Hydrochlorothiazide (Esidrix, HydroDiuril, Oretic)

Category:

  • Diuruetic

Description:

  • Antihypertensive, thiazide diuretic

Indications:

  • Edema associated with CHF, hepatic cirrhosis, corticosteroid and estrogen therapy

  • Hypertension

Contraindications:

  • Anuria

  • Renal decompensation

Precautions:

  • Pregnancy category D; 1st trimester may increase risk of congenital defects; use in later trimesters does not seem to carry this risk

  • Hypokalemia, renal disease, hepatic disease, gout

  • COPD, lupus erythematosus, diabetes mellitus

  • Children, vomiting, diarrhea, hyperlipidemia

Adverse Reactions (Side Effects):

  • CNS: depression, dizziness, drowsiness, fatigue, paresthesia, weakness, headache

  • CV: irregular pulse, orthostatic hypotension, palpitations, volume depletion

  • EENT: blurred vision

  • GI: anorexia, constipation, cramps, diarrhea, nausea, pancreatitis, vomiting

  • GU: frequency, decreased libido, impotence

  • HEME: agranulocytosis, aplastic anemia, hemolytic anemia, leukopenia, neutropenia, thrombocytopenia

  • METAB: hypercalcemia, hyperglycemia, hyperuricemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, increased creatinine, BUN

  • SKIN: fever, photosensitivity, purpupa, rash, urticaria

 

Dosage:

Administered orally (tablet, solution)

  • Adult:   PO 12.5-50mg daily, max 200mg daily; doses >50 mg/day generally not recommended due to increased incidence of hypokalemia and other metabolic disturbances

  • Child:   PO (<6 months) 2-3.3 mg/kg/day in 2 divided doses; (>6 months) 2 mg/kg/day in 2 divided doses

Drug interactions:

  • Antidiabetics: thiazide diuretics tend to increase blood glucose, may increase dosage requirements of antidiabetic drugs

  • Digitalis glycosides: diuretic-induced hypokalemia may increase risk of digitalis toxicity

Special considerations:

  • May cause gout attacks

  • May cause sensitivity to sunlight

  • Take early in day due to increased urination

    

 
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