Periodic monitoring of electrolytes is recommended, particularly in elderly patients and in patients receiving a high dose. Hydrochlorothiazide doses should be administered in the morning; if patients are on a twice daily dosing schedule, the second dose should be given before 6 PM.
Full Answer
When should I take HCTZ?
Hydrochlorothiazide is a type of medicine ... If you are not sure whether you should start taking this medicine, talk to your doctor. Tell your doctor if you have allergies to any other medicines ...
What are the dangers of taking hydrochlorothiazide?
Side effects requiring immediate medical attention
- Back, leg, or stomach pains
- black, tarry stools
- bleeding gums
- blistering, peeling, or loosening of the skin
- bloating
- blood in the urine or stools
- blue lips and fingernails
- blurred vision
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain or tightness
How to take hydrochlorothiazide properly?
Tips
- Dosages may need to be adjusted depending on the individual; higher dosages need extra monitoring by a doctor.
- Report any symptoms such as confusion, dizziness, muscular weakness, and GI disturbances to a doctor.
- Seek urgent medical advice if you are unable to urinate.
- Report any eye pain or visual disturbances immediately to your doctor.
How much Hydrochlorothiazide is safe to take?
Hydrochlorothiazide can be taken with or without food. In adults being treated for hypertension, the usual dose is 12.5 to 50 mg once daily. If the medicine has been prescribed for edema, most adults will take 25 to 100 mg once a day or in divided doses.
Is hydrochlorothiazide contraindicated in elderly?
No information is available on the relationship of age to the effects of hydrochlorothiazide tablets in geriatric patients. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving hydrochlorothiazide tablets.
What should I check before giving hydrochlorothiazide?
Monitor signs of fluid, electrolyte, or acid-base imbalances, including dizziness, drowsiness, blurred vision, confusion, hypotension, or muscle cramps and weakness. Report excessive or prolonged symptoms to the physician.
What is the route of administration for hydrochlorothiazide?
Hydrochlorothiazide comes as a tablet, capsule, and solution (liquid) to take by mouth. It usually is taken once or twice a day. When used to treat edema, hydrochlorothiazide may be taken daily or only on certain days of the week.
What is the first step in treating a patient with hypertension?
Diuretics are the first step in the treatment of most patients with hypertension and the new clinical trials should focus on drugs to be added to them as the second step in the management of hypertension.
What are nursing interventions for hydrochlorothiazide?
Nursing considerationsGive with food or milk if GI upset occurs.Mark calendars or provide other reminders of drug for alternate day or 3–5 days/wk therapy.Reduce dosage of other antihypertensives by at least 50% if given with thiazides; readjust dosages gradually as BP responds.More items...
What should a nurse monitor in a patient taking hydrochlorothiazide?
Patients who are taking thiazide diuretics should be monitored for electrolyte depletion, dehydration, weakness, hypotension, renal impairment, and hypersensitivities.
What is the contraindication for hydrochlorothiazide?
According to the manufacturer, hydrochlorothiazide is specifically contraindicated in patients with sulfonamide hypersensitivity. Hypersensitivity reactions may occur in patients with or without a history of allergy or bronchial asthma; however, reactions are more likely to occur in patients with such history.
What should you avoid when taking hydrochlorothiazide?
Hydrochlorothiazide may interact with other medicationsBarbiturates. If you take these drugs with hydrochlorothiazide, your blood pressure may be lowered too much. ... Lithium. ... Blood pressure drugs. ... Cholesterol-lowering drugs. ... Corticosteroids. ... Diabetes drugs. ... Narcotics. ... Nonsteroidal anti-inflammatory drugs (NSAIDs)
What are the most common side effects of hydrochlorothiazide?
Side EffectsBack, leg, or stomach pains.black, tarry stools.blistering, peeling, or loosening of the skin.bloating.blood in the urine or stools.blue lips and fingernails.chest pain or tightness.clay-colored stools.More items...•
What is the safest blood pressure medicine for the elderly?
There is no age threshold beyond which hypertension should not be treated. Thiazide diuretics are first-line therapy for isolated systolic hypertension, and they should be considered in any antihypertensive regimen in older persons.
When do you start medications for hypertension?
If you're 60 or older, the American College of Physicians and the American Academy of Family Physicians recommend you start treatment if your top blood pressure number is 130 or higher.
What are some steps used to lower high blood pressure?
Here are 10 lifestyle changes you can make to lower your blood pressure and keep it down.Lose extra pounds and watch your waistline. ... Exercise regularly. ... Eat a healthy diet. ... Reduce sodium in your diet. ... Limit the amount of alcohol you drink. ... Quit smoking. ... Cut back on caffeine. ... Reduce your stress.More items...
Usual Adult Dose For Edema
Usual dose: 25 mg to 100 mg orally once or twice dailyComments:-Some patients respond to intermittent therapy, (i.e., administration on alternate d...
Usual Adult Dose For Hypertension
Initial dose: 25 mg orally once dailyMaintenance dose: May increase to 50 mg orally daily, as a single or 2 divided dosesComments:-Patients usually...
Usual Pediatric Dose For Edema
Less than 6 months: Up to 3 mg/kg/day (up to 1.5 mg/pound) orally in 2 divided dosesLess than 2 years: 1 to 2 mg/kg/day (0.5 to 1 mg/pound) orally...
How does hydrochlorothiazide work?
Hydrochlorothiazide is a diuretic (this means it increases urination) that works by inhibiting the reabsorption of salts in the kidneys.
What are the side effects of hydrochlorothiazide?
Downsides. If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: A headache, dizziness on standing, dehydration, skin reactions, and depletion of electrolytes.
What is the abbreviation for HCTZ?
Hydrochlorothiazide belongs to the class of medicines known as thiazide diuretics. Hydrochlorothiazide may be abbreviated as HCTZ.
Can hydrochlorothiazide be used for sulfonamide?
Hydrochlorothiazide may be used to relieve edema and in the treatment of high blood pressure but may not be suitable for some people including those with sulfonamide allergies. 5. Tips. Dosages may need to be adjusted depending on the individual; higher dosages need extra monitoring by a doctor.
Can you share hydrochlorothiazide with children?
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use hydrochlorothiazide only for the indication prescribed.
Can hydrochlorothiazide be used for high blood pressure?
Used to lower blood pressure in people with high blood pressure; daily dosing is usually recommended when hydrochlorothiazide is used for this indication. May be used off-label for several other indications. May be used alone or in combination with other agents.
Can hydrochlorothiazide interact with other medications?
Medicines that interact with hydrochlorothiazide may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with hydrochlorothiazide. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
How long does it take to recover from thiazide withdrawal?
The restoration of normonatremia after thiazide withdrawal aids to the accurate diagnosis of thiazide-induced hyponatremia. However, up to two weeks may be needed after stopping the thiazide for full recovery of the diluting capacity and serum sodium normalization. This delay should be taken into account when investigating the subgroup of patients with possible thiazide-associated hyponatremia and a SIADH-like profile. In these patients, a thorough diagnostic work up for the presence of other causes for underlying SIADH should be done only if mild hyponatremia persists 2–3 weeks after the discontinuation of the thiazide.
What drugs affect water homeostasis?
Concominant administration of drugs affecting water homeostasis, such as SSRIs, NSAIDs or even benzodiazepines
How to treat oligosymptomatic hyponatremia?
In cases of chronic oligosymptomatic hyponatremia, therapy is based mainly on patients' extracellular volume status. In euvolemic states, discontinuation of thiazide and water restriction (up to 1 L/day) are usually enough to correct serum sodium levels. In hypovolemic hyponatremia, normal saline (0.9% sodium chloride solution) should be administered.[60] The rate of infusion of normal saline should be individualized and special attention should be given in elderly patients with underlying heart failure. [69]
What receptors are involved in the increase in water permeability in the renal tubules?
Direct upregulation of aquaporin-2 receptors expression in the renal tubules resulting in increased water permeability in the collecting duct
What is the effect of reduced NaCl reabsorption in the renal tubules?
Decreased free water excretion (diminished urine diluting ability) due to the reduced NaCl reabsorption in the renal tubules
How to correct hyponatremia?
Hyponatremia, especially when attributed to diuretics, should be carefully managed.[57] The first step is the discontinuation of the possible offending agent. The drug withdrawal results in restoration of urinary diluting ability leading to increased water diuresis. This effect increases the risk of rapid or even dangerous correction of hyponatremia. The measurement of urine electrolytes and calculation of urine/plasma electrolyte ratio [(urine Na++ urine K+)/serum Na+] are helpful. An urine/serum electrolyte ratio < 0.5 is indicative of increased water excretion, which is associated with potentially dangerous overtreatment of hyponatremia. In any case, frequent (every few hours) determination of serum electrolytes and careful evaluation of diuresis are mandatory for the safe and effective correction of hyponatremia. [53],[54],[58],[59]
Can potassium be added to thiazide?
Importantly, the potassium depletion that is frequently observed in thiazide-related hyponatremia should also be corrected. However, clinicians should be very careful in this setting. First, potassium anions should be taken into account in the calculation of the tonicity of the infused solutions. Thus, when intravenous potassium administration is required, potassium chloride should be added in hypotonic fluids. The administration of potassium chloride in normal saline should be avoided because it can result in rapid correction of hyponatremia and circulatory overload.[69] Second, the correction of hypovolemia and hypokalemia may be followed by an increased water diuresis, which increases substantially the risk of overcorrection of hyponatremia and its devastating consequences. [53],[54],[58],[59]In these cases, careful and frequent monitoring (every few hours) of serum sodium concentration and diuresis is mandatory. The correction rate in serum sodium, which should be < 8 meq/L in the first 24 h of therapy in patients with chronic hyponatremia, should be even lower (i.e., < 4–6 mmol/L per 24 h) in the presence of hypokalemia.[70] It should be noted that vasopressin receptor inhibitors (Vaptans) do not have any role in hypovolemic hyponatremia due to thiazide administration. [71]
How long does hydrochlorothiazide last?
Pharmacological effects begin in about 2 hours after an oral dose, peaks in 4 hours, and lasts for about 6 to 12 hours. Hydrochlorothiazide is not metabolized, and a majority is excreted in the urine unchanged. It also causes a loss of potassium and bicarbonate.
What is the effect of HCTZ on electrolytes?
HCTZ can cause electrolyte and/or fluid imbalances, including hypokalemia, hyponatremia, hypercalcemia, and/or hypomagnesemia. [10]
Which diuretic is most commonly used for hypertension?
Of the thiazide diuretics, hydrochlorothiazide is the most frequently used for the treatment of hypertension. Unfortunately, over the past decade, the use of hydrochlorothiazide has been declining, and it is being replaced by the angiotensin-converting enzyme inhibitors, which overall are far more effective and have fewer adverse effects.
What happens when you have toxic electrolytes?
Toxicity results in dehydration and electrolyte deficiencies such as hypokalemia, hypochloremia, and hyponatremia. This occurs because of excessive diuresis. Treatment is supportive such as fluids and electrolyte replacement. If the patient becomes hypotensive, vasopressors can be used. [2]
Does hydrochlorothiazide lower blood pressure?
This action leads to a diuretic action which lowers blood pressure , but there is also a loss of potassium in the urine.
Is HCTZ safe for hypertension?
Hydrochlorothiazide (HCTZ) is a thiazide-type diuretic which has been used clinically for more than half a century. The drug has been widely used to treat hypertension globally and is relatively very safe.
Is hydrochlorothiazide safe?
Hydrochlorothiazide is a thiazide-type diuretic which has been used clinically for more than half a century. The drug has been widely used to treat hypertension globally and is relatively very safe. Hydrochlorothiazide acts on the distal convoluted tubules and inhibits the sodium chloride co-transporter system.
What is hydrochlorothiazide used for?
Hydrochlorothiazide oral tablet is used to treat high blood pressure, and swelling caused by heart failure, liver damage, and certain medications.
What are the side effects of hydrochlorothiazide?
More common side effects. The more common side effects that can occur with hydrochlorothiazide include: blood pressure that’s lower than normal ( especially when standing up after sitting or lying down) dizziness. headache. weakness. erectile dysfunction (trouble getting or keeping an erection)
What temperature should hydrochlorothiazide be stored?
Store hydrochlorothiazide at a temperature between 68°F and 77°F (20°C and 25°C).
What to do if you have serious side effects?
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Is hydrochlorothiazide a prescription drug?
Hydrochlorothiazide is a prescription drug. It comes as a tablet or capsule that you take by mouth.
Does hydrochlorothiazide lower cholesterol?
Taking hydrochlorothiazide with certain drugs that lower cholesterol levels may make hydrochlorothiazide less effective. This means it may not work as well to treat your blood pressure or swelling. Examples of these cholesterol drugs include:
Can hydrochlorothiazide interact with other medications?
Hydrochlorothiazide may interact with other medications. Hydrochlorothiazide oral tablet can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
How often should I take HCTZ?
Yet, HCTZ does not provide sufficient effect across a full 24 hours. 10 In the past, physicians often prescribed HCTZ to be taken twice daily. I’ve never seen it prescribed twice daily in my career.
How does HCTZ work?
It works in the kidney at the distal convoluted tubule by reducing sodium (Na+) reabsorption. Since it decreases the reabsorption of Na + you eliminate more of it in the urine. Water follows sodium in the body so HCTZ decreases intravascular volume by increasing urine production.
Why was the Benazepril trial stopped?
The trial was stopped early due to the fact that the benazepril + amlodipine group had a 20% reduction in cardiovascular disease mortality as well as a 25% reduced risk of new-onset Type-2 Diabetes. The only difference here is the amlodipine and the HCTZ.
What is the first line of treatment for hypertension?
The Joint National Committee on Hypertension, 7th Edition (JNC 7) recommended a thiazide diuretic as first-line management for hypertension requiring medications. 2 This report was published in 2003 and has since been updated. JNC 8 still recommends HCTZ as an option for first-line therapy.
How long has HCTZ been around?
HCTZ has been available for more than half a century. It is the most common blood pressure medication prescription in the entire world. In 2007, over 130 million prescriptions were written for HCTZ in the U.S. alone. 29
What is the most common medication prescribed for hypertension?
The benefits of these medications varies from class to class and even within the same class. Despite the fact that hydrochlorothiazide ( HCTZ) is one of the most common diuretics prescribed for hypertension, the medical literature suggests that chlorthalidone, indapamide, and even the aldosterone receptor blockers (spironolactone & eplerenone) are superior to HCTZ. 23
How long does it take to improve blood pressure with lercanidipine?
A study in 2014 used Lercanidipine alone for baseline therapy for the first 4 weeks of the study. The wall-to-lumen ratio (retinal artery measurement), capillary density, and pulse wave velocity & central blood pressure (measured by SphygmoCor) were all “significantly improved” with 4 weeks of lercanidipine therapy.
If you are NURSING
Precaution: LIMITED AMOUNTS EXCRETED WITH NO KNOWN ADVERSE EFFECTS IN INFANT.
If you are an adult over 60
management or monitoring precaution: Cardiovascular-Increased sensitivity to effects on blood pressure. Metabolic-More likely to develop hypokalemia or hypomagnesemia. Endocrine-May worsen glucose control in diabetics. Renal-Not effective with CrCL < 30mL/min.
Giving Haloperidol to a child under 12
Sorry, we have no data available. Please contact your doctor or pharmacist.
How It Works
- Hydrochlorothiazide is a diuretic (this means it increases urination) that works by inhibiting the reabsorption of salts in the kidneys.
- Hydrochlorothiazide also lowers blood pressure in people with high blood pressure by an unknown mechanism; people with normal blood pressure are not usually affected by hydrochlorothiazide.
- Hydrochlorothiazide is a diuretic (this means it increases urination) that works by inhibiting the reabsorption of salts in the kidneys.
- Hydrochlorothiazide also lowers blood pressure in people with high blood pressure by an unknown mechanism; people with normal blood pressure are not usually affected by hydrochlorothiazide.
- Hydrochlorothiazide belongs to the class of medicines known as thiazide diuretics. Hydrochlorothiazide may be abbreviated as HCTZ.
Upsides
- Used in addition to other drugs to remove fluid build-up (edema) in the body caused by heart failure, liver disease, renal disease, and steroid or estrogen therapy. May be used to treat edema due t...
- Intermittent (as needed) therapy may be appropriate for some people with edema.
- Used to lower blood pressure in people with high blood pressure; daily dosing is usually reco…
- Used in addition to other drugs to remove fluid build-up (edema) in the body caused by heart failure, liver disease, renal disease, and steroid or estrogen therapy. May be used to treat edema due t...
- Intermittent (as needed) therapy may be appropriate for some people with edema.
- Used to lower blood pressure in people with high blood pressure; daily dosing is usually recommended when hydrochlorothiazide is used for this indication.
- May be used off-label for several other indications.
Downsides
- If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: 1. A headache, dizziness on standing, dehydration, skin reactions, and depletion of electrolytes. Effects may be aggravated by alcohol, illness, or hot weather. 2. Rarely, may cause acute angle glaucoma. Symptoms include e…
Bottom Line
- Hydrochlorothiazide may be used to relieve edema and in the treatment of high blood pressure but may not be suitable for some people including those with sulfonamide allergies.
Tips
- Dosages may need to be adjusted depending on the individual; higher dosages need extra monitoring by a doctor.
- Report any symptoms such as confusion, dizziness, muscular weakness, and GI disturbances to a doctor.
- Seek urgent medical advice if you are unable to urinate.
- Dosages may need to be adjusted depending on the individual; higher dosages need extra monitoring by a doctor.
- Report any symptoms such as confusion, dizziness, muscular weakness, and GI disturbances to a doctor.
- Seek urgent medical advice if you are unable to urinate.
- Report any eye pain or visual disturbances immediately to your doctor.
Response and Effectiveness
- Hydrochlorothiazide starts to work within 2 hours and its peak effect occurs within 4 hours. The diuretic and blood pressure lowering effects of hydrochlorothiazide may last six to 12 hours.
Interactions
- Medicines that interact with hydrochlorothiazide may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with hydrochlorothiazide. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions sh…
References
- Hydrochlorothiazide. Revised 11/2021. AHFS DI Essentials https://www.drugs.com/monograph/hydrochlorothiazide.html
Further Information
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use hydrochlorothiazide only for the indication prescribed. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Copyright 1996-2022 Drugs.com. Revision date: March 21, 2022. Medi…