How does hydrochlorothiazide with irbesartan treat high blood pressure. What are the potential side effects of this combination medication. Who should avoid using this medicine and what precautions should be taken.

Understanding Hydrochlorothiazide and Irbesartan Combination

Hydrochlorothiazide and irbesartan is a combination medication used to treat high blood pressure. This powerful duo consists of an angiotensin receptor blocker (ARB) – irbesartan, and a thiazide diuretic (water pill) – hydrochlorothiazide. Together, they work to lower blood pressure through different mechanisms, providing a more comprehensive approach to hypertension management.

How Does This Combination Work?

Irbesartan blocks the action of angiotensin II, a hormone that narrows blood vessels, while hydrochlorothiazide helps the body eliminate excess water and salt. This dual-action approach effectively reduces blood pressure by relaxing blood vessels and decreasing blood volume.

Proper Usage and Dosage Instructions

Taking hydrochlorothiazide and irbesartan correctly is crucial for its effectiveness and safety. Here are some key points to remember:

• Follow your doctor’s dosage instructions carefully
• Your dose may need adjustment to find the optimal level
• Take the medication at the same time each day
• Drink plenty of fluids, especially if you exercise or sweat excessively
• If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose

Proper storage is also important. Keep the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Potential Side Effects and Risks

While hydrochlorothiazide and irbesartan can be highly effective in treating high blood pressure, it’s important to be aware of potential side effects. Some common side effects include:

• Dizziness or lightheadedness
• Dehydration
• Kidney problems
• Vision changes or glaucoma
• Allergic reactions

Is weight gain a side effect of hydrochlorothiazide and irbesartan? While weight gain is not typically associated with this medication, some patients may experience fluid retention or changes in electrolyte balance that could affect weight. It’s important to discuss any weight changes with your healthcare provider.

Drug Interactions and Precautions

Certain medications and substances can interact with hydrochlorothiazide and irbesartan, potentially altering its effectiveness or increasing the risk of side effects. It’s crucial to inform your doctor about all medications, supplements, and herbal products you’re using.

Key Interactions to Be Aware Of:

• Aliskiren (especially in diabetic patients)
• NSAIDs (e.g., aspirin, ibuprofen, naproxen)
• Lithium
• Insulin or oral diabetes medications
• Potassium supplements or salt substitutes
• Alcohol and sedatives

Can hydrochlorothiazide and irbesartan be taken with other blood pressure medications? In some cases, your doctor may prescribe additional blood pressure medications alongside this combination. However, this should only be done under close medical supervision due to the potential for additive effects and increased risk of side effects.

Special Precautions for Specific Groups

Certain individuals need to exercise extra caution when using hydrochlorothiazide and irbesartan:

• Pregnant women: This medication can harm an unborn baby and should not be used during pregnancy
• Breastfeeding mothers: Consult your doctor before using this medication while breastfeeding
• People with kidney problems, liver disease, or heart failure
• Diabetics
• Those with a history of gout, high cholesterol, or lupus
• Individuals with asthma or allergies

How does hydrochlorothiazide and irbesartan affect individuals with diabetes? This medication may affect blood sugar levels and potentially interact with diabetes medications. Close monitoring and possible dose adjustments of diabetes medications may be necessary.

Managing Blood Pressure Long-Term

While hydrochlorothiazide and irbesartan can effectively control blood pressure, it’s important to understand that this medication is not a cure for hypertension. Long-term management typically involves:

1. Consistent medication use as prescribed
2. Regular blood pressure monitoring
3. Lifestyle modifications (e.g., diet, exercise, stress management)
4. Regular check-ups with your healthcare provider

Is it safe to stop taking hydrochlorothiazide and irbesartan once blood pressure is under control? No, it’s crucial not to stop this medication without consulting your doctor, even if you feel well. Abruptly stopping can lead to a rapid increase in blood pressure, which can be dangerous.

Monitoring and Follow-Up Care

Regular monitoring is essential when taking hydrochlorothiazide and irbesartan. Your healthcare provider will likely schedule periodic lab tests and check-ups to:

• Assess the medication’s effectiveness
• Monitor kidney function
• Check electrolyte levels
• Adjust dosage if necessary
• Identify any potential side effects early

How often should blood tests be done when taking hydrochlorothiazide and irbesartan? The frequency of blood tests can vary depending on individual factors, but typically, your doctor may recommend tests every 3-6 months or more frequently when starting the medication or adjusting the dose.

Lifestyle Considerations While Using This Medication

While hydrochlorothiazide and irbesartan can significantly help manage high blood pressure, incorporating healthy lifestyle habits can enhance its effectiveness and improve overall cardiovascular health. Consider the following recommendations:

Dietary Modifications

A heart-healthy diet can complement the effects of your medication. Focus on:

• Reducing sodium intake
• Increasing consumption of fruits, vegetables, and whole grains
• Limiting saturated and trans fats
• Moderating alcohol consumption

How does sodium intake affect the effectiveness of hydrochlorothiazide and irbesartan? High sodium intake can counteract the medication’s effects by causing fluid retention and increasing blood pressure. Reducing sodium can enhance the medication’s effectiveness and help maintain healthy blood pressure levels.

Exercise and Physical Activity

Regular physical activity can support blood pressure management. Consider:

• Engaging in moderate aerobic exercise for at least 150 minutes per week
• Incorporating strength training exercises twice a week
• Starting slowly and gradually increasing intensity if you’re new to exercise

Always consult your doctor before starting a new exercise regimen, especially if you have other health conditions.

Stress Management

Chronic stress can contribute to high blood pressure. Implement stress-reduction techniques such as:

• Meditation or mindfulness practices
• Deep breathing exercises
• Yoga or tai chi
• Engaging in hobbies or activities you enjoy

Hydration Considerations

Proper hydration is crucial when taking hydrochlorothiazide and irbesartan. The diuretic effect of hydrochlorothiazide can increase fluid loss, potentially leading to dehydration if not managed properly.

How much water should you drink when taking hydrochlorothiazide and irbesartan? While individual needs may vary, aim to drink at least 8 glasses (64 ounces) of water daily, unless otherwise directed by your healthcare provider. Increase your fluid intake during hot weather, exercise, or illness.

Understanding Potential Long-Term Effects

While hydrochlorothiazide and irbesartan are generally considered safe for long-term use, it’s important to be aware of potential effects that may develop over time:

Electrolyte Imbalances

Long-term use of hydrochlorothiazide can affect electrolyte levels, particularly:

• Potassium: May lead to hypokalemia (low potassium levels)
• Sodium: Can cause hyponatremia (low sodium levels) in some cases
• Magnesium: Levels may decrease over time

Regular blood tests can help monitor these levels, and your doctor may recommend supplements or dietary changes if necessary.

Metabolic Effects

Some studies suggest that long-term use of thiazide diuretics like hydrochlorothiazide may have slight effects on:

• Glucose metabolism: Potentially increasing the risk of new-onset diabetes in some individuals
• Lipid profile: May cause small increases in cholesterol levels

These effects are generally mild and often outweighed by the benefits of blood pressure control. Your doctor will monitor these parameters and adjust treatment if needed.

Bone Health

Hydrochlorothiazide may have a positive effect on bone density by reducing calcium excretion. However, the long-term impact on fracture risk is still being studied.

Does long-term use of hydrochlorothiazide and irbesartan affect kidney function? While these medications are generally safe for the kidneys, long-term use requires regular monitoring of kidney function. In some cases, particularly in individuals with pre-existing kidney issues, dosage adjustments may be necessary to ensure kidney health.

Navigating Emergency Situations

Understanding how to handle emergencies while on hydrochlorothiazide and irbesartan is crucial for patient safety. Here are some scenarios to be aware of:

Allergic Reactions

Although rare, severe allergic reactions can occur. Symptoms may include:

• Rash or hives
• Swelling of face, lips, tongue, or throat
• Difficulty breathing

If you experience these symptoms, seek immediate medical attention.

Extremely Low Blood Pressure

In some cases, blood pressure may drop too low, causing symptoms such as:

• Severe dizziness or lightheadedness
• Fainting
• Unusual weakness

If you experience these symptoms, sit or lie down immediately and contact your healthcare provider.

Dehydration

The diuretic effect of hydrochlorothiazide can sometimes lead to dehydration, especially in hot weather or during illness. Watch for signs such as:

• Extreme thirst
• Dry mouth
• Decreased urination
• Dark-colored urine

Increase your fluid intake and contact your doctor if symptoms persist.

What should you do if you accidentally take an extra dose of hydrochlorothiazide and irbesartan? If you take an extra dose, monitor yourself for signs of low blood pressure. If you experience severe symptoms, contact your healthcare provider or seek emergency medical attention. Do not take additional doses to compensate for the extra one.

Alternative Treatment Options

While hydrochlorothiazide and irbesartan are effective for many people, they may not be suitable for everyone. Your doctor might consider alternative treatments if:

• You experience significant side effects
• The medication is not effectively controlling your blood pressure
• You have certain health conditions that contraindicate its use

Other Medication Options

Alternative blood pressure medications may include:

• ACE inhibitors
• Calcium channel blockers
• Beta-blockers
• Other types of diuretics

Non-Pharmacological Approaches

In some cases, lifestyle modifications alone may be sufficient to control mild hypertension. These may include:

• Dietary changes (e.g., DASH diet)
• Regular exercise
• Stress reduction techniques
• Weight loss (if overweight)
• Limiting alcohol consumption
• Quitting smoking

Can lifestyle changes replace the need for hydrochlorothiazide and irbesartan? While lifestyle modifications are crucial for overall heart health and can significantly impact blood pressure, they may not be sufficient for everyone, especially those with moderate to severe hypertension. Always consult with your healthcare provider before making changes to your medication regimen.

Future Developments and Research

The field of hypertension management is continually evolving, with ongoing research aimed at improving treatment options and outcomes. Some areas of current interest include:

Personalized Medicine

Researchers are exploring ways to tailor blood pressure treatments based on individual genetic profiles and other personal factors. This approach could lead to more effective and targeted therapies with fewer side effects.

New Drug Combinations

Scientists are investigating novel drug combinations that may offer improved efficacy or reduced side effect profiles compared to current options.

Long-Term Outcomes

Ongoing studies are assessing the long-term cardiovascular outcomes of various antihypertensive treatments, including hydrochlorothiazide and irbesartan combination therapy.

How might future developments in hypertension treatment affect patients currently using hydrochlorothiazide and irbesartan? While current treatments like hydrochlorothiazide and irbesartan remain effective for many patients, future developments may offer more personalized or refined treatment options. Patients should stay informed and discuss any new developments with their healthcare providers to ensure they’re receiving the most appropriate and up-to-date care for their individual needs.

Irbesartan/hydrochlorothiazide (By mouth) | Drug Notes | Health Information

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Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide), Irbesartan (ir-be-SAR-tan)

Treats high blood pressure. This medicine contains an angiotensin receptor blocker (ARB) and a thiazide diuretic (water pill).

Brand Name(s):

Avalide

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to irbesartan, hydrochlorothiazide, or a sulfa drug, or if you are pregnant or not able to urinate.

How to Use This Medicine:

Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting while you are using this medicine.
• Missed dose:
  Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with aliskiren if you have diabetes.
• Some medicines can affect how irbesartan/hydrochlorothiazide works. Tell your doctor if you are using aliskiren, carbamazepine, cholestyramine, colestipol, lithium, an NSAID pain or arthritis medicine (such as aspirin, celecoxib, diclofenac, ibuprofen, naproxen), insulin or diabetes medicine that you take by mouth, or steroids (such as hydrocortisone, methylprednisolone, prednisone, prednisolone, dexamethasone).
• Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.
• This medicine can intensify the effects of alcohol or other medicine that makes you sleepy or dizzy, such as narcotic pain medicine.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney problems, liver disease, heart failure, diabetes, glaucoma, gout, high cholesterol, or lupus. Tell your doctor if you have a history of asthma or allergies.
• This medicine may cause the following problems:
  • Kidney problems
  • Vision problems or glaucoma
• This medicine could lower your blood pressure too much and cause you to feel dizzy or lightheaded. This is more likely to happen when you first use the medicine or if you become dehydrated. Stand or sit up slowly if you are dizzy.
• Do not stop using this medicine without asking your doctor, even if you feel well. This medicine will not cure your high blood pressure, but it will help keep it in the normal range. You may have to take blood pressure medicine for the rest of your life.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Confusion, weakness, muscle twitching
• Decrease in how much or how often you urinate
• Dry mouth, increased thirst, muscle cramps, nausea or vomiting, uneven heartbeat
• Lightheadedness, dizziness, fainting
• Rapid weight gain, swelling in your hands, ankles, or feet
• Vision changes or eye pain

If you notice these less serious side effects, talk with your doctor:

• Muscle or joint pain
• Tiredness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 1/27/2017

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Hydrochlorothiazide side effects and how to avoid them

Hydrochlorothiazide side effects include weight changes, electrolyte imbalance, sun sensitivity, skin reactions, chest pain, joint pain, and hair loss

Common hydrochlorothiazide side effects | Serious side effects | Weight changes | Electrolyte imbalance | Sun sensitivity | Severe allergic or skin reactions | Chest pain | Joint pain | Hair loss | Side effects timeline | Contraindications | Warnings | Interactions | How to avoid side effects 

Hydrochlorothiazide (HCTZ) is a generic drug commonly prescribed to lower blood pressure in people diagnosed with high blood pressure, but it is also used to reduce swelling of the extremities due to congestive heart failure, ascites, or treatment with corticosteroids or estrogen. As a thiazide diuretic (water pill), hydrochlorothiazide increases the elimination of water and salt through the urine. This helps to bring down blood pressure. Many of hydrochlorothiazide’s side effects are related to its diuretic effects. Some side effects are avoidable, some can be minimized, and others may require medical intervention.

Common side effects of hydrochlorothiazide

The most common side effect of hydrochlorothiazide is low potassium levels, a direct effect of the drug’s diuretic effects. Anywhere from 1/3 to ½ of people taking hydrochlorothiazide will eventually have depleted potassium levels. Many of the other common side effects are also related to the body’s increased elimination of water and electrolytes:

• Low potassium
• Low sodium
• Low magnesium
• Elevated calcium
• Low chloride
• Elevated blood sugar
• Elevated cholesterol and fat levels
• Elevated uric acid levels
• Orthostatic hypotension (dizziness and vertigo when standing)
• Dizziness
• Diarrhea
• Abdominal pain
• Weakness
• Headache
• Hair loss
• Rash

Serious side effects of hydrochlorothiazide

Hydrochlorothiazide’s most serious side effects include:

• Dangerously low potassium levels
• Electrolyte imbalance
• Sun sensitivity
• Abnormal heartbeats
• Swollen pancreas
• Skin cancer
• Kidney dysfunction
• Kidney failure
• Anemia
• Low white blood cell counts (which can interfere with the body’s ability to fight infection)
• Low platelet levels (which can cause bruising or bleeding)
• Angle-closure glaucoma
• Worsening of lupus
• Severe allergic reactions or serious skin reactions

Weight changes

Hydrochlorothiazide eliminates more water from the body than usual, so body weight may decrease. That’s nice to see on a bathroom scale, but it isn’t fat or muscle weight. It’s water weight. When hydrochlorothiazide is stopped, the water weight will probably return in short order.

Electrolyte imbalance 

Electrolyte imbalances are a common and sometimes serious side effect of hydrochlorothiazide. The drug can deplete the body of one or more electrolytes, including sodium, potassium, magnesium, and chloride. It can also increase calcium levels. The effects seem to be dose-related. While the incidence of electrolyte problems has not been determined, they are common enough that people taking hydrochlorothiazide need to be periodically tested for electrolyte levels, particularly potassium. People taking hydrochlorothiazide should know the signs of electrolyte depletion, particular hypokalemia, or low potassium, such as weakness, fatigue, muscle cramps, and constipation. Contact a healthcare professional if any of these symptoms are noticed.

Sun sensitivity

Hydrochlorothiazide is associated with an increased risk of certain skin cancers. The medication causes sun sensitivity. Patients who take hydrochlorothiazide should visit their dermatologist on a regular basis for skin screenings. Also, people who take this drug should avoid tanning beds and avoid the sun when possible. When in the sun, it is important to wear protective clothing and apply and reapply sunscreen (of at least SPF 30) frequently.

Severe allergic or skin reactions

In rare cases, a serious allergic or skin reaction may occur. These reactions can be life-threatening or cause death. If you notice any of the following symptoms, get emergency medical help right away. Symptoms of a serious allergic reaction can include hives, difficulty breathing, or swelling of the face, lips, tongue, or throat. Symptoms of a serious skin reaction may include sore throat, fever, burning eyes, red or purple rash, or blistering or peeling skin. 

Chest pain 

Hydrochlorothiazide has not been associated with causing or worsening chest pain. However, it is frequently combined with other blood pressure drugs that may worsen chest pain. When taking more than one prescription drug, it’s sometimes difficult to determine which drug is responsible for individual side effects. Chest pain is a serious symptom, so make sure to tell the prescribing healthcare provider.

Joint pain 

Joint pain is not a side effect of hydrochlorothiazide. However, the drug can worsen some types of existing joint diseases. Because hydrochlorothiazide reduces the fluid volume of blood, it results in a percentage increase of other substances in the blood like uric acid. If uric acid levels get high enough, the excess crystallizes in the joints. This can cause or worsen gout, an arthritic condition due to uric acid crystals building up in the joints. How often hydrochlorothiazide contributes to gout flare-ups is unknown, but the joint pain is certainly painful and sometimes debilitating.

Hair loss 

Thinning hair is a side effect of thiazide diuretics. The hair loss won’t happen all at once as it does with some drugs, such as cancer drugs. Instead, it will take a few months. The incidence is unknown, but remember that hydrochlorothiazide is typically used with other blood pressure drugs. One type of blood pressure drug, beta blockers, are also associated with hair loss and hair thinning. The good news is that drug-induced hair loss is usually reversible once the offending drug has been stopped. 

How soon do hydrochlorothiazide side effects start?

Hydrochlorothiazide’s diuretic effects begin within an hour or two of taking the capsule or tablet and peak in one to five hours. Some side effects may appear during that time, including diarrhea, nausea, and vomiting. Allergic reactions, however, could happen very rapidly even after taking the first dose. Many other side effects are delayed and could take days, weeks, or months to manifest.

How long do hydrochlorothiazide side effects last?

The body will adapt to hydrochlorothiazide, so some side effects may get better over time as you get used to the medicine. Those that don’t will mostly resolve after the drug has been stopped, particularly the most common side effects. Even hair loss is often reversible when caused by drugs like hydrochlorothiazide. 

What are the long-term side effects of hydrochlorothiazide?

Most of hydrochlorothiazide’s side effects will get better after the drug has been stopped. Some may require time to get better, such as allergic reactions or gout. Some side effects such as skin cancer or kidney damage may have long-term or lifelong consequences.

Hydrochlorothiazide contraindications

Hydrochlorothiazide is too dangerous for some people to take:

• Kidney problems: people with reduced kidney function (creatinine clearance of less than 10 mL/minute; although some references recommend not using hydrochlorothiazide if creatinine clearance is under 30) or inability to produce urine (anuria) cannot take hydrochlorothiazide without risking kidney damage or failure
• Newborns with jaundice: Jaundice can be worsened in newborns who are given hydrochlorothiazide
• Allergies: People allergic to hydrochlorothiazide or sulfa drugs cannot safely take the drug

Pregnancy

Hydrochlorothiazide is not restricted for use in pregnant women. In terms of risk, it’s in the same category as acetaminophen and prenatal vitamins. However, it is considered a risk to the fetus in women with pre-eclampsia or similar placental problems and generally should not be used. Anyone who is pregnant or planning to become pregnant should consult their healthcare provider for medical guidance before taking hydrochlorothiazide. 

Breastfeeding

A healthcare professional might suggest other treatment options for breastfeeding women, though hydrochlorothiazide (at lower doses) is not contraindicated in those cases. Nursing babies could develop serious problems from the small amounts of hydrochlorothiazide present in breast milk. In addition, hydrochlorothiazide may affect breast milk production. In fact, it is often used off-label in higher doses to suppress lactation.

Children

Hydrochlorothiazide is FDA-approved for use in children as young as newborns. 

Hydrochlorothiazide warnings

Like all diuretics, hydrochlorothiazide may cause problems because of pre-existing health conditions or other issues.

Cautions

Hydrochlorothiazide can cause problems in people with certain medical conditions. In some cases, hydrochlorothiazide may worsen the condition, like gout, or bring it on a second time, like pancreatitis. These medical or physical conditions include:

• Diabetes
• Electrolyte problems
• Dehydration
• A history of gout
• A history of swollen pancreas
• Liver or kidney problems
• Irregular heartbeats
• A history of seizures
• Lupus

In addition, hydrochlorothiazide may cause problems in older patients including low sodium and falls. Finally, the risk for non-melanoma skin cancer goes up when taking hydrochlorothiazide, a risk that is greatest for white patients.

Abuse and dependence

Hydrochlorothiazide is not associated with drug abuse, dependence, or withdrawal.

Overdose

A hydrochlorothiazide overdose can cause a hazardous depletion of electrolytes, so immediate medical care is needed if an overdose is suspected. The symptoms of an overdose may include:

• Nausea
• Dizziness
• Weakness
• Muscle pain
• Dry mouth/thirst

The maximum dosage will depend on age and the condition being treated. The maximum adult dose for hypertension is 50 mg per day; for fluid retention, the maximum daily dose is 100 mg.

Recalls

Hydrochlorothiazide recalls are rare and limited to quality problems at individual manufacturers.

Hydrochlorothiazide interactions

People using hydrochlorothiazide often are taking other drugs. Some of these can be risky when taken with hydrochlorothiazide:

• Other blood pressure medications, though commonly prescribed with hydrochlorothiazide, increase the risk for low blood pressure
• Corticosteroids such as prednisone increase the risk of electrolyte loss when taking thiazide diuretics
• Bile resins (such as cholestyramine) can make it harder for the body to absorb hydrochlorothiazide
• Antidiabetic drugs may be less effective because thiazide diuretics can increase blood sugar levels
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen may reduce the effectiveness of hydrochlorothiazide and increase the risk of kidney damage
• Some drugs like aminoglycoside antibiotics and lithium can damage the kidneys; they are more likely to damage the kidneys when taken with a diuretic
• Barbiturates, sedatives, and opioids increase the risk of orthostatic hypotension and, as a result, may increase the risks of accidents, fainting, and falls
• Stimulants (such as Adderall) increase blood pressure and so can decrease hydrochlorothiazide’s effectiveness at lowering blood pressure.
• Marplan (isocarboxazid), an antidepressant in the monoamine oxidase inhibitor (MAOI) drug class, is never given with drugs that lower blood pressure because the combination could cause a dangerous drop in blood pressure. Other drugs in the MAOI class can have the same effect and should not be taken with hydrochlorothiazide. 

Foods and drinks to avoid when taking hydrochlorothiazide include alcohol, excessive amounts of caffeine, and diuretic herbs like dandelion, hibiscus, or green tea. 

How to avoid hydrochlorothiazide side effects

Diuretics like hydrochlorothiazide often involve unwanted adverse effects, but they are important tools in fighting high blood pressure. A few guidelines can help both to minimize side effects and maximize the drug’s benefits. 

1. Take hydrochlorothiazide as directed

Understand and follow all the directions given by the prescriber or printed on the prescription label. The standard dose is 12.5–50 mg per day for hypertension and 25–100 mg daily for edema. Generally, it is best to take hydrochlorothiazide in the morning. This is because it makes you urinate, and taking it at night would disrupt your sleep. 

What if you miss a dose of hydrochlorothiazide? If a dose is missed, take it when remembered. However, if it’s almost time for the next dose, skip the missed dose. Take the next scheduled dose at the regular time. Do not double up on doses to try to make up for a missed dose. 

2. Give the prescriber a complete medical history

The most worrisome side effects involve worsening existing medical conditions, so make sure the prescribing healthcare provider has an entire medical history, especially:

• Kidney disease
• Liver disease
• Gout
• Diabetes
• Low potassium
• High calcium
• Narrow angles in the eyes or a history of glaucoma
• Seizure disorders
• Heart rate problems
• Any upcoming parathyroid tests
• Pregnancy or breastfeeding

3.

Give the prescriber a list of all drugs being taken

Drug interactions are another major source of side effects, so make sure the prescribing healthcare provider has a complete picture of the prescription drugs, over-the-counter medications, and vitamins or dietary supplements being taken, particularly:

• Blood pressure medications
• Corticosteroids
• Bile resins such as cholestyramine or colestipol
• Lithium
• NSAIDs

4. Do not miss follow-up appointments or tests

Staying safe on diuretics may require follow-up visits and tests. In this way, side effects can be corrected before they become hazardous. 

5. Drink plenty of fluids

To avoid dehydration, drink plenty of clear fluids throughout the day. Avoid going outside if it’s hot. If hydrochlorothiazide is being used to treat fluid retention, follow the fluid restrictions given by the prescribing healthcare provider.

6. Avoid laxatives

Laxatives can cause dehydration. The risk is even greater when taking diuretics. The best advice is not to use laxatives casually when taking diuretics. If constipation is a problem, get medical advice about the most suitable treatment.

7. Skip the calcium supplements

Hydrochlorothiazide can increase calcium levels in the body. If taking calcium or vitamin D supplements, talk to the prescriber about continuing those supplements.

8. Avoid taking a late dose

Hydrochlorothiazide can be taken at any time of day, but if taken late, it could interfere with sleep by requiring frequent trips to the bathroom. Most people prefer to take hydrochlorothiazide in the morning.

9. Use sunblock

Hydrochlorothiazide increases the risk of developing non-melanoma skin cancer. That risk approximately triples for people with white skin. Avoid the sun. If it’s unavoidable, use high SPF sunscreen, and reapply frequently, especially if you are swimming and/or sweating.

How to treat side effects of hydrochlorothiazide

Not all hydrochlorothiazide side effects are avoidable. They are manageable, though. Some can be managed at home, but others may require a healthcare professional.

Dizziness

When standing up, stand up slowly and carefully. If standing up brings on an attack of dizziness or lightheadedness, sit down immediately. The primary goal is to avoid injuries brought on by a fall. Once the spinning or lightheadedness has stopped, then stand up slowly to prevent a relapse. Report symptoms of dizziness to your healthcare provider. 

Dehydration

If any sign of dehydration is noticed, immediately drink clear fluids such as water or sports drinks. Contact a healthcare provider for medical advice. An extreme case of dehydration may require a visit to the emergency room. The symptoms of dehydration include:

• Thirst
• Dry mouth
• Dry eyes
• Urinating less than four times per day
• Dark and strong-smelling urine
• Dry skin
• Dizziness
• Drowsiness
• Tiredness
• Irregular or racing heartbeat

Electrolyte imbalances

Electrolyte imbalances, including potassium depletion, can quickly develop into a serious medical condition, so call a healthcare professional for medical advice if any of the symptoms of electrolyte imbalance are noticed:

• Increased thirst
• Weakness
• Low energy
• Muscle cramps or muscle pain
• Constipation
• Confusion
• Abnormal or fast heartbeats
• Tingling

Eye problems

Get immediate emergency medical treatment if eye pain, vision changes, “halos,” or blurred vision are experienced when taking hydrochlorothiazide. These could be symptoms of a form of glaucoma that progresses very rapidly.

Allergic reactions

A skin or allergic reaction to hydrochlorothiazide or any other drug can be very serious. Stop taking the drug and get emergency medical care at any sign of a severe skin or allergic reaction:

• Wheezing
• Shortness of breath
• Trouble breathing
• Swelling of the face, lips, tongue, or throat
• Hives
• Red or purple rash
• Blistering or peeling skin
• Skin pain
• Fever
• Sore throat
• Eye pain and burning

Sources

• Drug-induced alopecia. A review of the literature, Therapie
• Drug-induced hair loss and hair growth. Incidence, management and avoidance, Drug Safety
• Hydrochlorothiazide, Epocrates
• Hydrochlorothiazide capsule prescribing information, U. S. National Library of Medicine
• Hydrochlorothiazide drug summary, Prescriber’s Digital Reference

Medicines that can make you gain weight

Taking medicines that your doctor prescribes for you for a particular reason may be accompanied by side effects that are not always desirable. Unfortunately, doctors do not always warn about what medications can lead to, and many would like to know what to expect from a course of medications.

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One of the most common drug side effects is weight gain. Let’s make a reservation right away – this does not happen for everyone and not always, but you can be one of those “lucky ones” who really put on weight.

We talk about drugs that can cause weight gain. We are sure that it is better to know and take some steps in advance so as not to gain weight than to accidentally discover an extra 3-5, or even 10 kg, gained over several weeks of taking the drug.

In general, it would be absolutely useful to discuss with the doctor all the possible “side effects” that the prescribed medicine can cause in order to take timely action. This, however, applies to any side effects, and not just those associated with weight. In some cases, undesirable effects are inevitable, but there are situations when their occurrence can be completely avoided or at least made less pronounced.

Steroids

Steroid preparations can be prescribed for various diseases. They make it quite easy to achieve an improvement in the condition, but the treatment is often accompanied by an undesirable effect, including insomnia, increased appetite and swelling. All this is the perfect combo for those extra pounds to literally stick in strategic places. It is important that steroids are available in different forms – these can be ointments and creams, sprays, as well as tablets. The latter just cause weight gain the most. You can reduce your chances of gaining weight by choosing the lowest possible dose for you, as well as adjusting your diet and choosing the ideal sleep pattern for you.

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Antidepressants

Many people say that you can gain weight on antidepressants. Fortunately, not everyone is gaining it, although this, of course, is quite real. Selective serotonin reuptake inhibitors pose the greatest danger in this regard, so if you are taking drugs whose active ingredient belongs to this class of substances, be careful.

The fact is that such drugs not only improve your mood and help you feel less depressed, but also increase your appetite. And here the connection is quite obvious: you want to eat more – you eat more – your weight increases.

If you are prone to weight gain, then discuss with your doctor in advance that you are worried about the fact that he will become more – it is likely that he will be able to choose another suitable drug for you.

Birth control pills

Oral contraceptives have many side effects, some of which are quite pleasant and desirable. But, let’s not hide, weight gain is not included in this list for everyone.

It works like this: progesterone, which is part of birth control pills, increases appetite, which causes women to eat more and gain weight. Another possible mechanism is that while taking contraceptives, the body begins to more actively retain water, and the weight also goes up because of this.

Antihistamines

Popular antihistamine-based allergy medications are most often not available by prescription. They can be prescribed by a doctor, but many people buy these drugs on their own initiative and choose the dosage on their own.

In addition to the fact that the selection of medicines still has to be done by a specialist, there is another danger. All the same kilograms that you can gain. Taking allergy medications frequently can lead to weight gain. This happens more often in women than in men. If you notice that you are really gaining weight on the background of a course of antihistamines, but at least try to change the dosage form: the spray in this case will be much less dangerous than tablets.

Blood pressure medications

Medicines prescribed for hypertension, such as beta-blockers and angiotensin receptor blockers, also affect weight. Unfortunately, in the case of such drugs, the choice is not too rich. There is nothing to replace them and cancel, most likely, the doctor will not allow. And this means that in order to prevent gaining extra pounds, you will have to carefully monitor your lifestyle, adjust your diet and try to introduce at least a minimum of physical activity into your daily routine.

Migraine Medicines

Migraine pain is terrible and excruciating, so finding that a particular medicine really helps with these nightmarish headaches is priceless. People who suffer from migraines are often ready to go to great lengths to improve their condition, and they may not even notice such “little things” as weight gain while taking medication.

However, in any case, for those who suffer from migraines, it is important to monitor their condition, minimize or completely eliminate the influence of triggers that can provoke a migraine attack.

Psychopharmacotherapy. Is weight gain inevitable?

A very popular question from patients: “ Is it possible to avoid weight gain when taking psychotropic therapy? ”

I can answer that it is possible to take drugs without a significant increase in body weight, and there are even options for weight loss during treatment with psychopharmacotherapy.

The problem is not only related to taking drugs, it is multifaceted. Much depends on the patient himself – habits and lifestyle, the implementation of the doctor’s recommendations, there are factors that are associated with the metabolic processes of the body, hereditary predisposition. Weight gain comes not from drugs, but from what you eat. You eat more calories than you burn. Sweet gives a feeling of pleasure with minimal effort and cost. And after a long stress, the desire to receive it is very great. Although it can also be obtained from physical activity, from hobbies, etc. , but it takes effort and most people follow the path of least resistance – ate a chocolate bar, went to McDonald’s, etc. Given that against the background of stress, there is usually a decrease in body weight, often significant, and there is confidence that this will not harm.

For many patients, stress does not affect appetite, and even eating a lot of sweets does not affect the scales, because. because of the experiences, everything “burns out”.

But against the background of treatment, the level of anxiety and irritability decreases, which leads to a slowdown in metabolic processes, and if the patient continues to consume the same amount of easily digestible carbohydrates, this leads to weight gain.

There are also patients who seize anxiety and, on the contrary, note an increase in weight against the background of stress, and so, with rare exceptions, they have a decrease in body weight during treatment with psychotropic drugs.

I would also like to note an alternative – there are a number of drugs that, while improving mood and reducing anxiety, do not affect appetite, and some even reduce it, and most patients lose body weight.