Description
Latin name
Hydrochlorothiazide
Release form
tablets
packaging 20 pcs
Pharmacological action
Medium-strength hydrochlorothiazide-thiazide diuretic. Reduces reabsorption of Na + at the level of the cortical segment of the Henle loop, without affecting its portion, passing in the brain layer of the kidney, which determines a weaker diuretic effect in comparison with furosemide. Blocks carbonic anhydrase in the proximal convoluted tubule, enhances urinary excretion of K + (in the distal tubules, Na + is exchanged for K +), bicarbonates and phosphates. Virtually no effect on CBS (Na + is excreted either together with Cl- or with bicarbonate, therefore, with alkalosis, the excretion of bicarbonates is enhanced, with acidosis – chlorides). Increases excretion of Mg2 + traps Ca2 + ions and excretion of urates in the body. The diuretic effect develops after 1-2 hours, reaches a maximum after 4 hours, lasts 10-12 hours. The effect decreases with a decrease in glomerular filtration rate and stops when its value is less than 30 ml / min. In patients with diabetes insipidus, it has an antidiuretic effect (reduces urine volume and increases its concentration). Lowers blood pressure by decreasing bcc, changing the reactivity of the vascular wall, reducing the pressure effect of vasoconstrictor drugs (epinephrine, norepinephrine) and increased depressant effect on the ganglia.
Indications
Arterial hypertension
edema syndrome of various origins (CHF, portal hypertension, nephrotic syndrome, chronic renal failure, fluid retention during obesity), gestosis (nephropathy, edema, eclampsia) .
Contraindications
Hypersensitivity, gout, diabetes mellitus (severe forms), chronic renal failure (CK less than 20-30 ml / min, anuria), hypokalemia, hypercalcemia, hyponatremia pregnancy (I trimester), lactation.
Caution: II-III trimesters of pregnancy.
Special instructions
To prevent deficiency of K + and Mg2 +, a diet with a high content of these salts, potassium-sparing diuretics, K + and Mg2 + salts are prescribed. Regular monitoring of plasma levels of K +, glucose, uric acid, lipids and creatinine is required. During the treatment period, care must be taken when driving vehicles and engaging in other potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.
Composition
1 tablet contains:
Active ingredient: hydrochlorothiazide (in terms of 100% substance) – 100 mg
Excipients: microcrystalline cellulose, milk sugar (lactose), potato starch, magnesium stearate.
Dosage and administration of
To reduce blood pressure: by mouth, 25-50 mg / day, with slight diuresis and natriuresis observed only on the first day of administration (prescribed for a long time in combination with other antihypertensive drugs: vasodilators, ACE inhibitors, sympatholytics, beta-blockers). With an increase in dose from 25 to 100 mg, a proportional increase in diuresis, natriuresis and a decrease in blood pressure are observed. In a single dose of more than 100 mg, the increase in urine output and a further decrease in blood pressure are insignificant, a disproportionately increasing loss of electrolytes, especially K + and Mg2 +, is observed. Increasing the dose over 200 mg is impractical, because amplification of diuresis does not occur.
With edematous syndrome (depending on the condition and reaction of the patient), a daily dose of 25-100 mg is prescribed, taken once (in the morning) or in 2 doses (in the morning). Elderly – 12.5 mg 1-2 times a day.
For children aged 2 months to 14 years – 1 mg / kg / day. The maximum dose for children under the age of 6 months is 3.5 mg / kg / day, up to 2 years – 12.5-37.5 mg / day, 3-12 years – 100 mg / day, divided into 2-3 doses. After 3-5 days of treatment, it is recommended to take a break for 3-5 days. As a maintenance therapy in a specified dose is prescribed 2 times a week. When using an intermittent course of treatment with administration after 1-3 days or within 2-3 days with a subsequent break, the decrease in effectiveness is less pronounced and side effects develop less frequently. To reduce intraocular pressure, 25 mg is prescribed 1 time in 1-6 days, the effect occurs after 24-48 hours.
With diabetes insipidus, 25 mg 1-2 times a day with a gradual increase in dose (daily dose – 100 mg) until the therapeutic effect (reduction of thirst and polyuria), further dose reduction is possible.
Side effects
Dry mouth, nausea, vomiting, diarrhea, weakness, fatigue, dizziness, headache, palpitations, leg cramps, hypokalemia, hypomagnesemia, hyponatremia, hyperuricemia, hypercalcemia, hyperglycemia, exacerbation of gout, thrombosis, thromboembolism, hypercreatininemia, acute interstitial nephritis, vasculitis, progression of myopia, neutropenia, thrombocytopenia, hemorrhagic pancreatitis, acute cholecystitis (against cholelithiasis), orthostatic hypotension, allergic dermatitis.
Drug interactions
drugs that intensively bind to proteins (indirect anticoagulants, clofibrate, NSAIDs) enhance the diuretic effect. The antihypertensive effect is enhanced by vasodilators, beta-blockers, barbiturates, phenothiazines, tricyclic antidepressants, ethanol. It enhances the neurotoxicity of salicylates, weakens the effects of oral hypoglycemic drugs, norepinephrine, epinephrine and anti-gout drugs, enhances the side effects of cardiac glycosides, cardiotoxic and neurotoxic effects of Li + drugs, the effect of peripheral muscle relaxants, and reduces quinidine excretion. With the simultaneous administration of methyldopa, hemolysis may develop. Colestyramine reduces absorption. Reduces the effect of oral contraceptives.
Overdose
Symptoms: hypokalemia (adynamia, paralysis, constipation, arrhythmias), drowsiness, decreased blood pressure.
Treatment: infusion of electrolyte solutions to compensate for K + deficiency (prescribing K + and potassium-sparing diuretics).
Storage Conditions
In a dry, dark place at a temperature not exceeding 25 ° C. In a sealed package.
Dosage form
tablets
Possible product names
HYDROCHLORothIAZIDE 0.1 N20 TABLE
Hydrochlorothiazide 100mg Tab. X20 (R)
Hydrochlorothiazide Tab 100mg N20
HYDROCHLORothIAZIDE TAB. 100MG No. 20
HYDROCHLORothIAZIDE TAB. 100MG No.20 (09.09)
Valenta Pharmaceuticals, Russia
