DIURETICS, THIAZIDE

Brand & Generic Names

Anhydron	Hygroton
Apo-Chlorthalidone	Metahydrin
Apo-Hydro	METHYCLOTHIAZIDE
Aquatensen	METOLAZONE
BENDROFLUMETHIAZIDE	Mykrox
BENZTHIAZIDE	Naqua
CHLOROTHIAZIDE	Naturetin
CHLORTHALIDONE	Neo-Codema
CYCLOTHIAZIDE	Novo-Hydrazide
Diucardin	Novo-Thalidone
Diuchlor H	Oretic
Diulo	POLYTHIAZIDE
Diuril	QUINETHAZONE
Duretic	Renese
Enduron	Saluron
Esidrix	Thalitone
Fluidil	TRICHLORMETHIAZIDE
HYDROCHLOROTHIAZIDE	Uridon
HydroDIURIL	Urozide
HYDROFLUMETHIAZIDE	Zaroxolyn
Hydromox

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes, for some.
• Drug class: Antihypertensive, diuretic (thiazide)

Uses

• Controls, but doesn't cure, high blood pressure.
• Reduces fluid retention (edema) caused by conditions such as heart disorders and liver disease.

Dosage & Usage Information

How to take:
Tablet or liquid--Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food. Don't exceed dose.

When to take:
At the same time each day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Forces sodium and water excretion, reducing body fluid.
Relaxes muscle cells of small arteries.
Reduced body fluid and relaxed arteries lower blood pressure.

Time lapse before drug works:
4 to 6 hours. May require several weeks to lower blood pressure.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.
Non-prescription drugs without consulting doctor.

Overdose

SYMPTOMS:
Cramps, weakness, drowsiness, weak pulse, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Muscle cramps.

Infrequent:

• Blurred vision, severe abdominal pain, nausea, vomiting, irregular heartbeat, weak pulse.
• Dizziness, mood changes, headaches, weakness, tiredness, weight changes, decreased sex drive, diarrhea.
• Dry mouth, thirst.

Rare:

• Rash or hives.
• Jaundice, joint pain, black stools.
• Sore throat, fever.

Warnings & Precautions

Don't take if:
You are allergic to any thiazide diuretic drug.

Before you start, consult your doctor:

• If you are allergic to any sulfa drug or tartrazine dye.
• If you have gout, systemic lupus erythematosis.
• If you have liver, pancreas, diabetes or kidney disorder.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons, especially dizziness and excessive potassium loss.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing.

Infants & children:
No problems expected.

Prolonged use:

• You may need medicine to treat high blood pressure for the rest of your life.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood sugar, kidney function, blood pressure, serum electrolytes.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Don't discontinue without medical advice.

Others:

• Hot weather and fever may cause dehydration and drop in blood pressure. Dose may require temporary adjustment. Weigh daily and report any unexpected weight decreases to your doctor.
• May cause rise in uric acid, leading to gout.
• May cause blood-sugar rise in diabetics.
• May affect results in some medical tests.
• Advise any doctor or dentist whom you consult that you take this medicine.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
ACE inhibitors*:	Decreased blood
captopril, enalapril,	pressure.
Allopurinol	Decreased allopurinol effect.
Amiodarone	Increased risk of heartbeat
	irregularity due to low potassium.
Amphotericin B	Increased potassium.
Antidepressants,	Dangerous drop in
tricyclic (TCA)*	blood pressure. Avoid combination
	unless under medical supervision.
Antidiabetic agents,	Increased blood
oral*	sugar.
Antihypertensives*	Increased hypertensive effect.
Barbiturates*	Increased antihypertensive effect.
Beta-adrenergic	Increased antihypertensive
blockers*	effect. Dosages of both drugs may
	require adjustments.
Calcium supplements*	Increased calcium in blood.
Carteolol	Increased antihypertensive effect.
Cholestyramine	Decreased antihypertensive effect.
Colestipol	Decreased antihypertensive effect.
Cortisone drugs*	Excessive potassium loss that
	causes dangerous heart rhythms.
Didanosine	Increased risk of pancreatitis.
Digitalis	Excessive potassium
preparations*	loss that causes dangerous heart
	rhythms.
Diuretics, thiazide*	Increased effect of other thiazide
	diuretics.
Indapamide	Increased diuretic effect.
Indomethacin	Decreased antihypertensive effect.
Lithium	Increased effect of lithium.
MAO inhibitors*	Increased antihypertensive effect.
Nicardipine	Blood pressure drop. Dosages may
	require adjustment.
Nimodipine	Dangerous blood pressure drop.
Nitrates*	Excessive blood pressure drop.
Opiates*	Dizziness or weakness when standing
	up after sitting or lying down.
Pentoxifylline	Increased antihypertensive effect.
Potassium	Decreased potassium
supplements*	effect.
Probenecid	Decreased probenecid effect.
Sotalol	Increased antihypertensive effect.
Terazosin	Decreases effectiveness of
	terazosin.
Zinc supplements	Increased need for zinc.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Dangerous blood pressure drop.
Beverages:	None expected.
Cocaine	Increased risk of heart block and
	high blood pressure.
Licorice.	Excessive potassium loss that
	causes dangerous heart rhythms.
Marijuana:	May increase blood pressure.
Tobacco:	None expected.