Hydrochlorothiazide

Description Hydrochlorothiazide is a thiazide diuretic.

Indications

• Edema
• Arterial hypertension

Contraindications

• Refractory hypokalemia, hyponatremia, hypercalcemia
• Severe renal failure
• Severe hepatic failure
• Gout or other symptomatic hyperuricemia
• Addison’s disease

Dosage

Adults:

• Oral route:
  • Edema: Initially 25-50 mg per day (if edema is severe, up to 75 mg per day); where possible, reduce the maintenance dose.
  • Arterial hypertension: 12.5-25 mg per day, increasing if necessary up to 50 mg per day.

Children:

• Oral route: 1-2 mg/kg per day (in 1-2 doses), adjust according to response. For infants up to 6 months: up to 3 mg/kg per day.

Elderly:

• Oral route: 12.5 mg once daily may be sufficient.

Adverse Reactions

• Most common: Orthostatic hypotension, mildly impaired digestion (anorexia, nausea, vomiting, diarrhea, constipation), impotence (resolves when the drug is stopped), hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia, hypochloremic alkalosis, hyperuricemia, gout, hyperglycemia, increased cholesterol concentration.
• Other: Rash, increased photosensitivity, other increased sensitivity reactions (including pneumonitis, pulmonary edema, severe skin reactions), blood changes (including neutropenia and thrombocytopenia), pancreatitis, intrahepatic cholestasis.

Pregnancy

• Risk category: BM (D – when used to treat hypertension in pregnant women). Thiazides can cause thrombocytopenia in newborns.

Breastfeeding

• Small amounts of the drug enter breast milk. High doses suppress lactation. It is believed that the use of this drug should not harm a breastfed infant.

Warnings

• Use with caution in cases of hypokalemia, hyperuricemia, renal failure, hepatic failure, porphyria, diabetes mellitus, systemic lupus erythematosus, as well as in elderly individuals.