Hydrochlorothiazide 25mg Tablets

Hydrochlorothiazide is a thiazide diuretic that inhibits the reabsorption of sodium and chloride ions in the distal convoluted tubule of the nephron. This action leads to increased excretion of sodium, chloride, and water, as well as potassium and magnesium. It also decreases calcium excretion. The antihypertensive effect is initially due to a decrease in plasma volume and cardiac output, followed by a decrease in peripheral vascular resistance with chronic use.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion or feeling sleepy
+ Unusual thirst or hunger
+ Frequent urination
+ Flushing or fast breathing
+ Breath that smells like fruit
Signs of fluid and electrolyte problems, such as:
+ Mood changes or confusion
+ Muscle pain or weakness
+ Abnormal heartbeat or severe dizziness
+ Increased thirst or seizures
+ Feeling extremely tired or weak
+ Decreased appetite or inability to urinate
+ Changes in urine output or dry mouth
+ Dry eyes or severe stomach upset
Signs of pancreatitis (pancreas problems), including:
+ Severe stomach pain
+ Severe back pain
+ Severe stomach upset or vomiting
Signs of kidney problems, such as:
+ Inability to urinate or changes in urine output
+ Blood in the urine or significant weight gain
+ Dark urine or yellow skin and eyes
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak
Abnormal sensations, such as burning, numbness, or tingling
Shortness of breath
Restlessness
Difficulty getting or maintaining an erection

Eye Problems:

This medication can cause certain eye problems, which may lead to permanent vision loss if left untreated. If you experience any of the following symptoms, contact your doctor immediately:

Changes in vision
Eye pain (usually occurring within hours to weeks of starting the medication)

Skin Cancer Risk:

Rarely, people taking hydrochlorothiazide have developed certain types of skin cancer. To minimize this risk, protect your skin from the sun and follow your doctor's recommendations for skin checks. If you notice any changes in the color or size of a mole, or any new or changing skin lumps or growths, contact your doctor right away.

Other Side Effects:

Most people do not experience significant side effects, but some may occur. If you are bothered by any of the following side effects or if they persist, contact your doctor:

Constipation, diarrhea, stomach upset, vomiting, or decreased appetite
Stomach cramps
Dizziness, tiredness, or weakness
Headache

Reporting Side Effects:

If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
A known sulfa allergy.
Difficulty urinating or inability to pass urine.
Current use of dofetilide or lithium.

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

Important Information About Your Medication

It is crucial that you inform all of your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This will help ensure that you receive the best possible care.

Caution When Performing Daily Activities

Until you know how this medication affects you, avoid driving and other tasks that require you to be alert. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying down position, and be cautious when climbing stairs.

Monitoring Your Health

Follow your doctor's instructions for regular blood tests and other laboratory evaluations. This medication may cause increases in cholesterol and triglyceride levels, so it is essential to discuss your lipid profile with your doctor if you have high cholesterol or triglycerides.

Managing Related Health Conditions

If you have diabetes, you will need to closely monitor your blood sugar levels. Additionally, check your blood pressure as directed by your doctor. This medication may affect certain laboratory tests, so be sure to inform all of your healthcare providers and laboratory personnel that you are taking this medication.

Interactions with Other Medications and Substances

If you have high blood pressure, consult with your doctor before taking over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

Understanding the Medication's Effects

This medication is a potent diuretic, which means it can cause your body to lose excess fluid and electrolytes (such as potassium). Your doctor will closely monitor you to adjust the dosage as needed to prevent severe health problems.

Dietary Considerations

If you are on a low-salt or salt-free diet, discuss this with your doctor. Additionally, talk to your doctor before consuming alcohol, marijuana, or other forms of cannabis, or taking prescription or OTC medications that may cause drowsiness.

Managing Potential Side Effects

Inform your doctor if you experience excessive sweating, fluid loss, vomiting, or diarrhea, as these can lead to low blood pressure. If you take cholestyramine or colestipol, consult with your pharmacist about how to take these medications with this drug, and be aware of the potential for gout attacks.

Special Considerations

If you have lupus, this medication may cause your condition to become active or worsen. Report any new or worsening symptoms to your doctor immediately. This medication may also increase your risk of sunburn, so take precautions when spending time outdoors and inform your doctor if you experience sunburn easily.

Age-Related Considerations

If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.

Pregnancy and Breastfeeding

Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Your doctor will discuss the benefits and risks of this medication with you, and help you make an informed decision about its use.

• Anuria
• Hypersensitivity to hydrochlorothiazide or other sulfonamide-derived drugs

• Lithium (increased lithium toxicity due to decreased renal clearance)
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (may reduce diuretic, natriuretic, and antihypertensive effects of thiazides)
• Digoxin (increased risk of digitalis toxicity due to hypokalemia)
• Corticosteroids, ACTH (increased risk of electrolyte depletion, particularly hypokalemia)
• Cholestyramine, Colestipol (may impair absorption of hydrochlorothiazide)
• Diazoxide (enhanced hyperglycemic and hypotensive effects)
• Neuromuscular blocking agents (e.g., tubocurarine) (enhanced effect due to hypokalemia)

• Antidiabetic agents (insulin, oral hypoglycemics) (may decrease hypoglycemic effect, requiring dose adjustment)
• Other antihypertensives (additive hypotensive effect)
• Alcohol, barbiturates, narcotics (additive orthostatic hypotension)
• Pressor amines (e.g., norepinephrine) (possible decreased arterial responsiveness)
• Allopurinol (increased risk of hypersensitivity reactions to allopurinol)
• Amantadine (increased risk of amantadine toxicity)
• Calcium salts (increased serum calcium due to decreased excretion)
• Cyclosporine (increased risk of hyperuricemia and gouty complications)

• Not available (most clinically significant interactions are moderate or major)

• Dizziness or lightheadedness (especially upon standing, indicative of hypotension)
• Muscle cramps or weakness (indicative of hypokalemia or hypomagnesemia)
• Excessive thirst, dry mouth, lethargy, confusion (indicative of dehydration or hyponatremia)
• Nausea, vomiting, loss of appetite
• Swelling of ankles or feet (if edema is not resolving)
• Signs of gout (sudden joint pain, swelling, redness)
• Increased urination (expected, but monitor for excessive fluid loss)
• Skin rash or increased sensitivity to sunlight (photosensitivity)

Generally considered Category B. Not recommended for routine use in healthy pregnant women for edema or hypertension, as it does not prevent pre-eclampsia and may reduce placental perfusion. May be used in specific cases where the benefit outweighs the risk, particularly if other antihypertensives are not effective or tolerated.

Excreted in breast milk. Use with caution. May suppress lactation due to fluid loss. Potential for adverse effects in the infant (e.g., electrolyte imbalance, jaundice). Consider alternative agents, especially in preterm infants or during the first month postpartum.

Use with caution. Dosing is weight-based. Not typically first-line for hypertension in children. More susceptible to electrolyte imbalances. Close monitoring of fluid and electrolytes is crucial.

More sensitive to the effects of diuretics, including hypotension and electrolyte imbalances (especially hypokalemia and hyponatremia). Start with lower doses and titrate slowly. Close monitoring of renal function and electrolytes is essential.

• Hydrochlorothiazide is a first-line agent for essential hypertension, especially in patients who are Black or have a history of stroke.
• Take in the morning to prevent nocturia (nighttime urination).
• Can cause photosensitivity; advise patients to use sunscreen and protective clothing.
• May increase serum uric acid, potentially precipitating gout attacks.
• Can cause hyperglycemia, requiring careful monitoring in diabetic patients.
• Often used in combination with ACE inhibitors or ARBs to enhance antihypertensive effect and mitigate potassium loss (ACEIs/ARBs tend to increase potassium, while HCTZ decreases it).
• Ineffective in severe renal impairment (CrCl < 30 mL/min); loop diuretics are preferred in these cases.

• Other thiazide diuretics (e.g., Chlorthalidone, Indapamide)
• Loop diuretics (e.g., Furosemide, Torsemide) for more potent diuresis or renal impairment
• Potassium-sparing diuretics (e.g., Spironolactone, Amiloride)
• ACE inhibitors (e.g., Lisinopril, Enalapril)
• Angiotensin Receptor Blockers (ARBs) (e.g., Valsartan, Losartan)
• Calcium Channel Blockers (e.g., Amlodipine, Diltiazem)
• Beta-blockers (e.g., Metoprolol, Atenolol)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.