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Hydrochlorothiazide (Hydrochlorothiazide) - Summary

 
 



SUMMARY

Hydrochlorothiazide Capsules, 12.5 mg is the 3,4-dihydro derivative of chlorothiazide. Its chemical name is 6-chloro-3,4-dihydro- 2H- 1,2,4-benzothiadiazine-7-sulfonamide 1,1-dioxide.

Hydrochlorothiazide is 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 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.


See all Hydrochlorothiazide indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Hydrochlorothiazide

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.

Effect of nebivolol vs. hydrochlorothiazide on the walking capacity in hypertensive patients with intermittent claudication. [2011.07]
CONCLUSION: The increases in ICD, ACD and ABI with nebivolol suggest that this medication does not have negative effects on hypertensive patients with symptomatic PAD, and can be used for treatment of hypertension in these patients at high cardiovascular risk without reducing the walking ability.

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Clinical Trials Related to Hydrochlorothiazide

Telmisartan80/HCTZ25 Versus telmisartan80/HCTZ12.5 in Hypertension Not Responding to telmisartan80/HCTZ12.5 [Completed]
The primary objective of this trial is to demonstrate that a fixed dose combination of telmisartan 8 0 mg plus hydrochlorothiazide 25 mg (T80/H25) is superior in reducing blood pressure after eight wee ks compared with a fixed dose combination of telmisartan 80 mg plus hydrochlorothiazide 12. 5 mg (T80

/H12. 5) in patients who fail to respond to six weeks treatment with T80/H12. 5.

Fasting Study of Hydrochlorothiazide Tablets 50 mg to Hydrochlorothiazide Tablets 50 mg [Completed]
The objective of this study was to investigate the bioequivalence of Mylan's hydrochlorothiazide 50mg tablets to Ivax's Hydrochlorothiazide 50 mg tablets following a single, oral 50 mg (1x50 mg) dose administered under fasting conditions.

A Randomized, Double-Blind, Placebo-Controlled, Forced-Titration, Phase IV Study Comparing Telmisartan 80 mg + Hydrochlorothiazide 25 mg [Micardis HCT] Versus Valsartan 160 mg + Hydrochlorothiazide 25 mg [Diovan HCT] Taken Orally for Eight Weeks in Patients With Stage 1 and Stage 2 Hypertension. [Completed]

Irbesartan/Hydrochlorothiazide and Irbesartan in the Treatment of Mild to Moderate Hypertension [Completed]
Study Objectives :

- To demonstrate the reduction in office Blood Pressure following a 8-week regimen of

irbesartan / hydrochlorothiazide using irbesartan as a reference.

- To demonstrate the reduction in office Blood Pressure after 4-week regimen of irbesartan

/ hydrochlorothiazide using irbesartan as a reference.

- To compare the response rate (defined as office Systolic Blood Pressure/Diastolic Blood

Pressure reduce more than 10mmHg from Week 0) of patients after 4-week and 8-week regimen of irbesartan / hydrochlorothiazide versus irbesartan.

- To compare the proportion of patients requiring titration after 4-week regimen of

irbesartan/hydrochlorothiazide versus irbesartan

- To ascertain the safety and tolerability of irbesartan / hydrochlorothiazide versus

irbesartan when administered once daily

A Comparison of Telmisartan + Hydrochlorothiazide With Amlodipine + Hydrochlorothiazide in the Control of Blood Pressure in Older Patients With Predominantly Systolic Hypertension. (ATHOS Study) [Completed]
The primary objective of this clinical trial was to show that the combination of telmisartan 80 mg + hydrochlorothiazide (HCTZ) 12. 5 mg was not inferior to and was possibly superior to amlodipine 10 mg + HCTZ 12. 5 mg in reducing the systolic blood pressure (SBP) in the last six hours of the 24-hour dose period [as measured by 24-hour ambulatory blood pressure monitoring ( ABPM)] in elderly patients with predominantly systolic hypertension. The primary endpoint was the change from baseline in SBP in the last six hours of the 24-hour dose period (as measured by 24-hour ABPM) at the end-of-study visit.

more trials >>

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: 2011-12-09

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