Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: decrease in vision, eye pain. This medication may cause a loss of too much body water ( dehydration) and salt/ minerals.
- 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)
- tingling in your hands, legs, and feet.
What are the most common side effects of hydrochlorothiazide?
- Cramps and muscle weakness
- Dizziness, headache, or thirst
- Stomach pain, nausea, vomiting, diarrhea, or loss of appetite
- Dizziness
- Blurred vision
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
What happens when you stop taking hydrochlorothiazide?
What happens when you stop taking hydrochlorothiazide? Hydrochlorothiazide does not cause specific withdrawal symptoms, but quitting this medication suddenly can lead to higher blood pressure, heart problems, and an increase in water retention from the underlying medical conditions that the prescription drug treats.
Can you suddenly stop taking hydrochlorothiazide?
You may need to use blood pressure medicine for the rest of your life. Do not stop using hydrochlorothiazide and metoprolol suddenly, even if you feel fine. Stopping suddenly may cause serious or life-threatening heart problems. Follow your doctor's instructions about tapering your dose.
What are the adverse effects of hydrochlorothiazide in the treatment of hypertension ATI?
More common side effectsnausea.vomiting.stomach cramping.diarrhea.constipation.loss of appetite.dizziness.headache.More items...
What are the adverse effects of loop diuretics?
Common and shared side effects of the loop diuretics include dizziness, headache, gastrointestinal upset, hypernatremia, hypokalemia and dehydration.
How does hydrochlorothiazide affect blood pressure?
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. This action leads to a diuretic action that lowers blood pressure, but there is also a potassium loss in the urine.
Which is a possible adverse effect of thiazide diuretics?
Side effects include increased urination and sodium loss. Diuretics can also affect blood potassium levels. If you take a thiazide diuretic, your potassium level can drop too low (hypokalemia), which can cause life-threatening problems with your heartbeat.
Which diuretic is contraindicated in patients with hypertension?
Hydrochlorothiazide diuretics are used to manage hypertension and edema. Thiazide diuretics are contraindicated for patients who have anuria or hypersensitivity.
What are the contraindications of diuretics?
Diuretics are contraindicated in patients with known drug hypersensitivity and those with electrolyte imbalance. They should be used cautiously in anyone with renal dysfunction, as changes in blood flow and kidney perfusion may further compromise a diseased kidney.
What are the most common side effects of hydrochlorothiazide?
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)tingling in your hands, legs, and feet.More items...
What are the dangers of taking hydrochlorothiazide?
Blood and urine tests may be needed to check for unwanted effects. Check with your doctor right away if you have seizures, decreased urine, drowsiness, dry mouth, excessive thirst, increased heart rate or pulse, muscle pains or cramps, nausea or vomiting, or unusual tiredness or weakness.
What are the contraindications for hydrochlorothiazide?
Who should not take HYDROCHLOROTHIAZIDE?sympathectomy.diabetes.increased activity of the parathyroid gland.high cholesterol.a type of joint disorder due to excess uric acid in the blood called gout.low amount of magnesium in the blood.high amount of calcium in the blood.low amount of sodium in the blood.More items...
What is the most important adverse effect of loop and thiazide diuretics?
Adverse effects for loop diuretics are like thiazide diuretics and include hyponatremia, hypokalemia, and alkalosis. One notable adverse loop diuretic effect is increased calcium excretion; hence, loop diuretics are not suitable for hypertensive patients with osteoporosis.
Why are thiazides not used in hypertension?
Safety and Adverse Effects Thiazides can reduce the excretion of calcium and uric acid and therefore increase their plasma levels. As well, they increase potassium and magnesium excretion, leading to hypokalemia and hypomagnesemia. Hypokalemia seems to be implicated in the pathogenesis of thiazide-induced dysglycemia.
Can thiazide cause hypotension?
The results showed that patients on thiazide diuretics had a higher incidence of postural hypotension (reduction in systolic blood pressure greater than 20 mmHg on standing after 2 minutes) than patients on loop diuretics (12 out of 20 vs 4 out of 20, p less than 0.05).
What is the role of thiazide diuretics in the kidney?
Despite the evidence for direct vasodilation, the predominant activity of thiazide diuretics is to inhibit a directly coupled Na-Cl cotransporter (NCC; gene symbol SLC12A3) along the distal convoluted tubule (DCT) of the kidney.
When were thiazide diuretics invented?
Thiazide diuretics were developed during the 1950s, when chemists and physiologists at Merck Sharpe and Dohme tested derivatives of sulfonamide-based carbonic anhydrase inhibitors, with the goal of discovering drugs that enhance the excretion of sodium with chloride rather than sodium bicarbonate. *.
Does thiazide lower blood pressure?
Because of common use, however, the term “thiazide” is used herein. †Early studies reported that thiazides do not reduce blood pressure in normotensive humans. 44–46 Longer-term studies, however, indicate that these drugs do reduce blood pressure in normal individuals. 47.
Do thiazides reduce arterial pressure?
In this state, the effect of thiazides to reduce arterial pressure is enhanced. Clearly these observations in genetic syndromes do not exclude a direct effect of thiazides on blood vessels as contributing to their hypotensive effectiveness.
Does thiazide cause hypokalemia?
Thiazide- Induced Hypokalemia. When thiazides were introduced into clinical medicine, relatively high doses were used (≤150 mg/d of hydrochlorothiazide), and hypokalemia was common and severe. During the 1970s, the first of several debates about unwanted consequences of thiazides arose.
Is hypokalemia a diuretic?
However, the report concludes that hypokalemia is the most likely cause of diuretic-induced hyperglycemia and cites experimental and observational data supporting this conclusion. These data are convincing, but there are indications that nonrenal effects of thiazides may also be involved.
What is the best medication for hypertension?
Diuretics. There are three classes of diuretic drugs that are used to treat hypertension. Most commonly used are thiazide diuretics such as hydrochlorothiazide or chlorthalidone. There is not usually an increased urine flow after the first one or two days of taking these medications. Nevertheless, it is best to take them in ...
Why are ACEIs used for hypertension?
ACEIs are widely used to treat hypertension because they are effective, have relatively few side effects and in reduce the complications of hypertension such as heart attacks and strokes. They have a special use in patients with diabetes mellitus who have protein the urine (“diabetic nephropathy”) and in patients with chronic kidney disease (CKD) in whom they appeared to have beneficial actions in slowing the loss of kidney function above that achieved by other agents.
Can diuretics cause low blood pressure?
Over treatment with diuretics can lead to low blood pressure , orthostatic hypotension (weakness, dizziness and possibly fainting on standing) and a feeling of tiredness and lethargy, all of which can be prevented or reversed by holding the diuretic for a day or two and resuming, if necessary, at a lower dosage.
Can a thiazide be used for gout?
Diuretics lead to some increase in uric acid and should not normally to be used in patients with gout.
Does Tempol lower blood pressure?
In so doing, tempol lowers blood pressure in animals and protects the blood vessels, kidneys, heart, and brain from damage. It is being developed as a potential therapy by the Hypertension, Kidney, and Vascular Research Center in collaboration with the Georgetown Drug Development Program.
Is salt intake a risk factor for hypertension?
Amongst those factors that are under our control which influence the probability of developing hypertension, an excessive dietary salt intake is probably the most important . Research in animal models at Georgetown at the Center for Hypertension, Kidney, and Vascular Research has linked dietary salt intake with oxidative stress that may underlie the hypertension and adverse consequences that follow from a persistently increased salt intake in the diet.
Is thiazide a first line drug?
For this reason, the Joint National Commission on Hypertension Detection Evaluation and Treatment (JNCVII) recommended thiazide diuretics as first line therapy for patients with hypertension, unless there were special reasons to select another type of drug.
Is chlorthalidone the same as hydrochlorothiazide?
Abstract. Diuretics have been used for years to treat hypertension as both a monotherapy and in combination. Hydrochlorothiazide, indapamide, and chlorthalidone have frequently been considered in the same category as thiazide diuretics, but there is no evidence that their activities are similar. Studies have shown that chlorthalidone ...
Does hydrochlorothiazide reduce mortality?
Studies have shown that chlorthalidone and indapamide reduce cardiovascular morbidity and mortality; however, there is no study indicating that hydrochlorothiazide has beneficial effects on cardiovascular outcomes such as myocardial infarction, renal failure, stroke, or death.
Is hydrochlorothiazide a diuretic?
Hydrochlorothiazide has less effect on blood pressure, a high risk of metabolic side effects, and may not have pleiotropic effects. As a result, it is not accurate to evaluate chlorthalidone and indapamide as similar to thiazide diuretics. Indapamide or chlorthalidone is a better choice of diuretic for use in the treatment of hypertension.
How Thiazides Reduce Blood Pressure
Thiazide-Induced Hypokalemia
- When thiazides were introduced into clinical medicine, relatively high doses were used (≤150 mg/d of hydrochlorothiazide), and hypokalemia was common and severe. During the 1970s, the first of several debates about unwanted consequences of thiazides arose. Hypokalemia was deemed hazardous by many investigators; associations with ventricular arrhythmias were espec…
Thiazide-Induced Hyperglycemia
- Although concern about hypokalemic arrhythmias from thiazide use continues, its preeminence has been replaced by concern about other metabolic adverse effects. Recently, this led the National Heart Lung and Blood Institute to convene a working group to examine mechanisms, consequences, and prevention of diuretic-induced dysglycemia. Their preliminary report63 sum…
Thiazide-Induced Structural Kidney Damage
- Recently, another potential adverse effect of thiazide treatment has been described. Rats that received thiazides chronically showed evidence of “subtle glomerular injury characterized by periglomerular fibrosis and wrinkling and thickening of the glomerular basement membrane” (see Figure 2A).3 The kidneys showed evidence of oxidative stress as wel...
NCC Deficiency and Essential Hypertension
- A final insight into effects of thiazide diuretics may come from novel genetic approaches. GS and BS are autosomal, recessive, salt-wasting disorders that reduce blood pressure by mutations in salt transport genes along the loop of Henle and DCT. Recently, Lifton et al87tested whether a single mutant copy of these genes might lower blood pressure without causing frank disease, th…
Summary and Conclusions
- The presence of vasodilatation in individuals with GS argues that thiazide-induced vasodilation reflects whole-body autoregulation because of renal actions, although a component of drug-induced direct vasodilatation cannot be excluded. The absence of hyperglycemia observed to date in patients with GS raises the possibility that glucose intolerance during thiazide treatment …
Treatment
- There are three classes of diuretic drugs that are used to treat hypertension. Most commonly used are thiazide diuretics such as hydrochlorothiazide or chlorthalidone. There is not usually an increased urine flow after the first one or two days of taking these medications. Nevertheless, it is best to take them in the morning to prevent annoying urine production overnight. They are effect…
Interactions
- Diuretics increase the effectiveness or all other classes of antihypertensive agents. Therefore, almost any subject, except those with a contraindication, should receive a diuretic if their blood pressure requires more than one drug for its management.
Adverse effects
- Adverse Effects: Diuretics increase the excretion of potassium and can lead to hypokalemia (low blood potassium concentration) which predisposes to irregular heart beats, and muscular weakness. However, a combination of a thiazide or loop diuretic with a distal, potassium sparing agent (such as in the combined medications, Maxzide or Moduretic), pr...
Types
- Different Drugs: Thiazide diuretics include: hydrochlorothiazide (usual starting dose 12.5 to 25 mg daily) or chlorthalidone (similar dose range). Loop diuretics include: furosemide (Lasix), bumetanide (Bumex), and torsemide (Demadex), torsemide has a rather longer duration and is preferred in patients with heart failure. Ethacrinic acid (Edecrin) is used in the rare patients who …
Medical uses
- ACEIs are widely used to treat hypertension because they are effective, have relatively few side effects and in reduce the complications of hypertension such as heart attacks and strokes. They have a special use in patients with diabetes mellitus who have protein the urine (diabetic nephropathy) and in patients with chronic kidney disease (CKD) in whom they appeared to have …
Examples
- Individual Drugs: The following are examples of ACEIs in clinical practice: benazepril (Mylan), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), Lisinopril (Prinivil), moexipril (Univasc), quinapril (Accupril), ramipril (Altace) and trandolapril (Mavik). There are some small differences in how long these drugs act in the circulation, they are relatively small and, with the e…
Side effects
- Biochemical changes with ACEIs are usually insignificant in patients with normal kidney function. However, in those with impaired kidneys, they can raise the serum potassium concentration to levels that are dangerous and require either a change in therapy, or increasing thiazide or loop diuretic dosage to promote potassium loss. Such patients should discuss with their physician o…
Contraindications
- Special Indications: As these include patients with chronic kidney disease (but see the adverse effects above), early diabetes mellitus, congestive heart failure, or left ventricular hypertrophy. These drugs will not be discussed in detail since they are used infrequently.
Mechanism of action
- This group of drugs was introduced next after diuretics, to be used for hypertension. They act on a part of the nervous system that controls blood pressure, known as the sympathetic nervous system. Blockade of the sympathetic nervous system reduces blood pressure by relaxing blood vessels, and decreasing the rate and force of contraction of the heart. Therefore, beta blockers a…
Pharmacology
- The actions of these agents are enhanced in patients taking diuretic drugs and therefore are a good second or third line selection in those patients who are not controlled with a diuretic and an ACEI or ARB. Unfortunately, alpha blockers have been shown to be less affective than other groups of blood pressure lowering agents in preventing the complications of heart failure and he…
Categories
- Individual drugs: They fall into two categories. The first are called dihydropyridine CCBs and include amlodipine (Norvasc), felodipine (Plendil), nifedipine (Procardia), and nicardipine (Cardene). The second, termed nondihydropyridine CCBs include two drugs, diltiazem (Dilacor, Cardizem, Cartia, and Tiazac), and verapamil (Calan, Covera, Isoptin, Verelan). Both groups are e…
Effects
- Non-dihydropyridine CCBs cause cardiac slowing. This typically reduces the heart rate by about 10%. It can be beneficial in some patients with a fast heart rate or who have irregular heartbeat (atrial fibrillation), but in those with a slow initial heart rate, it can cause symptoms of decreased cardiac output (tiredness, lethargy, and dizziness on exertion). This group of drugs also can cau…
Research
- This is a rapidly developing field with extensive research, both by Centre scientists in the laboratory and clinical investigators in patients with hypertension. The following outlines some of the areas of research conducted at the Centre at Georgetown. Research at the Hypertension, Kidney and Vascular Research Centre at Georgetown has focused on a different path, namely dr…
Pathophysiology
- Oxidative stress occurs in cells and tissues of the body when oxygen reacts to form toxic molecules called reactive oxygen species (ROS). These can inactivate the normal signaling pathways between cells, damage cell membranes and proteins, and alter the DNA that forms the basis of our genes. Therefore, oxidative stress has widespread effects in the body. Increasing ev…
Cause
- Amongst those factors that are under our control which influence the probability of developing hypertension, an excessive dietary salt intake is probably the most important. Research in animal models at Georgetown at the Center for Hypertension, Kidney, and Vascular Research has linked dietary salt intake with oxidative stress that may underlie the hypertension and adverse consequ…
Resources
- For further information about how to support the research in Georgetown Universitys Center for Hypertension, Kidney, and Vascular Research, please see Georgetown Universitys Office of Advancement.