiazide with methyldopa, hemolysis may develop.
Analogs
Hydrochlorothiazide analogs are: Hydrochlorothiazide-SAR, Hydrochlorothiazide-Verte, Hypothiazide, Dichlothiazide.
Terms and conditions of storage
Store in a dark, dry place out of reach of children at temperatures up to 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Hydrochlorothiazide: prices in online pharmacies
|
Drug name Price Pharmacy |
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Hydrochlorothiazide 100 mg tablets 20 pcs. RUB 30 Buy |
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Hydrochlorothiazide 25 mg tablets 20 pcs. 32 RUB Buy |
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Hydrochlorothiazide 25mg tablets 20 pcs RUB 57 Buy |
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Hydrochlorothiazide tablets 100mg 20 pcs. 84 rbl. Buy |
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
