Hypothiazide - instructions for use, reviews, analogs and formulations (tablets 25 mg and 100 mg) of a diuretic for the treatment of hypertension and edema in adults, children and pregnancy

In this article, you can read the instructions for using the drug Hypothiazide. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Hypothiazide in their practice are presented. A big request is to add more actively your comments about the diuretic: the medicine helped to get rid of the disease, which complications and side effects were observed, possibly not declared by the manufacturer in the annotation. Analogues of Hypothiazide in the presence of existing structural analogues. Use for the treatment of hypertension and edematous syndrome in adults, children, as well as during pregnancy and lactation.

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

Sodium urine and diuresis occur within 2 hours and reach a maximum level in about 4 hours.

Thiazides also reduce the activity of carbonic anhydrase by increasing the excretion of bicarbonate ions, but this action usually manifests itself weakly and does not affect the pH of the urine.

Hydrochlorothiazide (the active substance of the drug Hypothiazide) also has antihypertensive properties. Thiazide diuretics do not affect normal blood pressure.

Composition

Hydrochlorothiazide + excipients.

Pharmacokinetics

Hypothiazide is incomplete, but it is absorbed rather quickly from the digestive tract. This action persists for 6-12 hours. Hydrochlorothiazide penetrates the placental barrier and is excreted in breast milk.The primary way of excretion is kidneys (filtration and secretion) in unmodified form.

Indications

• arterial hypertension (both for monotherapy and in combination with other antihypertensive drugs);
• edematous syndrome of various genesis (chronic heart failure, nephrotic syndrome, premenstrual tension syndrome, acute glomerulonephritis, chronic renal failure, portal hypertension, treatment with corticosteroids);
• control polyuria, mainly with nephrogenic diabetes insipidus;
• prevention of stone formation in the urinary tract in predisposing patients (reduction of hypercalciuria).

Forms of release

Tablets 25 mg and 100 mg.

Instructions for use and dosage

The dose should be selected individually. With a constant medical control, a minimally effective dose is established. The drug should be taken orally after a meal.

Adults

With arterial hypertension, the initial dose is 25-50 mg per day once, in the form of monotherapy or in combination with other antihypertensive agents. Some patients have an initial dose of 12.5 mg (both in monotherapy and in combination).It is necessary to apply a minimally effective dose, not exceeding 100 mg per day. When combining Hypothiazide with other antihypertensive drugs, it may be necessary to reduce the dose of another drug to prevent excessive blood pressure lowering.

The hypotensive effect is manifested within 3-4 days, but it may take 3-4 weeks to achieve the optimal effect. After the end of therapy, the hypotensive effect persists for 1 week.

With edematic syndrome of different genesis, the initial dose is 25-100 mg per day once or once every 2 days. Depending on the clinical response, the dose can be reduced to 25-50 mg per day once or once every 2 days. In some severe cases, at the beginning of treatment, an increase in the dose of the drug to 200 mg per day may be required.

In the syndrome of premenstrual tension, the drug is prescribed at a dose of 25 mg per day and is used from the onset of symptoms before the onset of menstruation.

In nephrogenic diabetes insipidus, the usual daily dose of the drug is 50-150 mg (in several steps).

In connection with the increased loss of potassium and magnesium ions during the treatment (potassium level in the serum may be <3.0 mmol / l), there is a need for the replacement of potassium and magnesium.

Children

Doses should be determined based on the weight of the child's body. Usual pediatric daily doses: 1-2 mg / kg body weight or 30-60 mg / m2 body surface 1 time per day. The daily dose in children aged 3 to 12 years is 37.5-100 mg.

Side effect

• hypokalemia, hypomagnesemia, hypercalcemia, hyponatremia (including confusion, convulsions, lethargy, slowing down of the thinking process, fatigue, excitability, muscle cramps);
• hypochloraemic alkalosis (including dry mouth, thirst, irregular heart rhythm, changes in mood or psyche, convulsions and muscle pain, nausea, vomiting, unusual fatigue or weakness);
• cholecystitis;
• pancreatitis;
• diarrhea;
• sialoadenitis;
• constipation;
• anorexia;
• arrhythmia;
• orthostatic hypotension;
• vasculitis;
• impaired renal function;
• interstitial nephritis;
• dizziness;
• temporarily blurred vision;
• headache;
• paresthesia;
• leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia;
• hives;
• purpura;
• necrotizing vasculitis;
• Stevens-Johnson syndrome;
• respiratory distress syndrome (including pneumonitis, noncardiogenic pulmonary edema);
• photosensitization;
• anaphylactic reactions up to shock;
• decreased potency.

Contraindications

• anuria;
• renal failure of severe degree (CK <30 ml / min);
• hepatic failure of severe degree;
• hard-to-control diabetes mellitus;
• Addison's disease;
• refractory hypokalemia, hyponatremia, hypercalcemia;
• children under 3 years old (for solid dosage form);
• hypersensitivity to the components of the drug;
• hypersensitivity to derivatives of sulfonamides.

Application in pregnancy and lactation

Contraindicated use of the drug in the first trimester of pregnancy. In the second and third trimester of pregnancy, the use of the drug is possible only if the intended benefit to the mother exceeds the potential risk to the fetus.

Hydrochlorothiazide penetrates the placental barrier. There is a danger of fetal or neonatal jaundice, thrombocytopenia and other consequences.

The drug is excreted in breast milk. If you need to use the drug during lactation, you should decide whether to stop breastfeeding.

Application in elderly patients

With caution should be used in elderly patients.

Use in children

Contraindicated in children under 3 years of age (for solid dosage form - tablets).

special instructions

With prolonged course treatment, clinical symptoms of disturbance of the water-electrolyte balance should be closely monitored, first of all, in patients at high risk: patients with cardiovascular disease, impaired liver function, severe vomiting, or signs of water-electrolyte imbalance including dry mouth, thirst, weakness, lethargy, drowsiness, anxiety, muscle aches or cramps, muscle weakness, hypotension, oliguria, tachycardia, complaints from the digestive tract).

The use of potassium-containing drugs or foods rich in potassium (including fruits and vegetables), especially with potassium loss due to increased diuresis, prolonged therapy with diuretics, or simultaneous treatment with glycosides of digitalis or corticosteroid drugs, avoids hypokalemia.

Increasing the excretion of magnesium in the urine with the use of thiazides can lead to hypomagnesemia.

With reduced renal function, monitoring of creatinine clearance is necessary. In patients with impaired renal function, the drug can cause azotemia and the development of cumulative effects. If the renal dysfunction is obvious, when oliguria occurs, the possibility of drug cancellation should be considered.

In patients with impaired liver function or progressive liver disease, thiazides should be used with caution, since a small change in the water-electrolyte balance, as well as the level of ammonium in the blood serum, can cause hepatic coma.

Thiazides can increase the concentration of bilirubin in the serum.

In severe cerebral and coronary sclerosis, the use of the drug requires special care.

Treatment with thiazide drugs may interfere with glucose tolerance. During a long course of treatment with manifest and latent diabetes, systematic control of carbohydrate metabolism is required in connection with the potential need to change the dose of hypoglycemic drugs.

It requires enhanced monitoring of the condition of patients with impaired uric acid metabolism.

In rare cases, with prolonged therapy, there was a pathological change in the parathyroid glands, accompanied by hypercalcemia and hypophosphatemia.

It meets the erroneous assertion that Hypothiazid can be used as a tool for weight loss, that is not true, as the effect in terms of weight loss lasts only during treatment and can not be regarded as a worthy alternative to the formation of a healthy lifestyle, identifying endocrine problems and power correction.

Thiazides are able to reduce the amount of Iodine that binds to serum proteins without showing signs of a disorder in the thyroid function.

Should take into account the possibility of gastro-intestinal complaints in patients with lactose intolerance, because Hypothiazid tablets 25 mg contain 63 mg of lactose, Hypothiazid 100 mg - 39 mg of lactose.

Impact on the ability to drive vehicles and manage mechanisms

In the initial stage of the drug (the duration of this period is determined individually), it is forbidden to drive a car and perform work that requires increased attention.

Drug Interactions

Simultaneous use of Hypothiazide with lithium salts should be avoided, as the renal clearance of lithium decreases and its toxicity increases.

With the simultaneous use of Hypothiazide with antihypertensive drugs, their effect is potentiated and the need for dose adjustment may appear.

With the simultaneous use of Hypothiazide with cardiac glycosides, hypokalemia and hypomagnesemia associated with the action of thiazide diuretics can increase the toxicity of digitalis.

With the simultaneous use of Hypothiazide with amiodarone, the risk of arrhythmias associated with hypokalemia increases.

With the simultaneous use of Hypothiazide with oral hypoglycemic agents, the effectiveness of the latter decreases and hyperglycemia may develop.

With the simultaneous use of Hypothiazide with corticosteroid drugs, calcitonin, the degree of excretion of potassium increases.

With the simultaneous use of Hypothiazide with non-steroidal anti-inflammatory drugs (NSAIDs), the diuretic and hypotensive effects of thiazides are weakened.

With the simultaneous use of Hypothiazide with nondepolarizing muscle relaxants, it is possible to enhance the effect of the latter.

With the simultaneous use of Hypothiazide with amantadine, a decrease in the clearance of amantadine is possible, which leads to an increase in the concentration of the latter in plasma and increases the risk of toxicity.

With the simultaneous use of Hypothiazide with colestyramine, the absorption of hydrochlorothiazide decreases.

With simultaneous use with ethanol (alcohol), barbiturates and opioid analgesics, the orthostatic hypotensive effect of thiazide diuretics increases.

Before carrying out tests for the function of parathyroid glands, thiazides should be discarded.

Analogues of the drug Hypothiazide

Structural analogs for the active substance:

• Hydrochlorothiazide;
• Hydrochlorothiazide ATS.

Analogues for the pharmacological group (diuretics):

• Aquaphor;
• Acrypamide;
• Aldactone;
• Apo Triazid;
• Arindap;
• Arifon;
• Arifon retard;
• Brinaldiks;
• Brinerdin;
• Brusniver;
• Bufenox;
• Vero Indapamide;
• Vero Spironolactone;
• Vero Triamtesis;
• Verospilactone;
• Veroshpiron;
• Hygroton;
• Diazide;
• Diakarb;
• Diver;
• Isobar;
• Indap;
• Indapamide;
• Inder;
• Inverse;
• Indians;
• Indyur;
• Inspra;
• Ionik;
• Kanefron H;
• Clopamid;
• Cristepin;
• Lasix;
• Lespenefril;
• Lasersflain;
• Lescopryl;
• Lauras;
• Mannitol;
• Mannitol;
• Moderetik;
• Urea;
• Diuretic collection;
• Niebelong H;
• Normatens;
• Oxodoline;
• Pamid;
• Pylozuril;
• Retapres;
• Sinepres;
• Spironaxan;
• Spironol;
• Spironolactone;
• Tenzar;
• Torasemide;
• Triamtel;
• Trigrim;
• Urakton;
• Uregit;
• Urflorin;
• Urological (diuretic) collection;
• Uroflux;
• Phytolysin;
• Phytonefrol;
• Furon;
• Furosemide;
• Fursemide;
• Cimalon.

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