Hydrochlorothiazide, tablets 25 mg 20 pcs

Diuretic. The primary mechanism of action of thiazide diuretics is to increase diuresis by inhibiting reabsorption of sodium and chlorine ions in the initial part of the renal tubules. This leads to increased excretion of sodium and chlorine and, consequently, water. The excretion of other electrolytes, namely potassium and magnesium, also increases. At maximum therapeutic doses, the diuretic/natriuretic effect of all thiazides is approximately the same.

Natriuresis and diuresis occur within 2 h and reach maximum levels after approximately 4 h.

The thiazides also reduce carboanhydrase activity by increasing excretion of bicarbonate ions, but this effect is usually weak and has no effect on urine pH.

Hydrochlorothiazide also has hypotensive properties. Thiazide diuretics do not affect normal BP.

Indications

Active ingredient

Composition

Active ingredient:

hydrochlorothiazide 25 mg;

Associates:

Lactose monohydrate,

povidone,

p> cellulose,

corn starch,

magnesium stearate.

How to take, the dosage

Set individually. The single dose is 25-50 mg, the daily dose is 25-100 mg. Frequency of administration depends on indications and patient’s reaction to treatment.

Interaction

When concomitant use of antihypertensives, nondepolarizing myorelaxants, their effect is increased.

Concomitant use of barbiturates, diazepam, ethanol increases the risk of orthostatic hypotension.

Simultaneous use with GCS increases the risk of hypokalemia and orthostatic hypotension.

Concomitant use with ACE inhibitors (including captopril, enalapril) increases the antihypertensive effect.

Perhaps severe arterial hypotension, especially after the first dose of hydrochlorothiazide, apparently due to hypovolemia, which leads to transient enhancement of hypotensive effect of ACE inhibitor.

The risk of impaired renal function increases. The development of hypokalemia is not excluded.

The concomitant use of oral hypoglycemic agents decreases their effectiveness.

In concomitant use of calcium and/or vitamin D preparations in high doses hypercalcemia and risk of metabolic acidosis due to delayed urinary calcium excretion caused by thiazide diuretics are possible.

Concomitant use with allopurinol increases the risk of allergic reactions, especially in patients with impaired renal function.

Concomitant use with digoxin may increase the risk of glycoside intoxication.

Concomitant use with indomethacin, piroxicam, naproxen, phenylbutazone may slightly reduce the hypotensive effect.

Concomitant use with irbesartan may lead to additive hypotensive effect.

In concomitant use with carbamazepine there have been reports of hyponatremia.

Concomitant use with colestipol, colestiramine decreases absorption and diuretic effect of hydrochlorothiazide.

Concomitant use with lithium carbonate may increase the blood concentration of lithium salts to toxic levels.

Concomitant use with orlistat decreases the effectiveness of hydrochlorothiazide, which may lead to a significant increase in BP and development of hypertensive crisis.

Concomitant use with sotalol may cause hypokalemia and development of pirouette-type ventricular arrhythmias.

Special Instructions

With caution, use in patients with gout and diabetes mellitus.

In patients with renal insufficiency, systematic monitoring of plasma electrolyte and CK concentrations is necessary.

In case of signs of potassium deficiency and concomitant use of cardiac glycosides, GCS, and ACTH, potassium preparations or potassium-saving diuretics are indicated.

In long-term use, a diet rich in potassium should be followed.

The simultaneous use of diuretics with NSAIDs is not recommended.

Contraindications

Severe renal dysfunction, hepatic insufficiency, severe forms of gout and diabetes, hypersensitivity to sulfonamides.

Side effects

Electrolyte disturbances

Hypokalemia, hypomagnesemia, hypercalcemia, and hypochloremic alkalosis: dry mouth, thirst, irregular heart rhythm, mood or mental changes, cramps and muscle pain, nausea, vomiting, unusual fatigue or weakness. Hypochloremic alkalosis can cause hepatic encephalopathy or hepatic coma.

Hyponatremia: confusion, convulsions, lethargy, slowed thinking process, fatigue, agitation, 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 may manifest. Serum lipid levels may increase with high doses.

Gastrointestinal disorders: cholecystitis or pancreatitis, cholestatic jaundice, diarrhea, sialadenitis, constipation, anorexia.

Cardiovascular system and blood (hemopoiesis, hemostasis): arrhythmia, orthostatic hypotension, vasculitis; very rarely – leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia.

Nervous system and sensory system disorders: dizziness, blurred vision (temporarily), headache, paresthesias.

High sensitivity reactions: urticaria, purpura, necrotizing vasculitis, Stevens-Johnson syndrome, respiratory distress syndrome (including pneumonitis and noncardiac pulmonary edema), photosensitivity, anaphylactic reactions up to and including shock.

Others: decreased potency, impaired renal function, interstitial nephritis.

Similarities