Hydrochlorothiazide
(Esidrix, HydroDiuril, Oretic)
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Category:
Description:
Indications:
Contraindications:
-
Anuria
-
Renal
decompensation
Precautions:
-
Pregnancy
category D; 1st trimester may increase risk of congenital
defects; use in later trimesters does not seem to carry this risk
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Hypokalemia,
renal disease, hepatic disease, gout
-
COPD,
lupus erythematosus, diabetes mellitus
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Children,
vomiting, diarrhea, hyperlipidemia
Adverse
Reactions (Side Effects):
-
CNS:
depression, dizziness, drowsiness, fatigue, paresthesia, weakness,
headache
-
CV:
irregular pulse, orthostatic hypotension, palpitations, volume
depletion
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EENT:
blurred vision
-
GI:
anorexia, constipation, cramps, diarrhea, nausea, pancreatitis,
vomiting
-
GU:
frequency, decreased libido, impotence
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HEME:
agranulocytosis, aplastic anemia, hemolytic anemia, leukopenia,
neutropenia, thrombocytopenia
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METAB:
hypercalcemia, hyperglycemia, hyperuricemia, hypochloremia,
hypokalemia, hypomagnesemia, hyponatremia, increased creatinine, BUN
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SKIN:
fever, photosensitivity, purpupa, rash, urticaria
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Dosage:
Administered
orally (tablet, solution)
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Adult:
PO 12.5-50mg daily, max 200mg daily; doses >50 mg/day
generally not recommended due to increased incidence of hypokalemia
and other metabolic disturbances
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Child:
PO (<6 months) 2-3.3 mg/kg/day in 2 divided doses; (>6
months) 2 mg/kg/day in 2 divided doses
Drug
interactions:
-
Antidiabetics:
thiazide diuretics tend to increase blood glucose, may increase dosage
requirements of antidiabetic drugs
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Digitalis
glycosides: diuretic-induced hypokalemia may increase risk of
digitalis toxicity
Special
considerations:
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Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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