Description and Brand Names
Drug information provided by: Merative, Micromedex®
US Brand Name
- Aquazide H
- Hydrocot
- Microzide
- Zide
Descriptions
Hydrochlorothiazide is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.
Hydrochlorothiazide is also used to treat fluid retention (edema) that is caused by congestive heart failure, severe liver disease (cirrhosis), kidney disease, or treatment with a steroid or hormone medicine.
Hydrochlorothiazide is a thiazide diuretic (water pill). It is used to help reduce the amount of water in the body by increasing the flow of urine. It may also be used for other conditions as determined by your doctor.
This medicine is available only with your doctor's prescription.
This product is available in the following dosage forms:
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies have not been performed on the relationship of age to the effects of hydrochlorothiazide capsules or tablets in the pediatric population. Safety and efficacy have not been established.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of hydrochlorothiazide capsules in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving hydrochlorothiazide capsules.
No information is available on the relationship of age to the effects of hydrochlorothiazide tablets in geriatric patients. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving hydrochlorothiazide tablets.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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Acarbose
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Aceclofenac
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Acemetacin
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Acetyldigoxin
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Albiglutide
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Albuterol
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Alogliptin
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Amphetamine
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Amtolmetin Guacil
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Arsenic Trioxide
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Aspirin
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Benzphetamine
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Bromfenac
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Bromocriptine
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Bufexamac
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Buprenorphine
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Canagliflozin
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Cefepime
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Celecoxib
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Chlorpropamide
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Choline Salicylate
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Clonixin
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Codeine
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Dapagliflozin
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Deslanoside
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Desmopressin
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Dexibuprofen
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Dexketoprofen
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Dextroamphetamine
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Diclofenac
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Diflunisal
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Digitalis
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Digitoxin
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Digoxin
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Dihydrocodeine
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Dipyrone
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Droperidol
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Droxicam
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Dulaglutide
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Empagliflozin
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Etodolac
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Etofenamate
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Etoricoxib
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Exenatide
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Felbinac
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Fenoprofen
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Fentanyl
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Fepradinol
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Feprazone
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Flecainide
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Floctafenine
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Flufenamic Acid
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Flurbiprofen
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Formoterol
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Glimepiride
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Glipizide
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Glyburide
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Hydromorphone
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Ibuprofen
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Indomethacin
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Insulin
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Insulin Aspart, Recombinant
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Insulin Bovine
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Insulin Degludec
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Insulin Detemir
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Insulin Glulisine
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Ketanserin
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Ketoprofen
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Ketorolac
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Levomethadyl
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Linagliptin
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Liraglutide
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Lisdexamfetamine
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Lithium
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Lixisenatide
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Lornoxicam
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Loxoprofen
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Lumiracoxib
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Meclofenamate
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Mefenamic Acid
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Meloxicam
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Meperidine
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Methadone
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Methamphetamine
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Methotrexate
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Metildigoxin
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Miglitol
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Morniflumate
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Morphine
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Morphine Sulfate Liposome
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Nabumetone
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Naproxen
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Nateglinide
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Nepafenac
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Niflumic Acid
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Nimesulide
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Nimesulide Beta Cyclodextrin
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Oliceridine
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Ouabain
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Oxaprozin
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Oxymorphone
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Oxyphenbutazone
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Parecoxib
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Phenylbutazone
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Piketoprofen
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Pioglitazone
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Piroxicam
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Porfimer
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Pramlintide
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Proglumetacin
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Propyphenazone
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Proquazone
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Proscillaridin
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Repaglinide
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Rofecoxib
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Rosiglitazone
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Salicylic Acid
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Salsalate
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Saxagliptin
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Sitagliptin
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Sodium Salicylate
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Sotalol
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Sufentanil
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Sulindac
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Tapentadol
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Tenoxicam
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Tiaprofenic Acid
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Tolazamide
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Tolbutamide
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Tolfenamic Acid
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Tolmetin
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Topiramate
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Tramadol
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Valdecoxib
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Vildagliptin
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Vonoprazan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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Aminolevulinic Acid
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Bepridil
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Carbamazepine
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Cholestyramine
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Ginkgo
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Gossypol
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Licorice
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
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Anuria (not able to urinate) or
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Sulfa drug allergy (eg, sulfamethoxazole/trimethoprim, Bactrim®, Septra®)—Should not be used in patients with these conditions.
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Asthma or
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Diabetes or
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Electrolyte imbalance (eg, high calcium or low magnesium, potassium, sodium in the body) or
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Glaucoma, angle-closure or
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Gout or
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Hypercholesterolemia (high cholesterol in the blood) or
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Hyperuricemia (high uric acid in the blood) or
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Hypoglycemia (low blood sugar) or
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Liver disease or
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Myopia (nearsightedness) or
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Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.
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Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Proper Use
In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt) or potassium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.
Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to receive it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
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For fluid retention (edema):
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For oral dosage form (tablets):
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Adults—The usual dose is 25 to 100 milligrams (mg) daily as a single or divided dose. Your doctor may want you to take this dose every other day or on 3 to 5 days each week.
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Children—Dose is based on body weight and must be determined by your doctor.
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For high blood pressure:
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For oral dosage form (capsule):
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Adults—At first, 12.5 milligrams (mg) or one capsule once a day. Your doctor may want you to take this alone or together with other blood pressure medicines. Your doctor may increase your dose as needed. However, the dose is usually not more than 50 mg per day.
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Children—Use and dose must be determined by your doctor.
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For oral dosage form (tablets):
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Adults—At first, 25 milligrams (mg) once a day. Your doctor may increase your dose as needed and may be taken as a single dose or divided into two doses.
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Children—Dose is based on body weight and must be determined by your doctor.
Missed Dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
Check with your doctor right away if you have seizures, decreased urine, drowsiness, dry mouth, excessive thirst, increased heart rate or pulse, muscle pains or cramps, nausea or vomiting, or unusual tiredness or weakness. These may be symptoms of a condition called hypokalemia or potassium loss.
Check with your doctor right away if you have blurred vision, difficulty in reading, eye pain, or any other change in vision during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).
This medicine may cause some people to become dizzy. Do not drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.
Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.
Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (eg, tests for parathyroid function) may be affected by this medicine.
This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.
Do not take other medicines unless they have been discussed with your doctor. This includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
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Back, leg, or stomach pains
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black, tarry stools
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bleeding gums
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blistering, peeling, or loosening of the skin
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bloating
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blood in the urine or stools
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blue lips and fingernails
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blurred vision
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burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
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chest pain or tightness
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chills
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clay-colored stools
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cloudy urine
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cold sweats
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confusion
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constipation
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cough or hoarseness
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coughing that sometimes produces a pink frothy sputum
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coughing up blood
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cracks in the skin
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darkened urine
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decrease in urine-concentrating ability
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decreased frequency or amount of urine
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diarrhea
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difficult, fast, or noisy breathing
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difficulty with swallowing
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dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
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dry mouth
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fast or irregular heartbeat
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fever
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flushed, dry skin
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fruit-like breath odor
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general body swelling
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general feeling of discomfort or illness
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greatly decreased frequency of urination or amount of urine
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headache
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hives, itching, rash
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increased hunger
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increased sweating
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increased thirst
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increased urination
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indigestion
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joint pain, stiffness, or swelling
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loss of appetite
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loss of heat from the body
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lower back or side pain
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muscle cramps or pain
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nausea or vomiting
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nosebleeds
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numbness, tingling, pain, or weakness in the hands or feet
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painful or difficult urination
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pains in the stomach or side, possibly radiating to the back
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pale skin
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persistent non-healing sore
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pink growth
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pinpoint red spots on the skin
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puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
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red, irritated eyes
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red skin lesions, often with a purple center
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red, swollen skin
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reddish patch or irritated area
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redness, soreness, or scaly skin
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seizures
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shiny bump
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sore throat
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sores, ulcers, or white spots on the lips or in the mouth
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sores, welting, or blisters
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swelling of the face, fingers, legs, ankles, feet, or lower legs
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swollen or painful glands
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tenderness of salivary glands
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thickening of bronchial secretions
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trembling
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trouble breathing
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unpleasant breath odor
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unusual bleeding or bruising
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unusual tiredness or weakness
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unusual weight loss
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vomiting of blood
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weakness and heaviness of the legs
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weight gain
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white, yellow or waxy scar-like area
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yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
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Cramping
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decreased interest in sexual intercourse
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difficulty having a bowel movement (stool)
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feeling of constant movement of self or surroundings
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hair loss or thinning of the hair
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inability to have or keep an erection
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increased sensitivity of the skin to sunlight
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loss in sexual ability, desire, drive, or performance
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muscle spasm
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redness or other discoloration of the skin
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restlessness
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sensation of spinning
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severe sunburn
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weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Portions of this document last updated: Aug. 01, 2024
Original article: https://www.mayoclinic.org/drugs-supplements/hydrochlorothiazide-oral-route/side-effects/drg-20071841