HYDROCHLOROTHIAZIDE oral

Therapeutic action

• Thiazide diuretic

Indications

• Hypertension
• Oedema associated with renal, hepatic or congestive heart failure

Forms and strengths

• 12.5 mg and 25 mg tablets

Dosage

Hypertension

• Adult: 12.5 to 25 mg once daily in the morning (max. 25 mg daily)

Oedema associated with renal, hepatic or congestive heart failure

• Adult: 25 mg once daily in the morning or 25 mg 2 times daily (max. 100 mg daily)

Duration

• According to clinical response

Contra-indications, adverse effects, precautions

• Do not administer to patients with severe renal failure.
• Administer with caution in patients with hypokalaemia, hyponatraemia and in elderly patients.
• May cause:
  • dehydration, hypotension, hypokalaemia, hyponatraemia;
  • gastrointestinal disturbances, headache, dizziness, skin rash, impotence, photosensitivity.
• Avoid or monitor combination with NSAIDs (risk of renal impairment); lithium (increased plasma concentrations of lithium). 
• Monitor combination with:
  • drugs that provoke hypotension (e.g. haloperidol, amitriptyline) and antihypertensive drugs (risk of hypotension);
  • potassium-depleting drugs (e.g. corticosteriods, laxatives, amphotericin B), sodium-depleting drugs (e.g. SSRI, carbamazepine), drugs enhancing hypercalcemic effect (e.g. calcium, ergocalciferol);
  • oral antidiabetics and insulin (risk of hyperglycaemia).
• Pregnancy: CONTRA-INDICATED
• Breast-feeding: CONTRA-INDICATED

Remarks

• A potassium-rich diet (dates, bananas, mangos, oranges, tomatoes, etc.) is recommended during treatment. If potassium level is < 3.5 mmol/litre, administer a sustained-released potassium supplement. 
• Diuretics are not indicated in the treatment of nutritional oedema.

Storage