Hydrochlorothiazide

Hydrochlorothiazide tablets are indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Hydrochlorothiazide tablets have also been found useful in edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure.

The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias. In the event of overdosage, symptomatic and supportive measures should be employed. Emesis should be induced or gastric lavage performed.

The following adverse reactions have been reported and, within each category, are listed in order of decreasing severity. Body as a Whole: Weakness Cardiovascular: Hypotension including orthostatic hypotension (may be aggravated by alcohol, barbiturates, narcotics or antihypertensive drugs). Digestive: Pancreatitis, jaundice (intrahepatic cholestatic jaundice), diarrhea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia.

Use with caution in severe renal disease. In patients with renal disease, thiazides may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function. Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma. Thiazides may add to or potentiate the action of other antihypertensive drugs.

When given concurrently the following drugs may interact with thiazide diuretics. Alcohol, Barbiturates, or Narcotics: Potentiation of orthostatic hypotension may occur. Antidiabetic Drugs - (Oral Agents and Insulin): Dosage adjustment of the antidiabetic drug may be required. Other Antihypertensive Drugs: Additive effect or potentiation. Cholestyramine and Colestipol Resins: Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins.

Store at 20 - 25 C (68 - 77 F). [See USP for Controlled Room Temperature]. Dispense in a tight, light-resistant container as defined in the USP, using a child-resistant closure.