Hydrochlorothiazide
Ozon
844 Items
2019-09-19
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Clinical Pharmacology
Hydrochlorothiazide - thiazide diuretic. Impairs the reabsorption of sodium ions, chlorine and water in the distal nephron tubules. Increases the excretion of potassium, magnesium, bicarbonate ions; detains calcium in the body. The diuretic effect occurs after 2 hours, reaches a maximum after 4 hours and lasts up to 12 hours. Helps reduce high blood pressure. In addition, it reduces polyuria in patients with diabetes insipidus (the mechanism of action is not fully understood). In some cases, lowers intraocular pressure in glaucoma.
Indications
Arterial hypertension (monotherapy or in combination with other antihypertensive drugs), edematous syndrome of various genesis (chronic heart failure, nephrotic syndrome, premenstrual syndrome, acute glomerulonephritis, chronic renal failure, portal hypertension, treatment with corticosteroids), polyuria control (mainly in nephrogenic cases, polymoris). ), prevention of the formation of stones in the urogenital tract in susceptible patients (reduction of hypercalciuria).
Composition
1 tablet contains:
Active substance: hydrochlorothiazide 25 mg;
Excipients: lactose monohydrate, povidone, cellulose, corn starch, magnesium stearate.
Hydrochlorothiazide is marketed under different brands and generic names, and comes in different dosage forms:
| Brand name | Manufacturer | Country | Dosage form |
|---|---|---|---|
| Hydrochlorothiazide | Ozon | Russia | pills |
| Hydrochlorothiazide | Valenta | Russia | pills |
| Hypothiazide | Sanofi-aventis | France | pills |
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Dosage and Administration
Install individually. Single dose - 25-50 mg daily dose - 25-100 mg. The frequency of treatment depends on the indications and the patient's response to treatment.
Adverse reactions
Electrolyte imbalance
Hypokalemia, hypomagnesemia, hypercalcemia and hypochloremic alkalosis: dry mouth, thirst, irregular heart rhythm, changes in mood or psyche, cramps and muscle pain, nausea, vomiting, unusual tiredness or weakness. Hypochloremic alkalosis can cause hepatic encephalopathy or hepatic coma.
Hyponatremia: confusion, convulsions, lethargy, slow thinking, fatigue, irritability, muscle cramps.
Metabolic phenomena: hyperglycemia, glucosuria, hyperuricemia with the development of a gout attack. Treatment with thiazides may decrease glucose tolerance, and latent diabetes mellitus can manifest. When high doses are used, serum lipid levels may increase.
On the part of the digestive tract: cholecystitis or pancreatitis, cholestatic jaundice, diarrhea, sialadenitis, constipation, anorexia.
Since the cardiovascular system and blood (hematopoiesis, hemostasis): arrhythmias, orthostatic hypotension, vasculitis; very rarely - leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia.
From the nervous system and sense organs: dizziness, blurred vision (temporarily), headache, paresthesias.
Hypersensitivity Reactions: urticaria, purpura, necrotizing vasculitis, Stevens-Johnson syndrome, respiratory distress syndrome (including pneumonitis and non-cardiogenic pulmonary edema), photosensitivity, anaphylactic reactions up to shock.
Other: reduced potency, impaired renal function, interstitial nephritis.
Contraindications
Hypersensitivity (including to other sulfonamides), anuria, severe renal (Cl creatinine - less than 30 ml / min) or liver failure, poorly controlled diabetes, Addison's disease, gout, children (up to 3 years).
Drug interactions
With the simultaneous use of antihypertensive drugs, non-depolarizing muscle relaxants, their action is enhanced.
With the simultaneous use of barbiturates, diazepam, ethanol increases the risk of orthostatic hypotension.
With simultaneous use with GCS, there is a risk of hypokalemia and also orthostatic hypotension.
With simultaneous use with ACE inhibitors (including captopril, enalapril), the antihypertensive effect is enhanced.
Possible marked arterial hypotension, especially after taking the first dose of hydrochlorothiazide, apparently due to hypovolemia, which leads to a transient increase in the hypotensive effect of the ACE inhibitor.
The risk of renal dysfunction increases. The development of hypokalemia is not excluded.
With simultaneous use of oral hypoglycemic drugs reduces their effectiveness.
With the simultaneous use of calcium and / or vitamin D in high doses, hypercalcemia and the risk of metabolic acidosis are possible due to the slowing down of calcium in the urine under the influence of thiazide diuretics.
With simultaneous use with allopurinol increases the risk of allergic reactions, especially in patients with impaired renal function.
With simultaneous use with digoxin may increase the risk of glycosidic intoxication.
With simultaneous use with indomethacin, piroxicam, naproxen, phenylbutazone, some decrease in the hypotensive effect is possible.
With simultaneous use with irbesartan, an additive hypotensive effect may develop.
With simultaneous use with carbamazepine, there are reports of the development of hyponatremia.
With simultaneous use with colestipol, colestiramine decreases the absorption and diuretic effect of hydrochlorothiazide.
With simultaneous use of lithium carbonate, it is possible to increase the concentration of lithium salts in the blood to a toxic level.
With simultaneous use with orlistat decreases the effectiveness of hydrochlorothiazide, which can lead to a significant increase in blood pressure and the development of hypertensive crisis.
With simultaneous use with sotalol possible hypokalemia and the development of ventricular arrhythmias of the "pirouette" type.
Pregnancy and Lactation
At the time of treatment should stop breastfeeding.
Special instructions
It is used with caution in patients with gout and diabetes.
In patients with renal insufficiency, systematic monitoring of plasma electrolyte concentration and CC is necessary.
With the appearance of signs of potassium deficiency, as well as the simultaneous use of cardiac glycosides, GCS and ACTH, administration of potassium or potassium-saving diuretics is indicated.
With prolonged use should follow a diet rich in potassium.
The simultaneous use of diuretics with NSAIDs is not recommended.
- Brand name: Hydrochlorothiazide
- Active ingredient: Hydrochlorothiazide
- Dosage form: Pills
- Manufacturer: Ozone
- Country of Origin: Russia
Studies and clinical trials of Hydrochlorothiazide (Click to expand)
- Narrow-bore liquid chromatography coupled to chemiluminescence detection for the analysis of pharmaceutical preparations containing hydrochlorothiazide and captopril
- Steady-state pharmacokinetics of diltiazem and hydrochlorothiazide administered alone and in combination
- Liquid chromatography–mass spectrometry and proton nuclear magnetic resonance characterization of trace level condensation products formed between lactose and the amine-containing diuretic hydrochlorothiazide
- Biopharmaceutical characteristics of a new propranolol/ hydrochlorothiazide tablet combination
- Comparative bioavailability and pharmacokinetics of hydrochlorothiazide from oral tablet dosage forms, determined by plasma level and urinary excretion methods
- Pharmacokinetics of mepindolol administered alone and in combination with hydrochlorothiazide—a bioequivalence study
- Preliminary observations on dissolution and bioavailability of triamterene–hydrochlorothiazide combination products
- Absorption and disposition of a new low-dose combination formulation of hydrochlorothiazide and triamterene
- Pharmacokinetic comparison of a combination tablet of enalapril and hydrochlorothiazide with enalapril and hydrochlorothiazide tablets administered together and separately
- Simple determination of hydrochlorothiazide in human plasma and urine by high performance liquid chromatography
- A single, selective and simple validated method for simultaneous estimation of amiloride and hydrochlorothiazide in human plasma by liquid chromatography–tandem mass spectrometry
- Development of solid-phase extraction method and its application for determination of hydrochlorothiazide in human plasma using HPLC
- Sensitive liquid chromatography–tandem mass spectrometry method for quantification of hydrochlorothiazide in human plasma
- Interaction of glycyrrhetinic acid, furosemide and hydrochlorothiazide with bovine serum albumin and their displacement interactions: capillary electrophoresis and fluorescence quenching study
- High-fat diet and hydrochlorothiazide increase oxidative stress in brain of rats
- Genotoxicity of hydrochlorothiazide in cultured human lymphocytes. I. Evaluation of chromosome delay and chromosome breakage
- Toxicology and carcinogenicity studies of diuretics in F344 rats and B6C3F1 mice 1. Hydrochlorothiazide
- Development and validation of a liquid chromatographic/electrospray ionization mass spectrometric method for the determination of benazepril, benazeprilat and hydrochlorothiazide in human plasma
- Formation of the unusual [M+H-11 Da]+ ion peak in the collision-induced dissociation mass spectrum of [M+H]+ ion of hydrochlorothiazide
- Purification and identification of an impurity in bulk hydrochlorothiazide
- Kaliuretic properties of furosemide and hydrochlorothiazide by in vivo liquid scintillation countin
- Diffuse reflectance studies of solid—solid interactions II. Interaction of metallic and nonmetallic adjuvants with anthracene, prednisone, and hydrochlorothiazide
- Hydrolysis of hydrochlorothiazide
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