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AHFS Consumer Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists; 2000-2011.

AHFS Consumer Medication Information.

Hydrochlorothiazide(hye droe klor oh thye' a zide)

Last Revision: May 15, 2012.

Notice

This MedWatch affects the following medications:

  • Amturnide (aliskiren hemifumarate, amlodipine besylate, and hydrochlorothiazide)

  • Tekturna (aliskiren hemifumarate)

  • Tekturna HCT (aliskiren hemifumarate and hydrochlorothiazide)

  • Tekamlo (aliskiren hemifumarate and amlodipine besylate)

  • Valturna (aliskiren hemifumarate and valsartan). Valturna will no longer be marketed after July 2012.

[Posted 04/20/2012] ISSUE: FDA notified healthcare professionals of possible risks when using blood pressure medicines containing aliskiren with other drugs called angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in patients with diabetes or kidney (renal) impairment. These drug combinations should not be used (are contraindicated) in patients with diabetes. In addition, avoid use of aliskiren with ARBs or ACEIs in patients with moderate to severe renal impairment (i.e., where glomerular filtration rate [GFR] < 60 mL/min). The labels for the aliskiren drugs are being updated based on preliminary data from a clinical trial, ''Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE).''

BACKGROUND: Aliskiren is a renin inhibitor used to treat high blood pressure (hypertension) by lowering blood pressure.

RECOMMENDATION: Concomitant use of aliskiren with ARBs or ACEIs in patients with diabetes is contraindicated because of the risk of renal impairment, hypotension, and hyperkalemia. Avoid use of aliskiren with ARBs or ACEIs in patients with renal impairment where GFR < 60 mL/min. Patients should not stop taking aliskiren without talking to your healthcare professional. Stopping aliskiren suddenly can cause problems if your high blood pressure (hypertension) is not treated.

See the Drug Safety Communication for the Data Summary at: http://www.fda.gov/Drugs/DrugSafety/ucm300889.htm for a list of ACEI and ARB products, and additional recommendations for healthcare professionals and patients. For more information visit the FDA website at: http://www.fda.gov/Safety/MedWatch/SafetyInformation and http://www.fda.gov/Drugs/DrugSafety.

Why is this medication prescribed?

Hydrochlorothiazide, a 'water pill,' is used to treat high blood pressure and fluid retention caused by various conditions, including heart disease. It causes the kidneys to get rid of unneeded water and salt from the body into the urine.

This medicine is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Hydrochlorothiazide comes as a tablet and liquid to take by mouth. It usually is taken once or twice a day. If you are to take it once a day, take it in the morning; if you are to take it twice a day, take it in the morning and in the late afternoon to avoid going to the bathroom during the night. Take this medication with a meal or snack. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Hydrochlorothiazide controls high blood pressure but does not cure it. Continue to take hydrochlorothiazide even if you feel well. Do not stop taking hydrochlorothiazide without talking to your doctor.

Other uses for this medicine

Hydrochlorothiazide may also be used to treat patients with diabetes insipidus and certain electrolyte disturbances and to prevent kidney stones in patients with high levels of calcium in their blood. Talk to your doctor about the possible risks of using this medicine for your condition.

What special precautions should I follow?

Before taking hydrochlorothiazide,

  • tell your doctor and pharmacist if you are allergic to hydrochlorothiazide, sulfa drugs, or any other drugs.

  • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other medicines for high blood pressure, anti-inflammatory medications such as ibuprofen (Motrin, Nuprin) or naproxen (Aleve), corticosteroids (e.g., prednisone), lithium (Eskalith, Lithobid), medications for diabetes, probenecid (Benemid), and vitamins. If you also are taking cholestyramine or colestipol, take it at least 1 hour after hydrochlorothiazide.

  • tell your doctor if you have or have ever had diabetes, gout, or kidney, liver, thyroid, or parathyroid disease.

  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking hydrochlorothiazide, call your doctor immediately.

  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking hydrochlorothiazide.

  • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.

  • remember that alcohol can add to the drowsiness caused by this drug.

  • plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Hydrochlorothiazide may make your skin sensitive to sunlight.

What special dietary instructions should I follow?

Follow your doctor's directions. They may include following a daily exercise program or a low-salt or low-sodium diet, potassium supplements, and increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) in your diet.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Frequent urination should go away after you take hydrochlorothiazide for a few weeks. Tell your doctor if any of these symptoms are severe or do not go away:

  • muscle weakness

  • dizziness

  • cramps

  • thirst

  • stomach pain

  • nausea

  • vomiting

  • diarrhea

  • loss of appetite

  • headache

  • hair loss

If you experience any of the following symptoms, call your doctor immediately:

  • sore throat with fever

  • unusual bleeding or bruising

  • severe skin rash with peeling skin

  • difficulty breathing or swallowing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medicine in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not allow the liquid to freeze. Throw away any medicine that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medicine.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS® Consumer Medication Information. © Copyright, 2011. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

The following brand names are from RxNorm, a standardized nomenclature for clinical drugs produced by the National Library of Medicine:

Brand names

  • Aquazide H

  • Carozide

  • Diaqua

  • Esidrix

  • Ezide

  • Hydro Par

  • HydroDIURIL

  • Hydrocot

  • Hydrokraft

  • Loqua

  • Oretic

Brand names of combination products

  • Accuretic 10/12.5 (containing Hydrochlorothiazide and quinapril)

  • Accuretic 20/12.5 (containing Hydrochlorothiazide and quinapril)

  • Accuretic 20/25 (containing Hydrochlorothiazide and quinapril)

  • Aldactazide (containing Hydrochlorothiazide and Spironolactone)

  • Aldoril (containing Hydrochlorothiazide and Methyldopa)

  • Amturnide (containing Amlodipine, Hydrochlorothiazide, and aliskiren)

  • Atacand HCT 16/12.5 (containing Hydrochlorothiazide and candesartan)

  • Atacand HCT 32/12.5 (containing Hydrochlorothiazide and candesartan)

  • Atacand HCT 32/25 (containing Hydrochlorothiazide and candesartan)

  • Avalide 150/12.5 (containing Hydrochlorothiazide and irbesartan)

  • Avalide 300/12.5 (containing Hydrochlorothiazide and irbesartan)

  • Avalide 300/25 (containing Hydrochlorothiazide and irbesartan)

  • Benicar HCT 20/12.5 (containing Hydrochlorothiazide and olmesartan)

  • Benicar HCT 40/12.5 (containing Hydrochlorothiazide and olmesartan)

  • Benicar HCT 40/25 (containing Hydrochlorothiazide and olmesartan)

  • Capozide 25/15 (containing Captopril and Hydrochlorothiazide)

  • Capozide 25/25 (containing Captopril and Hydrochlorothiazide)

  • Capozide 50/15 (containing Captopril and Hydrochlorothiazide)

  • Capozide 50/25 (containing Captopril and Hydrochlorothiazide)

  • Diovan HCT 160/12.5 (containing Hydrochlorothiazide and valsartan)

  • Diovan HCT 160/25 (containing Hydrochlorothiazide and valsartan)

  • Diovan HCT 320/12.5 (containing Hydrochlorothiazide and valsartan)

  • Diovan HCT 320/25 (containing Hydrochlorothiazide and valsartan)

  • Diovan HCT 80/12.5 (containing Hydrochlorothiazide and valsartan)

  • Diuretic Ap-Es (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Dutoprol 100/12.5 (containing Hydrochlorothiazide and Metoprolol)

  • Dutoprol 25/12.5 (containing Hydrochlorothiazide and Metoprolol)

  • Dutoprol 50/12.5 (containing Hydrochlorothiazide and Metoprolol)

  • Esimil (containing Guanethidine and Hydrochlorothiazide)

  • Exforge HCT 10/160/12.5 (containing Amlodipine, Hydrochlorothiazide, and valsartan)

  • Exforge HCT 10/160/25 (containing Amlodipine, Hydrochlorothiazide, and valsartan)

  • Exforge HCT 10/320/25 (containing Amlodipine, Hydrochlorothiazide, and valsartan)

  • Exforge HCT 5/160/12.5 (containing Amlodipine, Hydrochlorothiazide, and valsartan)

  • Exforge HCT 5/160/25 (containing Amlodipine, Hydrochlorothiazide, and valsartan)

  • HHR (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Hydrap-ES (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Hydro-Reserp (containing Hydrochlorothiazide and Reserpine)

  • Hydropres-25 (containing Hydrochlorothiazide and Reserpine)

  • Hydropres-50 (containing Hydrochlorothiazide and Reserpine)

  • Hydroserp (containing Hydrochlorothiazide and Reserpine)

  • Hydroserpine (containing Hydrochlorothiazide and Reserpine)

  • Hyzaar 100/12.5 (containing Hydrochlorothiazide and Losartan)

  • Hyzaar 100/25 (containing Hydrochlorothiazide and Losartan)

  • Hyzaar 50/12.5 (containing Hydrochlorothiazide and Losartan)

  • Inderide 40/25 (containing Hydrochlorothiazide and Propranolol)

  • Inderide 80/25 (containing Hydrochlorothiazide and Propranolol)

  • Lopressor HCT 100/25 (containing Hydrochlorothiazide and Metoprolol)

  • Lopressor HCT 100/50 (containing Hydrochlorothiazide and Metoprolol)

  • Lopressor HCT 50/25 (containing Hydrochlorothiazide and Metoprolol)

  • Lotensin HCT 10/12.5 (containing Hydrochlorothiazide and benazepril)

  • Lotensin HCT 20/12.5 (containing Hydrochlorothiazide and benazepril)

  • Lotensin HCT 20/25 (containing Hydrochlorothiazide and benazepril)

  • Lotensin HCT 5/6.25 (containing Hydrochlorothiazide and benazepril)

  • Mallopress (containing Hydrochlorothiazide and Reserpine)

  • Marpres (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Maxzide (containing Hydrochlorothiazide and Triamterene)

  • Micardis-HCT 40/12.5 (containing Hydrochlorothiazide and telmisartan)

  • Micardis-HCT 80/12.5 (containing Hydrochlorothiazide and telmisartan)

  • Micardis-HCT 80/25 (containing Hydrochlorothiazide and telmisartan)

  • Moduretic 5-50 (containing Amiloride and Hydrochlorothiazide)

  • Monopril-HCT 10/12.5 (containing Fosinopril and Hydrochlorothiazide)

  • Monopril-HCT 20/12.5 (containing Fosinopril and Hydrochlorothiazide)

  • Oreticyl 25 (containing Hydrochlorothiazide and deserpidine)

  • Oreticyl 50 (containing Hydrochlorothiazide and deserpidine)

  • Oreticyl Forte (containing Hydrochlorothiazide and deserpidine)

  • Prinzide (containing Hydrochlorothiazide and Lisinopril)

  • Quinaretic 10/12.5 (containing Hydrochlorothiazide and quinapril)

  • Quinaretic 20/12.5 (containing Hydrochlorothiazide and quinapril)

  • Quinaretic 20/25 (containing Hydrochlorothiazide and quinapril)

  • Ser-Ap-Es (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Serathide (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Serpazide (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Serpex (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Spironolactone Plus (containing Hydrochlorothiazide and Spironolactone)

  • Tekturna HCT 150/12.5 (containing Hydrochlorothiazide and aliskiren)

  • Tekturna HCT 150/25 (containing Hydrochlorothiazide and aliskiren)

  • Tekturna HCT 300/12.5 (containing Hydrochlorothiazide and aliskiren)

  • Tekturna HCT 300/25 (containing Hydrochlorothiazide and aliskiren)

  • Teveten HCT (containing Hydrochlorothiazide and eprosartan)

  • Timolide (containing Hydrochlorothiazide and Timolol)

  • Tri-Hydroserpine (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Tribenzor 20/5/12.5 (containing Amlodipine, Hydrochlorothiazide, and olmesartan)

  • Tribenzor 40/10/12.5 (containing Amlodipine, Hydrochlorothiazide, and olmesartan)

  • Tribenzor 40/10/25 (containing Amlodipine, Hydrochlorothiazide, and olmesartan)

  • Tribenzor 40/5/12.5 (containing Amlodipine, Hydrochlorothiazide, and olmesartan)

  • Tribenzor 40/5/25 (containing Amlodipine, Hydrochlorothiazide, and olmesartan)

  • Uni Serp (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Unipres (containing Hydralazine, Hydrochlorothiazide, and Reserpine)

  • Uniretic 15/12.5 (containing Hydrochlorothiazide and moexipril)

  • Uniretic 15/25 (containing Hydrochlorothiazide and moexipril)

  • Uniretic 7.5/12.5 (containing Hydrochlorothiazide and moexipril)

  • Vaseretic (containing Enalapril and Hydrochlorothiazide)

  • Zestoretic 10/12.5 (containing Hydrochlorothiazide and Lisinopril)

  • Zestoretic 20/12.5 (containing Hydrochlorothiazide and Lisinopril)

  • Zestoretic 20/25 (containing Hydrochlorothiazide and Lisinopril)

  • Ziac 10/6.25 (containing Bisoprolol and Hydrochlorothiazide)

  • Ziac 2.5/6.25 (containing Bisoprolol and Hydrochlorothiazide)

  • Ziac 5/6.25 (containing Bisoprolol and Hydrochlorothiazide)

What works?

  • Diuretics effective in lowering blood pressure when given as a second drug Diuretics effective in lowering blood pressure when given as a second drug
    Diuretics are a good first‐line treatment for high blood pressure (BP). Diuretics include loop diuretics and thiazides. We asked how much do diuretics reduce BP when used as the second drug to treat hypertension. We performed a search of the available scientific literature to find all trial evidence to assess this question. Fifty‐six trials were found. Fifty‐three trials involved thiazide diuretics (92% with the drug hydrochlorothiazide) and included a total of 15310 participants. Adding a thiazide to another anti‐hypertensive drug further reduces the BP by an additional 6/3 mmHg when given at the starting dose and reduces BP by 8/4 mmHg at 2 times the starting dose. This is approximately the same effect as when the drugs are used alone. A good estimate of the harms associated with diuretics cannot be estimated in this review because of the lack of reporting and the short duration of the trials.
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  • Making smart health choices Making smart health choices
    Develop the skills to assess health advice and make better-informed decisions about your health and managing illness.

Conditions of interest

  • Heart disease
    Heart disease is any disorder that affects the heart's ability to function normally. Various forms of heart disease include:
  • Diabetes insipidus
    Diabetes insipidus is a condition in which the kidneys are unable to conserve water.
  • Diabetes insipidus - nephrogenic
    Nephrogenic diabetes insipidus is a disorder in which a defect in the small tubes (tubules) in the kidneys causes a person to pass a large amount of urine. The tubules allow water to be removed from the body or reabsorbed.
  • Hypertension
    Hypertension is the term used to describe high blood pressure.
  • Diabetes
    Diabetes is a lifelong (chronic) disease in which there are high levels of sugar in the blood.
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