Hydrochlorothiazide is a commonly used diuretic, primarily functioning to help eliminate excess salt and water from the body. This medication works by increasing urine output, reducing blood volume, and thereby achieving a blood pressure-lowering effect. The most common uses of hydrochlorothiazide include the treatment of hypertension, edema caused by heart failure, and fluid retention due to liver cirrhosis or kidney disease.
The mechanism of hydrochlorothiazide involves inhibiting the reabsorption of sodium ions in the kidneys, promoting the excretion of sodium and chloride in urine. This process not only reduces fluid volume but also alleviates tissue edema and helps relax blood vessel walls, lowering blood pressure. This medication is typically used as a first-line treatment, but regular monitoring of patients' electrolytes and kidney function is necessary.
The generic name for hydrochlorothiazide is Hydrochlorothiazide, and common brand names include "Hydrodiuril" and "HCTZ." There may be other trade names in different countries or regions, but generic medications are often preferred by physicians due to their lower cost and equivalent efficacy.
This medication is available in tablet or capsule form for oral administration, with dosages typically starting at 12.5 mg and adjusted based on patient response. It is important to note that different brands may contain other excipients that could affect individual patient tolerance.
Hydrochlorothiazide belongs to the drug classification of "Thiazide Diuretics," which are a medium-strength category of diuretics. These medications primarily act on sodium channels in the kidneys, promoting the excretion of sodium and potassium, thereby reducing fluid volume.
In pharmacological classification, this drug possesses dual properties as both an "antihypertensive agent" and a "diuretic." Compared to other classes such as loop diuretics, hydrochlorothiazide has a longer half-life, allowing for once-daily dosing to maintain its effects.
Hydrochlorothiazide is primarily used to treat hypertension (primary hypertension), usually as monotherapy or in combination with other antihypertensive medications. For patients with heart failure, this drug can relieve dyspnea and peripheral edema caused by pulmonary edema.
This medication is also indicated for ascites due to liver cirrhosis or edema caused by nephrotic syndrome. In certain cases, hydrochlorothiazide may be used as an adjunct treatment for primary hyperaldosteronism, but it should be combined with other therapies.
Contraindications: Use is prohibited in individuals allergic to thiazide diuretics. Patients with severe renal impairment, hyperkalemia, or anuria should also avoid this medication. Use during pregnancy may increase the risk of fetal growth retardation, classified as FDA pregnancy category C.
Long-term use requires regular monitoring of electrolytes and kidney function. Diabetic patients should be aware that this medication may raise blood sugar levels, necessitating adjustments in insulin or oral hypoglycemic agents. Caution is advised when adjusting dosages for elderly patients to avoid dehydration or hypotension.
Avoid combining with potassium-altering medications (such as cyclosporine), as this may exacerbate potassium abnormalities. When taking potassium supplements or potassium-sparing diuretics, strict monitoring of serum potassium levels is required.
The initial dose is typically 12.5 mg to 25 mg once daily, adjusted based on blood pressure control, with a maximum dose generally not exceeding 100 mg/day. The tablets should be swallowed whole and not chewed, and it is recommended to take them in the morning to avoid nighttime diuresis that disrupts sleep.
During treatment, a normal diet should be maintained, but excessive intake of high-sodium foods should be avoided to prevent reducing the medication's effectiveness. Physicians may recommend potassium supplementation or the use of potassium-sparing diuretics to reduce the risk of electrolyte imbalances.
If a dose is missed, it should be taken as soon as remembered; however, if it is close to the next scheduled dose, the missed dose should be skipped, and the normal dosing schedule resumed. Do not double the dose to make up for a missed dose, as this may increase the risk of side effects.
Frequent missed doses may lead to poor blood pressure control. It is advisable to set reminders and label the medication bottle with dosing times to avoid missing doses.
Overdose of hydrochlorothiazide may lead to severe dehydration, hypotension, and electrolyte disturbances. If overdose symptoms (such as extreme thirst, confusion, muscle cramps) are observed, seek medical attention immediately and bring the medication bottle for reference.
Emergency measures include gastric lavage, intravenous fluid replacement, and electrolyte monitoring. Patients with severe hypokalemia may require immediate potassium replacement therapy, which should be performed under the assessment of qualified medical personnel.
It is recommended to take it at a fixed time to maintain stable drug efficacy, usually suggested in the morning to avoid nighttime diuresis affecting sleep. If a dose is missed, it should be taken immediately, but if it is close to the next dose, skip the missed dose and do not double the dose.
Can hydrochlorothiazide cause low potassium levels, and how should I monitor and respond?Long-term use requires regular blood tests to check potassium levels; if symptoms such as muscle weakness or palpitations occur, seek medical attention immediately. Physicians may recommend potassium supplements or suggest increasing potassium-rich foods (such as bananas, spinach), but do not adjust the dose on your own.
What precautions should I take when using it with other antihypertensive or diabetes medications?Combining with other diuretics or angiotensin-converting enzyme inhibitors may enhance antihypertensive effects; blood pressure should be monitored to avoid it becoming too low. Diabetic patients should monitor blood sugar levels regularly and communicate with their physician to adjust insulin or oral medication dosages.
Should I restrict salt intake during treatment?It is advisable to reduce high-sodium food intake to enhance drug efficacy, but complete salt restriction may lead to low blood pressure or electrolyte imbalances. Generally, daily salt intake should be less than 6 grams; discuss a personalized dietary plan with your physician.
What are the risks of suddenly stopping hydrochlorothiazide?Do not stop taking the medication on your own, as this may trigger rebound hypertension or worsen edema. If a medication adjustment is necessary, the physician will gradually reduce the dose and monitor symptoms. If side effects occur or overdose is suspected, contact medical personnel immediately and do not take matters into your own hands.
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