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Hydrochlorothiazide (Hydrochlorothiazide) - Summary

 
 



SUMMARY

Hydrochlorothiazide is a diuretic.

Hydrochlorothiazide Capsules are indicated in the management of hypertension either as the sole therapeutic agent, or in combination with other antihypertensives. Unlike potassium sparing combination diuretic products, Hydrochlorothiazide Capsules may be used in those patients in whom the development of hyperkalemia cannot be risked, including patients taking ACE inhibitors.
Usage in Pregnancy: The routine use of diuretics in an otherwise healthy woman is inappropriate and exposes mother and fetus to unnecessary hazard. Diuretics do not prevent development of toxemia of pregnancy, and there is no satisfactory evidence that they are useful in the treatment of developed toxemia.
Edema during pregnancy may arise from pathological causes or from the physiologic and mechanical consequences of pregnancy. Diuretics are indicated in pregnancy when edema is due to pathologic causes, just as they are in the absence of pregnancy. Dependent edema in pregnancy resulting from restriction of venous return by the expanded uterus is properly treated through elevation of the lower extremities and use of support hose; use of diuretics to lower intravascular volume in this case is illogical and unnecessary. There is hypervolemia during normal pregnancy which is harmful to neither the fetus nor the mother (in the absence of cardiovascular disease), but which is associated with edema, including generalized edema in the majority of pregnant women. If this edema produces discomfort, increased recumbency will often provide relief. In rare instances this edema may cause extreme discomfort which is not relieved by rest. In these cases a short course of diuretics may provide relief and may be appropriate.


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NEWS HIGHLIGHTS

Published Studies Related to Hydrochlorothiazide

Effects of sodium restriction and hydrochlorothiazide on RAAS blockade efficacy in diabetic nephropathy: a randomised clinical trial. [2014]
blockade on residual albuminuria in patients with type 2 diabetic nephropathy... INTERPRETATION: We conclude that sodium restriction is an effective

Long-Term Safety and Tolerability of the Oral Direct Renin Inhibitor Aliskiren with Optional Add-On Hydrochlorothiazide in Patients with Hypertension: A Randomized, Open-Label, Parallel-Group, Multicentre, Dose-Escalation Study with an Extension Phase. [2011.10.13]
BACKGROUND: Most patients with hypertension will require combination therapy with at least two agents from different antihypertensive classes to achieve blood pressure (BP) control. Thiazide diuretics, such as hydrochlorothiazide (HCTZ), are widely used in combination therapy. The volume reduction with these agents stimulates the renin-angiotensin system (RAS), making RAS inhibitors such as the direct renin inhibitor aliskiren a logical choice for combination therapy with HCTZ. OBJECTIVE: The aim of this study was to investigate the long-term safety, tolerability and efficacy of the direct renin inhibitor aliskiren, with or without addition of the diuretic HCTZ... CONCLUSION: In patients with hypertension, long-term treatment with aliskiren, with or without add-on HCTZ, is well tolerated and provides effective BP lowering that is sustained over 12 months. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00219037.

Chronotherapy with valsartan/hydrochlorothiazide combination in essential hypertension: improved sleep-time blood pressure control with bedtime dosing. [2011.08]
Administration of angiotensin receptor blockers at bedtime results in greater reduction of nighttime blood pressure than dosing upon awakening, independent of the terminal half-life of each individual medication. To obtain blood pressure (BP) target goals most patients require treatment with more than one hypertension medication...

Effect of valsartan, hydrochlorothiazide, and their combination on 24-h ambulatory blood pressure response in elderly patients with systolic hypertension: a ValVET substudy. [2011.08]
BACKGROUND: Stage 2 hypertension often requires combination antihypertensive therapy. Ambulatory blood pressure monitoring (ABPM) is a useful tool for studying antihypertensive drugs and their combinations. OBJECTIVE: This multicenter, double-blind, parallel-group, prompted-titration study of patients of at least 70 years of age with systolic hypertension compared the efficacy of valsartan, hydrochlorothiazide, and their combination on ambulatory blood pressure (ABP) reduction... CONCLUSION: In elderly hypertensives, starting combination therapy with valsartan/hydrochlorothiazide provides more effective 24-h blood pressure control than the monotherapy components, with few therapy-related side-effects.

A comparison of the efficacy and safety of irbesartan/hydrochlorothiazide combination therapy with irbesartan monotherapy in the treatment of moderate or severe hypertension in diabetic and obese hypertensive patients: a post-hoc analysis review. [2011.07]
Hypertension is difficult to treat in patients with type 2 diabetes mellitus (T2DM) or obesity. Combination therapies are often required to effectively lower blood pressure (BP) and attain BP goals... In patients with moderate or severe hypertension and with a BMI >/= 30 kg/m(2), initial treatment with irbesartan/HCTZ combination therapy was more effective than irbesartan monotherapy.

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Clinical Trials Related to Hydrochlorothiazide

Aliskiren vs Hydrochlorothiazide in Hypertensive Type II Diabetic Patients on Resistance Arteries [Withdrawn]
This study will be performed only at the Jewish General Hospital. It will investigate the effect of treatment with aliskiren, an inhibitor of renin, a substance produced by the kidney that constricts arteries and raises blood pressure, on the blood vessels, specifically the arteries, of subjects who have diabetes and elevated blood pressure (hypertension). To investigate blood vessels, different techniques will be used. For large arteries, these will be studied by non invasive methods using detection of the pulse wave or using ultrasound over the skin of the neck, the wrist and the groin. To study small vessels, the investigators will perform a biopsy on the buttock, under local anesthesia, and obtain a small sample of tissue from under the skin, from which the vessels will be dissected. The investigators have performed many hundreds of these small biopsies over the past 20 years for similar studies without any complications. The biopsies are very well tolerated. From this research the investigators will thus be able to learn what the structure and function of these vessels is in these patients, in comparison to a normal healthy group. The hypertensive diabetic subjects will then be assigned by chance (randomized trial) to treatment with the renin inhibitor aliskiren or a comparator, the diuretic hydrochlorothiazide. Aliskiren is a relatively new drug used to treat hypertension that is very well tolerated and is now being evaluated in numerous trials in hypertensive diabetic individuals. The diuretic is a well-know agent used to treat high blood pressure now for many years, and which is very well tolerated. Physicians, nurses and scientists involved in the study will be unaware of who is receiving which drug, as will be the patients (this is the meaning of double-blind trial). However, if there is any problem, the secret code will be broken and the individual withdrawn from the study. Subjects will be treated for a year, and the study procedures (non invasive and the biopsy) repeated at 6 months and after one year of treatment. During the study, blood samples will be drawn and urine collected at certain intervals to ensure safety of the treatment. Once tissues are obtained they will be studied in the laboratory. The study of the vessels will allow treatment us to determine how the treatment with the renin inhibitor aliskiren affects the structure and function as well as cellular and molecular aspects of arteries of hypertensive diabetic persons. The investigators expect these studies to provide us knowledge on mechanisms and perhaps new targets for future therapies of cardiovascular disease and hypertension.

Study to Evaluate the Efficacy and Safety of Combined Administration of TAK-536CCB and Hydrochlorothiazide in Patients With Grade I or II Essential Hypertension. [Completed]
The objective of this study is to compare the efficacy and safety of combined administration of TAK-536CCB (Fix-dose combination of Azilsartan and Amlodipine) and Hydrochlorothiazide (HCTZ) with those of TAK-536CCB in patients with Grade I or II essential hypertension.

Indapamide Versus Hydrochlorothiazide in Elderly Hypertensive Patients With Renal Insufficiency [Completed]
The purpose of this study is to evaluate the effects of indapamide SR 1. 5 mg on renal function, endothelial function, blood pressure variability by comparison with hydrochlorothiazide 25 mg, in patients with Mild to Moderate Renal Insufficiency and Hypertension.

Pharmacokinetic Interactions of Valsartan and Hydrochlorothiazide (Double Doses) [Completed]
This study was conducted to compare the rate and extent of absorption of valsartan and hydrochlorothiazide. To maximize the possibility of finding drug-drug interactions, the dose of valsartan and hydrochlorothiazide was doubled (320 mg of VAL and 25 mg of HCT).

Pharmacokinetic Interactions of Valsartan and Hydrochlorothiazide [Completed]
This study was conducted to compare the rate and extent of absorption of valsartan and hydrochlorothiazide following oral administration as a fixed dose combination tablet and concomitant administration of the individual drugs under fasting conditions in healthy Egyptian subjects. The study was extended to investigate any potential reaction between VAL and HCT.

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Reports of Suspected Hydrochlorothiazide Side Effects

Dizziness (60)Hypokalaemia (49)Blood Pressure Increased (49)Hyponatraemia (47)Torsade DE Pointes (43)Drug Ineffective (42)Hypotension (42)Electrocardiogram QT Prolonged (41)Renal Failure Acute (41)Completed Suicide (40)more >>


PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 3 ratings/reviews, Hydrochlorothiazide has an overall score of 8. The effectiveness score is 7.33 and the side effect score is 8.67. The scores are on ten point scale: 10 - best, 1 - worst.
 

Hydrochlorothiazide review by 52 year old female patient

  Rating
Overall rating:  
Effectiveness:   Moderately Effective
Side effects:   No Side Effects
  
Treatment Info
Condition / reason:   fluid retention increased BP
Dosage & duration:   25mg taken once daily for the period of two years
Other conditions:   Type2 diabetes
Other drugs taken:   Metformin Lisinopril
  
Reported Results
Benefits:   Helped with decreasing intermittent fluid retention in ankles and worked in conjunction with BP medication to decrease BP
Side effects:   calf cramps on occasion
Comments:   Took medication daily along with BP med, monitored BP at home. Occasionally have puffy ankles but not as often.

 

Hydrochlorothiazide review by 63 year old male patient

  Rating
Overall rating:  
Effectiveness:   Considerably Effective
Side effects:   Mild Side Effects
  
Treatment Info
Condition / reason:   high blood pressure
Dosage & duration:   25mg taken one a day for the period of 9 years
Other conditions:   none
Other drugs taken:   none
  
Reported Results
Benefits:   Reduced the blood pressure with few side effects at first
Side effects:   dehydration - this problem grew as the years passed and I seemed to become more sensitive to the drug. I finally started taking a 1/2 dose. I had dry eyes, constipation, mouth breathing. I would drink too much beer if I started drinking because I was so thirsty. Dry skin became an irritating problem. This problem has improved since I changed medications.
Comments:   The drug was very helpful at first. It improved my concentration, my ability to focus and pay attention increased and I slept better. As the years passed, I became aware that I was in a state of semi-dehydration much of the time. This did not dawn on me until I had taken the drug for over seven years. I started to keep water at my desk and drank a quart and a half on average every day just during the day at work. This helped considerably, but the dry skin and constipation finally lead to my asking the doctor for a change. I am curious if there is any connection between the dehydration and potential dementia.

 

Hydrochlorothiazide review by 63 year old male patient

  Rating
Overall rating:  
Effectiveness:   Considerably Effective
Side effects:   Mild Side Effects
  
Treatment Info
Condition / reason:   high blood pressure
Dosage & duration:   25mg taken one a day for the period of 9 years
Other conditions:   none
Other drugs taken:   none
  
Reported Results
Benefits:   Reduced the blood pressure with few side effects at first
Side effects:   dehydration - this problem grew as the years passed and I seemed to become more sensitive to the drug. I finally started taking a 1/2 dose. I had dry eyes, constipation, mouth breathing. I would drink too much beer if I started drinking because I was so thirsty. Dry skin became an irritating problem. This problem has improved since I changed medications.
Comments:   The drug was very helpful at first. It improved my concentration, my ability to focus and pay attention increased and I slept better. As the years passed, I became aware that I was in a state of semi-dehydration much of the time. This did not dawn on me until I had taken the drug for over seven years. I started to keep water at my desk and drank a quart and a half on average every day just during the day at work. This helped considerably, but the dry skin and constipation finally lead to my asking the doctor for a change. I am curious if there is any connection between the dehydration and potential dementia.

See all Hydrochlorothiazide reviews / ratings >>

Page last updated: 2015-08-10

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