Class: Thiazide Diuretic, Antihypertensive
Dosage Forms. Capsule: 12.5 mg; Tablet: 12.5 mg, 25 mg, 50 mg
Common FDA Label Indication, Dosing, and Titration.
1. Edema; adjunct: Adults: 25-100 mg po daily in single or divided doses; Children: 1-2 mg/kg po daily in single or divided doses, infants <6 mo old may require doses up to 3 mg/kg po daily in 2 divided doses; Infants <2 y old, max dose 37.5 mg/d; Children 2-12 y old, max dose 100 mg/d
Hypertension: Adults: initial, 12.5-25 mg po daily, titrate to maintenance dose 50-100 mg po daily or in divided doses; Children: 1-2 mg/kg po daily in single or divided doses, infants <6 mo old may require doses up to 3 mg/kg po daily in 2 divided doses; Infants <2 y old, max dose 37.5 mg/d; Children 2-12 y old, max dose 100 mg/d
1. Hypercalciuria: Adults: 25 mg po bid; Children: 1-2 mg/kg/d
2. Osteoporosis: Adults: 12.5-25 mg po daily
MOA. Thiazides increase sodium and chloride excretion by interfering with their reabsorption in the cortical diluting segment of the nephron.
Drug Characteristics: Hydrochlorothiazide
Medication Safety Issues: Hydrochlorothiazide
Drug Interactions: Hydrochlorothiazide
Adverse Reactions: Hydrochlorothiazide
Efficacy Monitoring Parameters. Decreased blood pressure, reductions in edema.
Toxicity Monitoring Parameters. Decreased serum and urine electrolytes, decreased renal function, increased serum uric acid or blood glucose. Seek medical attention if skin rash, yellowing of eyes or skin, decreased urine output, or symptoms of gout occur.
Key Patient Counseling Points. May cause dizziness. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert. Report signs/symptoms of hypotension. Eat high-potassium foods during therapy. Avoid alcohol and using NSAIDs.
Clinical Pearls. Full hypotensive effect may require 2-3 wk.