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Hydrochlorothiazide ( HCTZ or HCT ) is a diuretic medication often used to treat high blood pressure and swelling due to fluid build up.
Potential side effects include poor kidney function, electrolyte imbalances especially low blood potassium and less commonly low blood sodium, gout, high blood sugar, and feeling faint initially upon standing up.
It is in the thiazide medication class and acts by decreasing the kidneys ‘ ability to retain water.
Two companies, Merck and Ciba, state they discovered the medication which became commercially available in 1959.
1 Medical uses
2 Adverse effects
3 Mechanism of action
4 Society and culture
4.1 Trade names
5 See also
7 External links
Hydrochlorothiazide is frequently used for the treatment of hypertension, congestive heart failure, symptomatic edema, diabetes insipidus, renal tubular acidosis.
Most of the research supporting the use of thiazide diuretics in hypertension was done using chlorthalidone, a different medication in the same class. Hydrochlorothiazide is less effective than chlortalidone for lowering blood pressure
Hydrochlorothiazide is also sometimes used to prevent osteopenia and for treatment of hypoparathyroidism, hypercalciuria, Dent’s disease, and Ménière’s disease. For diabetes insipidus, the effect of thiazide diuretics is presumably mediated by a hypovolemia-induced increase in proximal sodium and water reabsorption, thereby diminishing water delivery to the ADH-sensitive sites in the collecting tubules and increasing the urine osmolality.
Thiazides are also used in the treatment of osteoporosis. Thiazides decrease mineral bone loss by promoting calcium retention in the kidney, and by directly stimulating osteoblast differentiation and bone mineral formation.
It may be given together with other antihypertensive agents in fixed-dose combination preparations, such as in losartan/hydrochlorothiazide (see below).
Hypokalemia, or low blood levels of potassium are an occasional side effect. It can be usually prevented by potassium supplements or by combining hydrochlorothiazide with a potassium-sparing diuretic
Other disturbances in the levels of serum electrolytes including hypomagnesemia (low magnesium), hyponatremia (low sodium), and hypercalcemia (high calcium)
Hyperuricemia, high levels of uric acid in the blood
Hyperglycemia, high blood sugar
Hyperlipidemia, high cholesterol and triglycerides
Nausea / vomiting
These side effects increase with the dose of the medication and are most common at doses of greater than 25 mg per day.
Package inserts, based on case reports and observational studies, have reported that an allergy to a sulfa drug predisposes the patient to cross sensitivity to a thiazide diuretic. A 2005 review of the literature did not find support for this cross-sensitivity.
Mechanism of action
Hydrochlorothiazide belongs to thiazide class of diuretics. It reduces blood volume by acting on the kidneys to reduce sodium (Na + ) reabsorption in the distal convoluted tubule. The major site of action in the nephron appears on an electroneutral NaCl co-transporter by competing for the chloride site on the transporter. By impairing Na + transport in the distal convoluted tubule, hydrochlorothiazide induces a natriuresis and concomitant water loss. Thiazides increase the reabsorption of calcium in this segment in a manner unrelated to sodium transport.
Society and culture
Co-Diovan ( valsartan and HCTZ )
Two generic benazepril HCl 20 mg and HCTZ 25 mg oral tablets
Hydrochlorothiazide is available as a generic drug under a large number of brand names, including Apo-Hydro, Aquazide, BPZide, Dichlotride, Esidrex, Hydrochlorot, Hydrodiuril, HydroSaluric, Hypothiazid, Microzide, Oretic and many others.
To reduce pill burden and in order to reduce side effects, hydrochlorothiazide is often used in fixed-dose combinations with many other classes of antihypertensive drugs such as:
ACE inhibitors — e.g. Prinzide or Zestoretic ( with lisinopril ), Co-Renitec (with enalapril ), Capozide (with captopril ), Accuretic (with quinapril ), Monopril HCT (with fosinopril ), Lotensin HCT (with benazepril ), etc.
Angiotensin receptor blockers — e.g. Hyzaar ( with losartan ), Co-Diovan or Diovan HCT ( with valsartan ), Teveten Plus (with eprosartan ), Avalide or CoAprovel (with irbesartan ), Atacand HCT or Atacand Plus (with candesartan ), etc.
Beta blockers — e.g. Ziac or Lodoz (with bisoprolol ), Nebilet Plus or Nebilet HCT (with nebivolol ), Dutoprol or Lopressor HCT (with metoprolol ), etc.
Direct renin inhibitors — e.g. Co-Rasilez or Tekturna HCT (with aliskiren )
Potassium sparing diuretics : Dyazide and Maxzide triamterene
Use of hydrochlorothiazide is prohibited by the World Anti-Doping Agency for its ability to mask the use of performance-enhancing drugs.
AMPA receptor positive allosteric modulator
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