How does hydrochlorothiazide interact with alcohol. What are the potential risks of combining hydrochlorothiazide and alcohol. How can patients safely manage their medication and alcohol consumption. What are the effects of hydrochlorothiazide on lipid levels. How should patients with hyperlipidemia be monitored while on thiazide therapy.

Understanding Hydrochlorothiazide: A Common Diuretic Medication

Hydrochlorothiazide is a widely prescribed diuretic medication used to treat various conditions, including hypertension and edema. As with many medications, it’s crucial to understand potential interactions, particularly with substances like alcohol. This comprehensive guide delves into the intricacies of hydrochlorothiazide and its interactions with alcohol and food.

The Interaction Between Hydrochlorothiazide and Alcohol

When it comes to combining hydrochlorothiazide and alcohol, caution is paramount. The interaction between these two substances can lead to significant effects on blood pressure and overall well-being.

Additive Blood Pressure Lowering Effects

Hydrochlorothiazide and alcohol can have synergistic effects in lowering blood pressure. This combined action may result in an excessive drop in blood pressure, leading to various symptoms and potential health risks.

Common Symptoms of Interaction

• Headache
• Dizziness
• Lightheadedness
• Fainting
• Changes in pulse or heart rate

These symptoms are more likely to occur at the beginning of treatment, after a dose increase, or when restarting treatment following an interruption. If you experience these symptoms and they persist or become troublesome, it’s crucial to consult your healthcare provider.

Safety Precautions and Recommendations

To ensure safe use of hydrochlorothiazide, especially when alcohol consumption is a factor, consider the following recommendations:

1. Avoid driving or operating hazardous machinery until you understand how the medication affects you.
2. Exercise caution when changing positions, such as standing up from a sitting or lying position.
3. Inform your healthcare provider about all medications, vitamins, and herbs you’re taking.
4. Never stop using any medications without first consulting your doctor.

How can patients safely manage their hydrochlorothiazide medication and alcohol consumption? It’s advisable to limit alcohol intake while taking hydrochlorothiazide. If you choose to drink, do so in moderation and be aware of how your body responds. Always follow your doctor’s advice regarding alcohol consumption while on this medication.

Hydrochlorothiazide and Its Impact on Lipid Levels

Beyond its interaction with alcohol, hydrochlorothiazide can have significant effects on lipid metabolism. Understanding these effects is crucial for patients, especially those with pre-existing lipid disorders.

Effects on Serum Lipids

Thiazide diuretics, including hydrochlorothiazide, may increase serum triglyceride and cholesterol levels, primarily affecting LDL (low-density lipoprotein) and VLDL (very low-density lipoprotein) cholesterol. However, the dose-dependency and long-term sustainability of these effects during chronic therapy remain uncertain.

How does hydrochlorothiazide affect lipid levels in the body? The medication can potentially raise triglycerides and cholesterol, particularly LDL and VLDL. This effect underscores the importance of regular lipid monitoring for patients on thiazide therapy, especially those with pre-existing hyperlipidemia.

Monitoring and Management

Patients with pre-existing hyperlipidemia may require closer monitoring during thiazide therapy. Healthcare providers may need to adjust lipid-lowering regimens accordingly based on individual patient responses.

Clinical Studies and Evidence

Several studies have investigated the effects of hydrochlorothiazide and other thiazide diuretics on glucose and lipid metabolism. These studies provide valuable insights into the metabolic impact of these medications.

Key Research Findings

• A study by Pollare et al. compared the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in hypertensive patients.
• Ames and Hill reported an increase in serum lipids during treatment of hypertension with chlorthalidone, another thiazide diuretic.
• Fager et al. examined the effects of various anti-hypertensive therapies, including hydrochlorothiazide, on serum lipoproteins.

These studies collectively highlight the potential metabolic effects of thiazide diuretics and underscore the importance of comprehensive patient monitoring.

Managing Hydrochlorothiazide Therapy in Patients with Hyperlipidemia

For patients with pre-existing hyperlipidemia, managing hydrochlorothiazide therapy requires a careful approach. Healthcare providers must balance the benefits of blood pressure control with the potential risks of worsening lipid profiles.

Strategies for Effective Management

1. Regular lipid profile monitoring
2. Adjustment of lipid-lowering medications as needed
3. Consideration of alternative antihypertensive medications in severe cases
4. Lifestyle modifications to support healthy lipid levels
5. Close collaboration between patients and healthcare providers

How should patients with hyperlipidemia be monitored while on thiazide therapy? Regular lipid profile tests are essential. The frequency of these tests may be increased, especially in the initial phases of treatment or after dose adjustments. Healthcare providers should also assess the overall cardiovascular risk profile and adjust treatment strategies accordingly.

Alternative Medications and Treatment Approaches

In cases where the lipid-altering effects of hydrochlorothiazide are of significant concern, healthcare providers may consider alternative treatment options. These may include:

• ACE inhibitors
• Angiotensin receptor blockers (ARBs)
• Calcium channel blockers
• Beta-blockers (with careful consideration of their own metabolic effects)

The choice of alternative medications should be based on individual patient factors, including overall health status, comorbidities, and specific treatment goals.

Lifestyle Modifications to Support Treatment

While medication management is crucial, lifestyle modifications play a vital role in managing both hypertension and lipid levels. Patients taking hydrochlorothiazide, especially those with concerns about lipid effects, should consider the following lifestyle changes:

Diet and Nutrition

• Adopt a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins
• Limit saturated and trans fats
• Increase intake of omega-3 fatty acids
• Reduce sodium consumption to support blood pressure control

Physical Activity

Regular exercise can help manage both blood pressure and lipid levels. Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, along with muscle-strengthening activities at least two days a week.

Weight Management

Maintaining a healthy weight can significantly impact both blood pressure and lipid profiles. Even modest weight loss can lead to improvements in these areas.

Stress Management

Chronic stress can contribute to hypertension and may indirectly affect lipid levels. Incorporate stress-reduction techniques such as meditation, yoga, or deep breathing exercises into your daily routine.

The Importance of Personalized Treatment Plans

Given the complex interplay between hydrochlorothiazide, alcohol, and lipid metabolism, it’s crucial to emphasize the importance of personalized treatment plans. Each patient’s response to medication can vary, and what works for one individual may not be suitable for another.

Factors Influencing Treatment Decisions

• Individual patient characteristics (age, gender, race)
• Comorbid conditions
• Overall cardiovascular risk profile
• Patient preferences and lifestyle factors
• Potential drug interactions with other medications

How can healthcare providers develop effective personalized treatment plans for patients on hydrochlorothiazide? A comprehensive approach that considers all relevant factors is essential. This may involve:

1. Detailed patient history and physical examination
2. Regular monitoring of blood pressure, lipid levels, and other relevant biomarkers
3. Open communication about alcohol consumption and other lifestyle factors
4. Collaborative decision-making between the healthcare provider and patient
5. Periodic reassessment of the treatment plan and adjustments as needed

The Role of Patient Education in Safe Medication Use

Empowering patients with knowledge about their medication is crucial for ensuring safe and effective use. When it comes to hydrochlorothiazide, patient education should cover several key areas:

Understanding the Medication

• How hydrochlorothiazide works
• Expected benefits and potential side effects
• Proper dosing and administration
• Importance of adherence to the prescribed regimen

Recognizing and Reporting Side Effects

Patients should be educated on common side effects of hydrochlorothiazide and when to seek medical attention. This includes understanding the potential symptoms of excessive blood pressure lowering when combined with alcohol.

Lifestyle Considerations

Clear guidance on alcohol consumption, dietary recommendations, and the importance of regular physical activity should be provided.

Monitoring and Follow-up

Patients should understand the need for regular check-ups and laboratory tests to monitor their response to the medication and detect any potential issues early.

How can healthcare providers effectively educate patients about hydrochlorothiazide and its interactions? Consider using a combination of verbal instructions, written materials, and visual aids. Encourage patients to ask questions and express any concerns they may have about their treatment.

Future Directions in Research and Treatment

As our understanding of hydrochlorothiazide and its effects on the body continues to evolve, ongoing research is crucial. Several areas warrant further investigation:

Long-term Metabolic Effects

More extensive longitudinal studies are needed to fully elucidate the long-term metabolic effects of hydrochlorothiazide, particularly concerning lipid profiles and glucose metabolism.

Personalized Medicine Approaches

Research into genetic factors that influence individual responses to hydrochlorothiazide could pave the way for more tailored treatment strategies.

Alternative Formulations

Development of new formulations or delivery methods for hydrochlorothiazide that minimize metabolic side effects while maintaining efficacy could significantly improve patient outcomes.

Combination Therapies

Further exploration of combination therapies that mitigate the potential negative metabolic effects of hydrochlorothiazide while enhancing its blood pressure-lowering efficacy is an important area of research.

What potential advancements in hydrochlorothiazide treatment can we expect in the coming years? While it’s difficult to predict specific breakthroughs, ongoing research in pharmacogenomics and drug delivery technologies holds promise for more targeted and effective treatments with fewer side effects.

Conclusion: Balancing Benefits and Risks in Hydrochlorothiazide Therapy

Hydrochlorothiazide remains a valuable tool in the management of hypertension and other conditions. However, its potential interactions with alcohol and its effects on lipid metabolism underscore the need for careful management and individualized treatment approaches.

By understanding these interactions, adhering to safety precautions, and maintaining open communication with healthcare providers, patients can maximize the benefits of hydrochlorothiazide therapy while minimizing potential risks. Regular monitoring, lifestyle modifications, and a comprehensive approach to cardiovascular health are key components of successful treatment.

As research continues to evolve, we can look forward to more refined treatment strategies that optimize the use of hydrochlorothiazide and similar medications, ultimately leading to improved patient outcomes and quality of life.

Hydrochlorothiazide and Alcohol/Food Interactions – Drugs.com

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There are 2 alcohol/food/lifestyle interactions with hydrochlorothiazide.

HydroCHLOROthiazide and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

thiazides – hyperlipidemia

Thiazide diuretics may increase serum triglyceride and cholesterol levels, primarily LDL and VLDL. Whether these effects are dose-related and sustained during chronic therapy are unknown. Patients with preexisting hyperlipidemia may require closer monitoring during thiazide therapy, and adjustments made accordingly in their lipid-lowering regimen

References

1. Pollare T, Lithell H, Berne C “A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension.” N Engl J Med 321
   (1989): 868-73
2. Ames RP, Hill P “Increase in serum-lipids during treatment of hypertension with chlorthalidone.” Lancet 1
   (1976): 721-3
3. Pollare T, Lithell H, Berne C “A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension.” N Engl J Med 321
   (1989): 868-73
4. Fager G, Berglund G, Bondjers G, Elmfeldt D, Lager I, Olofsson SO, Smith U, Wiklund O “Effects of anti-hypertensive therapy on serum lipoproteins. Treatment with metoprolol, propranolol and hydrochlorothiazide.” Artery 11
   (1983): 283-96
5. Beling S, Vukovich RA, Neiss ES, Zisblatt M, Webb E, Losi M “Long-term experience with indapamide.” Am Heart J 106
   (1983): 258-62
6. Slotkoff L “Clinical efficacy and safety of indapamide in the treatment of edema.” Am Heart J 106
   (1983): 233-7
7. “Product Information. HydroDIURIL (hydrochlorothiazide).” Merck & Co., Inc
   (2002):
8. “Product Information. Lozol (indapamide).” Rhone Poulenc Rorer
   (2002):
9. Luther RR, Glassman HN, Estep CB, Maurath CJ, Jordan DC “The effects of terazosin and methyclothiazide on blood pressure and serum lipids.” Am Heart J 117
   (1989): 842-7
10. “Product Information. Zaroxolyn (metolazone).” Rhone Poulenc Rorer
    (2001):
11. “Product Information. Thalitone (chlorthalidone).” Monarch Pharmaceuticals Inc
    (2001):
12. “Product Information. Diuril (chlorothiazide).” Merck & Co., Inc
    (2001):
13. Smith WM “Diuretics and cholesterol elevation.” JAMA 242
    (1979): 1612
14. “Product Information. Enduron (methyclothiazide).” Abbott Pharmaceutical
    (2001):
15. “Product Information. Metahydrin (trichlormethiazide).” Hoechst Marion Roussel
    (2001):
16. “Product Information. Diucardin (hydroflumethiazide).” Wyeth-Ayerst Laboratories
    (2001):
17. Elmfeldt D, Berglund G, Wedel H, Wilhelmsen L “Incidence and importance of metabolic side-effects during antihypertensive therapy.” Acta Med Scand Suppl 672
    (1983): 79-83
18. Winchester JF, Kellett RJ, Boddy K, Boyle P, Dargie HJ, Mahaffey ME, Ward DM, Kennedy AC “Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations. ” Clin Pharmacol Ther 28
    (1980): 611-8
19. Petri M, Cumber P, Grimes L, Treby D, Bryant R, Rawlins D, Ising H “The metabolic effects of thiazide therapy in the elderly: a population study.” Age Ageing 15
    (1986): 151-5
20. “Product Information. Renese-R (reserpine-polythiazide).” Pfizer US Pharmaceuticals, New York, NY.
21. Kasiske BL, Ma JZ, Kalil RS, Louis TA “Effects of antihypertensive therapy on serum lipids.” Ann Intern Med 122
    (1995): 133-41
22. Freis ED “The efficacy and safety of diuretics in treating hypertension.” Ann Intern Med 122
    (1995): 223-6
23. Ames RP “A comparison of blood lipid and blood pressure responses during the treatment of systemic hypertension with indapamide and with thiazides.” Am J Cardiol 77
    (1996): b12-6

View all 23 references

Hydrochlorothiazide drug interactions

There are 452 drug interactions with hydrochlorothiazide.

Hydrochlorothiazide disease interactions

There are 11 disease interactions with hydrochlorothiazide which include:

• anuria
• electrolyte losses
• liver disease
• lupus erythematosus
• renal function disorders
• asthma
• diabetes
• hyperlipidemia
• hyperparathyroidism
• hyperuricemia
• thyroid function tests

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More about hydrochlorothiazide

• hydrochlorothiazide consumer information
• Check interactions
• Compare alternatives
• Pricing & coupons
• Reviews (183)
• Drug images
• Latest FDA alerts (2)
• Side effects
• Dosage information
• Patient tips
• During pregnancy
• Support group
• Drug class: thiazide diuretics
• Breastfeeding
• En español

Related treatment guides

• Edema
• Diabetes Insipidus
• Osteoporosis
• High Blood Pressure
• Nephrocalcinosis

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Hydrochlorothiazide/lisinopril and Alcohol/Food Interactions – Drugs.com

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There are 5 alcohol/food/lifestyle interactions with hydrochlorothiazide / lisinopril.

Although hydroCHLOROthiazide and lisinopril are frequently combined together, their effects may be additive on lowering your blood pressure. You may need a dose adjustment or special tests to safely take both medications. Contact your doctor if you have a reduced heart rate, dizziness, fainting, or headaches. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

HydroCHLOROthiazide and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Consumer information for this interaction is not currently available.

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

1. Sternbach H “Fluoxetine-associated potentiation of calcium-channel blockers.” J Clin Psychopharmacol 11
   (1991): 390-1
2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA “Ethanol intoxication complicating intravenous nitroglycerin therapy.” Ann Intern Med 101
   (1984): 498-9
3. Feder R “Bradycardia and syncope induced by fluoxetine.” J Clin Psychiatry 52
   (1991): 139
4. Ellison JM, Milofsky JE, Ely E “Fluoxetine-induced bradycardia and syncope in two patients. ” J Clin Psychiatry 51
   (1990): 385-6
5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. “Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients.” Ther Drug Monit 23
   (2001): 435-40
6. Cerner Multum, Inc. “Australian Product Information.” O 0
7. Pacher P, Kecskemeti V “Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?” Curr Pharm Des 10
   (2004): 2463-75
8. Andrews C, Pinner G “Postural hypotension induced by paroxetine.” BMJ 316
   (1998): 595

View all 8 references

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Moderate-to-high dietary intake of potassium can cause hyperkalemia in some patients who are using angiotensin converting enzyme (ACE) inhibitors. In some cases, affected patients were using a potassium-rich salt substitute. ACE inhibitors can promote hyperkalemia through inhibition of the renin-aldosterone-angiotensin (RAA) system.

MANAGEMENT: It is recommended that patients who are taking ACE inhibitors be advised to avoid moderately high or high potassium dietary intake. Particular attention should be paid to the potassium content of salt substitutes.

References

1. “Product Information. Vasotec (enalapril).” Merck & Co., Inc
   (2002):
2. Good CB, McDermott L “Diet and serum potassium in patients on ACE inhibitors.” JAMA 274
   (1995): 538
3. Ray K, Dorman S, Watson R “Severe hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction.” J Hum Hypertens 13
   (1999): 717-20

thiazides – hyperlipidemia

Thiazide diuretics may increase serum triglyceride and cholesterol levels, primarily LDL and VLDL. Whether these effects are dose-related and sustained during chronic therapy are unknown. Patients with preexisting hyperlipidemia may require closer monitoring during thiazide therapy, and adjustments made accordingly in their lipid-lowering regimen

References

1. Pollare T, Lithell H, Berne C “A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension.” N Engl J Med 321
   (1989): 868-73
2. Ames RP, Hill P “Increase in serum-lipids during treatment of hypertension with chlorthalidone.” Lancet 1
   (1976): 721-3
3. Pollare T, Lithell H, Berne C “A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension.” N Engl J Med 321
   (1989): 868-73
4. Fager G, Berglund G, Bondjers G, Elmfeldt D, Lager I, Olofsson SO, Smith U, Wiklund O “Effects of anti-hypertensive therapy on serum lipoproteins. Treatment with metoprolol, propranolol and hydrochlorothiazide.” Artery 11
   (1983): 283-96
5. Beling S, Vukovich RA, Neiss ES, Zisblatt M, Webb E, Losi M “Long-term experience with indapamide.” Am Heart J 106
   (1983): 258-62
6. Slotkoff L “Clinical efficacy and safety of indapamide in the treatment of edema.” Am Heart J 106
   (1983): 233-7
7. “Product Information. HydroDIURIL (hydrochlorothiazide).” Merck & Co., Inc
   (2002):
8. “Product Information. Lozol (indapamide).” Rhone Poulenc Rorer
   (2002):
9. Luther RR, Glassman HN, Estep CB, Maurath CJ, Jordan DC “The effects of terazosin and methyclothiazide on blood pressure and serum lipids.” Am Heart J 117
   (1989): 842-7
10. “Product Information. Zaroxolyn (metolazone).” Rhone Poulenc Rorer
    (2001):
11. “Product Information. Thalitone (chlorthalidone).” Monarch Pharmaceuticals Inc
    (2001):
12. “Product Information. Diuril (chlorothiazide).” Merck & Co., Inc
    (2001):
13. Smith WM “Diuretics and cholesterol elevation.” JAMA 242
    (1979): 1612
14. “Product Information. Enduron (methyclothiazide).” Abbott Pharmaceutical
    (2001):
15. “Product Information. Metahydrin (trichlormethiazide).” Hoechst Marion Roussel
    (2001):
16. “Product Information. Diucardin (hydroflumethiazide).” Wyeth-Ayerst Laboratories
    (2001):
17. Elmfeldt D, Berglund G, Wedel H, Wilhelmsen L “Incidence and importance of metabolic side-effects during antihypertensive therapy.” Acta Med Scand Suppl 672
    (1983): 79-83
18. Winchester JF, Kellett RJ, Boddy K, Boyle P, Dargie HJ, Mahaffey ME, Ward DM, Kennedy AC “Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations. ” Clin Pharmacol Ther 28
    (1980): 611-8
19. Petri M, Cumber P, Grimes L, Treby D, Bryant R, Rawlins D, Ising H “The metabolic effects of thiazide therapy in the elderly: a population study.” Age Ageing 15
    (1986): 151-5
20. “Product Information. Renese-R (reserpine-polythiazide).” Pfizer US Pharmaceuticals, New York, NY.
21. Kasiske BL, Ma JZ, Kalil RS, Louis TA “Effects of antihypertensive therapy on serum lipids.” Ann Intern Med 122
    (1995): 133-41
22. Freis ED “The efficacy and safety of diuretics in treating hypertension.” Ann Intern Med 122
    (1995): 223-6
23. Ames RP “A comparison of blood lipid and blood pressure responses during the treatment of systemic hypertension with indapamide and with thiazides.” Am J Cardiol 77
    (1996): b12-6

View all 23 references

Hydrochlorothiazide/lisinopril drug interactions

There are 595 drug interactions with hydrochlorothiazide / lisinopril.

Hydrochlorothiazide/lisinopril disease interactions

There are 19 disease interactions with hydrochlorothiazide / lisinopril which include:

• angioedema
• bone marrow suppression
• CHF
• hemodialysis
• hyperkalemia
• hypotension
• anuria
• electrolyte losses
• liver disease
• lupus erythematosus
• renal function disorders
• liver disease
• renal dysfunction
• asthma
• diabetes
• hyperlipidemia
• hyperparathyroidism
• hyperuricemia
• thyroid function tests

Report options

Loading…

QR code containing a link to this page

More about hydrochlorothiazide / lisinopril

• hydrochlorothiazide/lisinopril consumer information
• Check interactions
• Compare alternatives
• Pricing & coupons
• Reviews (78)
• Drug images
• Side effects
• Dosage information
• During pregnancy
• Drug class: ACE inhibitors with thiazides
• En español

Related treatment guides

• Heart Failure
• High Blood Pressure

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Hydrochlorothiazide – description of the substance, pharmacology, use, contraindications, formula

Contents

• Structural formula

• Russian name

• English title

• Latin name

• chemical name

• Gross formula

• Pharmacological group of the substance Hydrochlorothiazide

• Nosological classification

• CAS code

• pharmachologic effect

• Characteristic

• Pharmacology

• Application of the substance Hydrochlorothiazide

• Contraindications

• Application restrictions

• Use during pregnancy and lactation

• Side effects of hydrochlorothiazide

• Interaction

• Overdose

• Dosage and administration

• Precautionary measures

• Trade names with the active substance Hydrochlorothiazide

Structural formula

Russian name

Hydrochlorothiazide

English name

Hydrochlorothiazide

Latin name

Hydrochlorothiazidum ( genus Hydrochlorothiazidi)

Chemical name

3

C ₇ H ₈ ClN ₃ O ₄ S ₂

Pharmacological group of the substance Hydrochlorothiazide

Diuretics

Nosological classification

ICD-10 code list

CAS code

58-93-5

Pharmacological action

Pharmacological action –

hypotensive , diuretic .

Characteristics

White or yellowish crystalline powder. Slightly soluble in water, sparingly soluble in methanol, insoluble in ether, freely soluble in alkaline solutions. Molecular weight 297.72.

Pharmacology

Reduces the reabsorption of sodium and chloride ions (to a lesser extent – potassium and bicarbonates) in the proximal tubules of the kidneys, increases the excretion of magnesium ions, reduces – calcium ions, uric acid. It inhibits the reactivity of the vascular wall in relation to the vasoconstrictive effects of mediators due to a decrease in the concentration of sodium ions in the cytoplasm of vascular myocytes, reduces BCC, lowers blood pressure.

Incompletely, but fairly rapidly absorbed from the gastrointestinal tract. In the blood, 40–60% binds to proteins. Penetrates through the hematoplacental barrier and into breast milk. Excreted by the kidneys. The diuretic effect develops after 30-60 minutes, reaches a maximum after 4-6 hours, persists for 6-12 hours.

The use of the substance Hydrochlorothiazide

chronic heart failure, nephrotic syndrome, premenstrual syndrome, acute glomerulonephritis, chronic renal failure, portal hypertension, corticosteroid treatment), control of polyuria (mainly in nephrogenic diabetes insipidus), prevention of urinary tract stones in predisposed patients (reduction of hypercalciuria).

Contraindications

Hypersensitivity (including to other sulfonamides), anuria, severe renal (Cl creatinine – less than 30 ml / min) or liver failure, difficult-to-control diabetes mellitus, Addison’s disease, gout, children’s age (up to 3 years ).

Restrictions for use

Hypokalemia, hyponatremia and hypercalcemia, ischemic heart disease, concomitant use of cardiac glycosides, impaired liver and kidney function, pregnancy, old age.

Use during pregnancy and lactation

FDA fetal category B.

Breastfeeding should be discontinued during treatment.

Substance side effects Hydrochlorothiazide

Electrolyte imbalance

Hypokalemia, hypomagnesemia, hypercalcemia and hypochloremic alkalosis: dry mouth, thirst, irregular heart rhythm, changes in mood or psyche, cramps and muscle pain, nausea, vomiting, unusual tiredness or weakness. Hypochloremic alkalosis can cause hepatic encephalopathy or hepatic coma.

Hyponatremia: confusion, convulsions, lethargy, slow thinking, fatigue, excitability, muscle cramps.

Metabolic effects: hyperglycemia, glucosuria, hyperuricemia with the development of an attack of gout. Treatment with thiazides may reduce glucose tolerance, and latent diabetes mellitus may manifest. At high doses, serum lipid levels may increase.

From the digestive tract: cholecystitis or pancreatitis, cholestatic jaundice, diarrhea, sialadenitis, constipation, anorexia.

From the side of the cardiovascular system and blood (hematopoiesis, hemostasis): arrhythmias, orthostatic hypotension, vasculitis; very rarely – leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia.

From the nervous system and sensory organs: dizziness, blurred vision (temporarily), headache, paresthesia.

Hypersensitivity reactions: urticaria, purpura, necrotizing vasculitis, Stevens-Johnson syndrome, respiratory distress syndrome (including pneumonitis and non-cardiogenic pulmonary edema), photosensitivity, anaphylactic reactions up to shock.

Other: decreased potency, impaired renal function, interstitial nephritis.

Interactions

Simultaneous use of hydrochlorothiazide with lithium salts should be avoided (renal clearance of lithium decreases, its toxicity increases).

It should be used with caution with antihypertensive drugs (their action is potentiated, it may be necessary to adjust the dose), cardiac glycosides (hypokalemia and hypomagnesemia associated with the action of thiazide diuretics may increase digitalis toxicity), amiodarone (its use simultaneously with thiazide diuretics may lead to an increased risk of arrhythmias associated with hypokalemia), oral hypoglycemic agents (their effectiveness decreases, hyperglycemia may develop), corticosteroids, calcitonin (increase potassium excretion), NSAIDs (may weaken the diuretic and hypotensive effect of thiazides), non-depolarizing muscle relaxants (their the effect may be enhanced), amantadine (clearance of amantadine may be reduced by hydrochlorothiazide, which leads to an increase in plasma concentrations of amantadine and possible toxicity), colestyramine (reduces the absorption of hydrochlorothiazide), ethanol, barbiturates and narcotic analgesics, which increase the effect of orthostatic hypotension.

Thiazides may reduce plasma levels of protein-bound iodine.

Thiazides should be discontinued before performing parathyroid function tests. Serum bilirubin concentration may be elevated.

Overdose

Symptoms: dehydration, severe electrolyte disturbances, confusion, dry mouth, lethargy, muscle weakness, drowsiness, tachycardia, hypotension, oliguria, decreased blood pressure, shock.

Treatment: induction of vomiting, gastric lavage, intravenous fluid, electrolytes, symptomatic therapy. The specific antidote is unknown.

Dosage and administration

Inside. The dosing regimen is set individually. With constant medical supervision, the minimum effective dose is established. Due to the increased loss of potassium and magnesium ions during treatment (serum potassium levels may decrease below 3.0 mmol / l), it becomes necessary to replace potassium and magnesium. With arterial hypertension – 25-50 mg 1 time per day (for some patients, an initial dose of 12. 5 mg is enough), with edematous syndrome – 25-100 (up to 200) mg / day. For children from 3 years old, the daily dose is 1-2 mg / kg, 3-12 years old – 37.5-100 mg / day.

Precautions

With prolonged course treatment, it is necessary to carefully monitor the clinical symptoms of fluid and electrolyte imbalance, primarily in high-risk patients: patients with diseases of the cardiovascular system and impaired liver function; in case of severe vomiting or if there are signs of a violation of the water and electrolyte balance, such as dry mouth, thirst, weakness, lethargy, drowsiness, anxiety, muscle pain or cramps, muscle weakness, hypotension, oliguria, tachycardia, complaints from the gastrointestinal tract.

Hypokalemia, especially in case of increased potassium loss (increased diuresis, prolonged treatment) or concomitant treatment with digitalis glycosides or corticosteroid drugs, can be avoided by the use of potassium-containing drugs or potassium-rich foods (fruits, vegetables). Thiazides have been shown to increase urinary excretion of magnesium, which may lead to hypomagnesemia.

If renal function is impaired, creatinine clearance needs to be monitored. In patients with impaired renal function, the drug may cause azotemia, and cumulative effects may also develop. If impaired renal function is evident, discontinuation of the drug should be considered upon the onset of oliguria.

In patients with impaired liver function or progressive liver disease, thiazides should be used with caution because slight changes in fluid and electrolyte balance, as well as serum ammonium levels, can cause hepatic coma.

In the case of severe cerebral and coronary sclerosis, the administration of the drug requires special care.

Treatment with thiazide drugs may impair glucose tolerance. During a long course of treatment with manifesting or latent diabetes mellitus, systematic monitoring of carbohydrate metabolism is necessary; it may be necessary to change the dose of hypoglycemic drugs. Enhanced monitoring of patients with impaired uric acid metabolism is required.

Alcohol, barbiturates, narcotic analgesics increase the orthostatic hypotensive effect of thiazide diuretics.

With long-term therapy, in rare cases, a pathological change in the parathyroid glands was observed, accompanied by hypercalcemia and hypophosphatemia. Thiazides can reduce the amount of iodine that binds to serum proteins without showing signs of thyroid dysfunction.

Patients suffering from lactose intolerance may experience gastrointestinal complaints due to the presence of lactose in the composition of the tablets.

At the initial stage of drug use (the duration of this period is determined individually), it is forbidden to drive a car and perform work that requires increased attention.

Trade names with active substance Hydrochlorothiazide

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Lek. form
All lek. forms substance substance-powder tablets

Dosage
All dosages 100 mg 25 mg No dosage

Manufacturer
All manufacturers Biochemist JSC Biochemist JSC Borisov Plant of Medical Preparations JSC (JSC “BZMP”) Valenta Pharmaceutics JSC (JSC “Valenta Pharm”) Valenta Pharmaceutics PJSC (PJSC “Valenta Pharm”) Ipka Laboratories Ltd. Cambrex Propharmaco Milan S.r.L. Ozone LLC Opella Healthcare Hungary Ltd. Polpharma S.A., Poland Pharmaceutical plant Pranapharm CTIX Life Science Pvt. Ltd. Pharmasyntez-Tyumen Pharmstandard-Leksredstva LLC Quinoin Plant of Pharmaceutical and Chemical Products ZAO Chanzhou Pharmaceutical Factory Unikem Laboratories Ltd.

Co-Vamloset tablet film 10 mg + 160 mg + 25 mg x30

Amlodipine + valsartan + hydrochlorothiazide

When using the drug, adverse events were mostly mild or moderately pronounced. Termination of treatment with the drug due to the development of adverse events was required in rare cases. Most often, the drug was discontinued due to the development of dizziness and a pronounced decrease in blood pressure.

No new adverse events were identified with the use of the drug compared with dual combination therapy and monotherapy with individual components.

As with short-term use, the drug was well tolerated with long-term use (within a year).

The incidence of adverse events was not related to gender, age or race.

When using the drug, changes in laboratory parameters were minimal and did not differ from those during monotherapy with individual components. With the simultaneous use of hydrochlorothiazide together with valsartan (triple combination therapy), there is a decrease in the hypokalemic effect of hydrochlorothiazide.

The most common adverse events reported in clinical studies (whether or not associated with the use of the drug) were dizziness, peripheral edema, headache, dyspepsia, fatigue, muscle spasm, back pain, nasopharyngitis, nausea.

The following criteria were used to estimate the frequency (according to WHO classification): very often (≥1/10), often (≥1/100, &lt.1/10), infrequently (≥1/1000, &lt.1/100) , rare (≥1 / 10,000, &lt,1/1000), very rare (&lt,1/10,000), frequency unknown (not enough data to estimate the frequency of development).

From the side of metabolism: often – hypokalemia, infrequently – hypercalcemia, hyperlipidemia, hyponatremia.

From the side of the nervous system: often – dizziness, headache, infrequently – insomnia / sleep disturbances, coordination disorders, postural dizziness and dizziness due to exercise, taste disorders, lethargy, paresthesia, neuropathy, incl. peripheral, drowsiness, fainting.

Sense organs: infrequently – visual disturbances, vertigo.

From the side of the cardiovascular system: often – a pronounced decrease in blood pressure, infrequently – tachycardia, orthostatic hypotension, phlebitis, thrombophlebitis.

From the respiratory system: infrequently – cough, shortness of breath, irritation in the throat.

From the digestive system: often – dyspepsia, infrequently – anorexia, abdominal discomfort, pain in the upper abdomen, bad breath, diarrhea, dry mouth, nausea, vomiting.

Dermatological reactions: infrequently – increased sweating, itching.

From the musculoskeletal system and connective tissue: infrequently – back pain, swelling in the joints, muscle spasms, muscle weakness, myalgia, pain in the extremities.

From the urinary system: often – pollakiuria, infrequently – increased plasma creatinine concentration, acute renal failure.

From the reproductive system: infrequently – erectile dysfunction.

On the part of the body as a whole: often – peripheral edema, increased fatigue, infrequently – abasia, gait disturbances, asthenia, general weakness, pain in the chest area.

From the side of laboratory parameters: infrequently – an increase in the content of urea nitrogen in the blood plasma, hyperuricemia, weight gain.

Amlodipine

, &lt,1/100), rarely (≥1/10,000, &lt,1/1000), very rare (&lt,1/10,000), the frequency is unknown (there is not enough data to estimate the frequency of development).

From the side of the hematopoietic system: very rarely – leukopenia, thrombocytopenia.

From the immune system: very rarely – hypersensitivity reactions.

From the side of metabolism: very rarely – hyperglycemia.

From the nervous system: often – dizziness, headache, drowsiness, infrequently – insomnia / sleep disturbances, mood lability, paresthesia, fainting, tremor, very rarely – muscular hypertension, peripheral neuropathy, neuropathy, frequency unknown – extrapyramidal disorders .

From the senses: infrequently – visual disturbances, tinnitus, taste disturbances.

From the side of the cardiovascular system: often – a feeling of palpitations, flushing of the face, infrequently – a pronounced decrease in blood pressure, very rarely – vasculitis, arrhythmias (including bradycardia, ventricular tachycardia, atrial fibrillation).

From the respiratory system: infrequently – shortness of breath, rhinitis, very rarely – cough.

From the digestive system: often – abdominal discomfort, pain in the upper abdomen, nausea, infrequently – change in the frequency of defecation, diarrhea, dry mouth, dyspepsia, vomiting, very rarely – gastritis, gingival hyperplasia, pancreatitis.

From the side of the liver and biliary tract: very rarely – increased activity of liver enzymes, increased plasma bilirubin concentration, hepatitis, intrahepatic cholestasis, jaundice.

Dermatological reactions: infrequently – alopecia, increased sweating, itching, rash, incl. exanthema, purpura, discoloration of the skin, very rarely – angioedema, erythema multiforme, urticaria.

From the musculoskeletal system and connective tissue: infrequently – arthralgia, back pain, muscle spasms, myalgia.

From the urinary system: infrequently – urination disorders, nocturia, pollakiuria.

From the reproductive system: infrequently – erectile dysfunction, gynecomastia.

On the part of the body as a whole: often – increased fatigue, edema, infrequently – asthenia, discomfort, general weakness, pain in the chest, pain of various localization.

From the side of laboratory parameters: infrequently – increase or decrease in body weight.

Valsartan

The following criteria were used to estimate the frequency (according to WHO classification): very often (≥1/10), often (≥1/100, &lt,1/10), infrequently (≥ 1/1000, &lt ,1/100), rarely (≥ 1/10,000, &lt,1/1000), very rare (&lt,1/10,000), the frequency is unknown (there is not enough data to estimate the frequency of development).

From the side of the hematopoietic system: the frequency is unknown – a decrease in hemoglobin and hematocrit, leukopenia, thrombocytopenia.

From the immune system: frequency unknown – hypersensitivity reactions.

On the part of the organ of hearing: infrequently – vertigo.

From the side of the cardiovascular system: the frequency is unknown – vasculitis.

From the respiratory system: infrequently – cough.

From the digestive system: infrequently – abdominal discomfort, pain in the upper abdomen.

From the side of the liver and biliary tract: frequency unknown – increased activity of liver enzymes, increased plasma bilirubin concentration.

Allergic reactions: frequency unknown – angioedema, itching, rash.

From the musculoskeletal system: the frequency is unknown – myalgia.

From the urinary system: the frequency is unknown – an increase in the concentration of creatinine in the blood plasma, impaired renal function, including acute renal failure.

On the part of the body as a whole: infrequently – increased fatigue.

From the side of laboratory parameters: the frequency is unknown – an increase in the content of potassium in the blood plasma.

In clinical studies with the use of valsartan in monotherapy, the following adverse events were noted (regardless of their causal relationship with the study drug): viral infections, upper respiratory tract infections, sinusitis, rhinitis, neutropenia, insomnia.

In rare cases, the use of valsartan may be accompanied by a decrease in hemoglobin and hematocrit. In controlled studies, in 0.8% and 0.4% of patients treated with valsartan, there was a significant decrease (more than 20%) in hematocrit and hemoglobin, respectively. For comparison, in patients receiving placebo, a decrease in both hematocrit and hemoglobin was noted in 0.1% of cases.

Neutropenia was detected in 1.9% of patients treated with valsartan and in 1.6% of patients treated with an ACE inhibitor.

In controlled studies, 3.9% and 16.6% of patients with chronic heart failure treated with valsartan showed an increase in the concentration of creatinine and blood urea nitrogen by more than 50%, respectively. For comparison, in patients receiving placebo, an increase in the concentration of creatinine and urea nitrogen was observed in 0.9% and 6.3% of cases.

A doubling of serum creatinine concentration was detected in 4.2% of patients after myocardial infarction who received valsartan and in 3.4% who received captopril.

In controlled studies, 10% of patients with chronic heart failure showed an increase in serum potassium by more than 20%. For comparison, in patients receiving placebo, an increase in potassium was observed in 5.1% of cases.

Hydrochlorothiazide

The following criteria were used to estimate the frequency (according to WHO classification): very often (≥1/10), often (≥1/100, &lt,1/10), infrequently (≥1/1000, &lt ,1/100), rarely (≥1/10,000, &lt,1/1000), very rare (&lt,1/10,000), the frequency is unknown (there is not enough data to estimate the frequency of development).

From the side of the hematopoietic system: rarely – thrombocytopenia, very rarely – agranulocytosis, depression of bone marrow hematopoiesis, hemolytic anemia, leukopenia.

From the immune system: very rarely – hypersensitivity reactions.

From the side of metabolism: often – hypokalemia, infrequently – hyperuricemia, hypomagnesemia, hyponatremia, rarely – hypercalcemia, hyperglycemia, very rarely – hypochloremic alkalosis.

From the nervous system: rarely – insomnia / sleep disturbances, depression, dizziness, headache, lethargy.

On the part of the organ of vision: infrequently – visual disturbances.

From the side of the cardiovascular system: infrequently – orthostatic hypotension, rarely – arrhythmias (including bradycardia, ventricular tachycardia, atrial fibrillation).

From the respiratory system: very rarely – respiratory distress syndrome, pulmonary edema and pneumonitis.

From the digestive system: infrequently – loss of appetite, nausea, vomiting, rarely – abdominal discomfort, pain in the upper abdomen, constipation, diarrhea, very rarely – pancreatitis.

From the side of the liver and biliary tract: rarely – hepatitis, intrahepatic cholestasis, jaundice.

Dermatological reactions: infrequently – rash, urticaria, rarely – increased photosensitivity, purpura, very rarely – necrotizing vasculitis, toxic epidermal necrolysis, lupus-like reactions, exacerbation of skin manifestations of systemic lupus erythematosus ki.