Hydrochlorothiazide
Hydrochlorothiazide
Microzide; mostly prescribed generically
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Summary
Classes
Common uses
Hypertension0, Edema (heart failure, hepatic, renal)0, Nephrogenic diabetes insipidus0, Calcium-stone prevention0
Pharmacy
Starting dose
12.5-25 mg PO once daily
Preparations
12.5 mg capsules; 12.5, 25, 50 mg tablets
US FDA Max
50 mg/d (hypertension); up to 200 mg/d (edema)
Pharmacology
Routes
Oral
Onset
Diuresis at 2 hours; antihypertensive effect within days, max at 3-4 weeks
Duration
6-12 hours
Half-life
6-15 hours[1]
Bioavailability
65-75% (oral)[1]
Pregnancy
Avoided where possible; can reduce placental perfusion and produce neonatal thrombocytopenia, jaundice, electrolyte disturbance. Labetalol or nifedipine preferred for chronic hypertension in pregnancy.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Hydrochlorothiazide inhibits the Na+/Cl- cotransporter (NCC) in the apical membrane of distal convoluted tubule cells, blocking sodium reabsorption and producing modest natriuresis with longer-term peripheral vasodilation that accounts for most of its antihypertensive effect.0 Decreases urinary calcium (used in stone prevention); raises serum uric acid, glucose, and lipids modestly; non-anion-gap hypokalemic metabolic alkalosis is the characteristic electrolyte pattern[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Microzide (hydrochlorothiazide), Watson, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/040735s011lbl.pdf