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Related to hydrochlorothiazide: Amlodipine, Ramipril


a thiazide diuretic used as an antihypertensive agent and for treatment of edema.


Apo-Hydro (CA), Diuchlor H (CA), Hydro-Par, Microzide, Neo-Codema (CA), Novo-Hydrazide (CA), PMS-Hydrochlorothiazide (CA), Urozide (CA)

Pharmacologic class: Thiazide diuretic

Therapeutic class: Diuretic, antihypertensive

Pregnancy risk category B


Increases sodium and water excretion by inhibiting sodium reabsorption in distal tubules; promotes excretion of chloride, potassium, magnesium, and bicarbonate. Also may produce arteriolar dilation, reducing blood pressure.


Capsules: 12.5 mg

Oral solution: 10 mg/ml, 100 mg/ml

Tablets: 12.5 mg, 25 mg, 50 mg, 100 mg

Indications and dosages

Edema caused by heart failure, renal dysfunction, cirrhosis, corticosteroid therapy, or estrogen therapy

Adults: 25 to 100 mg P.O. daily as a single dose or in divided doses. Maximum dosage is 200 mg/day.

Mild to moderate hypertension

Adults: Initially, 12.5 mg daily P.O.; then, based on blood pressure response, may give 12.5 to 50 mg/day P.O. Higher dosages may be given in refractory cases.

Children ages 2 to 12: 1 to 2 mg/kg/day P.O. in single dose or two divided doses, not to exceed 100 mg/day

Children younger than age 2: 1 to 2 mg/kg P.O. as single dose or divided doses, not to exceed 37.5 mg/day; infants less than age 6 months may require dosage of 3 mg/kg/day in two divided doses.

Off-label uses

• Hypercalcemia

• Ménière's disease


• Hypersensitivity to drug, other thiazides, sulfonamides, or tartrazine

• Renal decompensation or anuria


Use cautiously in:

• renal or severe hepatic impairment, fluid or electrolyte imbalances, gout, systemic lupus erythematosus, hyperparathyroidism, glucose tolerance abnormalities, bipolar disorder

• elderly patients

• pregnant or breastfeeding patients.


• Give with food or milk if GI upset occurs.

• Administer early in day so diuretic effect doesn't disturb sleep.

Adverse reactions

CNS: dizziness, drowsiness, lethargy, headache, insomnia, nervousness, vertigo, asthenia, asterixis, paresthesias, confusion, fatigue, encephalopathy

CV: chest pain, orthostatic hypotension, ECG changes, thrombophlebitis, arrhythmias

EENT: nystagmus

GI: nausea, vomiting, epigastric distress, anorexia, pancreatitis

GU: polyuria, nocturia, erectile dysfunction, loss of libido, renal failure

Hematologic: anemia, hemolytic anemia, agranulocytosis, leukopenia, thrombocytopenia

Hepatic: jaundice, hepatitis

Metabolic: dehydration, gout, hyperglycemia, hypokalemia, hypocalcemia, hypovolemia, hypomagnesemia, hyponatremia, hypophosphatemia, hyperuricemia, hypochloremic alkalosis

Musculoskeletal: muscle cramps

Skin: photosensitivity, urticaria, rash, dermatitis, purpura, alopecia, flushing

Other: fever, weight loss, anaphylaxis


Drug-drug. Adrenocorticotropic hormone, corticosteroids: increased risk of intensified electrolyte depletion, particularly hypokalemia

Allopurinol: increased risk of hypersensitivity reaction

Amphotericin B, corticosteroids, digoxin, mezlocillin, piperacillin, ticarcillin: increased risk of hypokalemia

Antihypertensives, barbiturates, nitrates, opioids: increased hypotension

Cholestyramine, colestipol: decreased hydrochlorothiazide absorption

Digoxin: increased risk of hypokalemia

Insulin, oral hypoglycemics: possible decreased hypoglycemic effect

Lithium: decreased excretion and increased blood level of lithium

Nondepolarizing skeletal muscle relaxants (such as tubocurarine): increased skeletal muscle relaxant effect

Nonsteroidal anti-inflammatory drugs: decreased hydrochlorothiazide efficacy

Vasopressors: decreased pressor effect

Drug-diagnostic tests. Bilirubin, blood and urine glucose (in diabetic patients), calcium, creatinine, uric acid: increased levels

Cholesterol, low-density lipoproteins, magnesium, potassium, protein-bound iodine, sodium, triglycerides, urinary calcium: decreased levels

Drug-herbs. Dandelion: interference with diuretic activity

Ginkgo: decreased antihypertensive effect

Licorice, stimulant laxative herbs (aloe, cascara sagrada, senna): increased risk of hypokalemia

Drug-behaviors. Alcohol use: increased hypotension

Sun exposure: increased risk of photo-sensitivity

Patient monitoring

• Monitor blood pressure, fluid intake and output, and daily weight.

• Assess electrolyte levels, especially potassium. Monitor for signs and symptoms of hypokalemia.

• Monitor blood urea nitrogen and creatinine levels.

• Check blood glucose level in diabetic patients.

• Assess for signs and symptoms of gout attacks in patients with gouty arthritis.

Patient teaching

• Advise patient to take with food or milk if GI upset occurs.

• Tell patient to take early in day to avoid nighttime urination.

• Instruct patient to track intermittent doses on calendar.

• Tell patient to weigh himself daily, at same time on same scale and wearing same clothes.

Instruct patient to report decreased urination, swelling, unusual bleeding or bruising, dizziness, fatigue, numbness, and muscle weakness or cramping.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.


A potent orally effective diuretic and antihypertensive agent related to chlorothiazide; can cause hypokalemia and hyperglycemia.


A diuretic drug, C7H8ClN3O4S2, used in the treatment of hypertension.


A potent orally effective diuretic andantihypertensive agent related to chlorothiazide.


A drug used to increase the output of urine so as to relieve the body of surplus water. A thiazide DIURETIC drug. The drug is on the WHO official list. A brand name is Hydrosaluric. Hydrochlorothiazide is formulated in conjunction with a variety of drugs. It is available with potassium under the brand name Amil-Co; with another diuretic as Dyazide, Moduret 25, Moduretic, Triam-Co; with ANGIOTENSIN CONVERTING ENZYME inhibitor drugs as Accuretic, Acezide, Capozide, Carace 10 Plus, Innozide and Zestoretic 20; with BETA BLOCKER drugs as Co-Betaloc, Kalten, Moducren and Monozide 10; and with an angiotensin II antagonist drug as Cozaar-Comp.


A potent orally effective diuretic and antihypertensive agent related to chlorothiazide; can cause hypokalemia and hyperglycemia.
References in periodicals archive ?
'Confirmatory laboratory analysis has established that the product did not contain hydrochlorothiazide, the stated active ingredient, glibenclamide was instead identified,' Adeyeye said.
Table 1: Diuretic activity Duration Group Urinary output (ml) Mean (SD) 5 h Control 1.08 (0.12) Standard 1.83 (0.26) (*) Hydrochlorothiazide 1.38 (0.14) Hydrochlorothiazide+misoprostol 2.17 (0.26) (*) 24 h Control 3.71 (0.29) Standard 8.21 (0.37) (*) Hydrochlorothiazide 4.46 (0.40) (*) Hydrochlorothiazide+misoprostol 8.00 (0.35) (*) Duration Diuretic index 5 h - 1.69 1.27 2.00 24 h - 2.21 1.20 2.15 (*) Significant P value of <0.05 when compared to control group.
The researchers said it "showed longer duration of action compared to hydrochlorothiazide."
The CAGR of sales revenue of valsartan hydrochlorothiazide in Chinese sample hospitals surpassed 100% from 2007 to 2012.
The present work describes two spectrophotometric methods for estimation of valsartan with hydrochlorothiazide in combination which are simultaneous equation method (method 1) and absorbance ratio method (method 2).
Low-sodium diet plus hydrochlorothiazide. This route provides another option to decrease urine output during lithium-induced NDI.
Avalide is comprised of the drugs irbesartan and hydrochlorothiazide. The recalled tablets contain 300 mg of irbesartan and 25 mg of hydrochlorothiazide.
Tribenzor combines amlodipine, marketed by Pfizer as Norvasc, olmesartan medoxomil, marketed by Daiichi Sankyo as Benicar, and a third drug, hydrochlorothiazide. The combination medication was approved for people whose high blood pressure isn't well controlled on other combinations of anti-hypertension drugs.
Common diuretics: hydrochlorothiazide (Microzide and others) and furosemide (Lasix).
This article in the Lancet comes from the India Polycap study, which examined the effects of the polypill--a combined statin, aspirin and folic acid with three blood pressure-lowering drugs (ramipril, atenolol and hydrochlorothiazide)--in middle-aged people without known cardiovascular disease.
BETA BLOCKER PLUS DIURETIC FOR HYPERTENSION atenolol chlorthalidone bisoprolol hydrochlorothiazide ACE INHIBITOR PLUS DIURETIC FOR HYPERTENSION captopril hydrochlorothiazide lisinopril hydrochlorothiazide benazepril hydrochlorothiazide moexipril hydrochlorothiazide quinapril hydrochlorothiazide CALCIUM CHANNEL BLOCKER PLUS ACE INHIBITOR FOR HYPERTENSION amlodipine benazepril