Hydrochlorothiazide pills 25mg №20

general characteristics

Hydrochlorothiazide;
6-chloro-7-sulfamoyl-3,4-dihydro-2H-1,2,4-benzothiadiazine-1,1-dioxide;
main physical and chemical properties: pills of color, white or white with a yellowish shade, with a biconvex surface. On the surface of the pills marbling and blotches of gray are allowed;
composition: one pill contains hydrochlorothiazide 25 mg;
excipients: lactose monohydrate, povidone, microcrystalline cellulose, corn starch, Magnesium stearate.

Dosage form

Pills.

Pharmacotherapeutic group

Thiazide diuretics. Hydrochlorothiazide. ATS C03A A03.

Pharmacological properties

. Hydrochlorothiazide is a diuretic and saluretic agent. It blocks the reabsorption of sodium, chlorine and water ions in the distal nephron tubules. Increases the excretion of potassium, magnesium, bicarbonate ions; reduces the excretion of Calcium in the urine as a result of direct action on the distal tubules, which can prevent the formation of calcium kidney stones.
The drug helps to reduce high blood pressure, causes a decrease in polyuria in patients with diabetes insipidus (the mechanism of action is ultimately unclear).In some cases, the drug lowers intraocular pressure in glaucoma.

. After ingestion, 60-80% of hydrochlorothiazide is rapidly absorbed from the digestive tract. The diuretic effect occurs after 2 hours, reaches a maximum after 4 hours and lasts up to 12 hours.
Approximately 95% of hydrochlorothiazide is excreted unchanged almost completely through the kidneys. Half-life is 5,6-14,8 hours. Minor amounts of the drug are displayed with bile.
Hydrochlorothiazide penetrates the placental barrier, passes into the mother's milk.

Indications for use

Arterial hypertension; edema in case of congestive heart failure, liver cirrhosis with ascites; treatment corticosteroid and estrogen; some renal dysfunction (including nephrotic syndrome, acute glomerulonephritis, chronic renal failure); central and nephrogenic diabetes insipidus, glaucoma (subcompensated forms).
Hydrochlorothiazide is also used to prevent the formation of calcium renal calculi, with idiopathic hypercalciuria.

Dosage and administration

Hydrochlorothiazide is administered orally during or after a meal. Dose set individually. A single dose when taking the drug as a diuretic from 0.025 g to 0.2 g. lungs cases prescribed by 0.025 g - 0.05 g (1-2 tablets) per day, in more severe cases - 0.1 g per day.
With long-term treatment, sometimes the drug is prescribed 2-3 times a week. The duration of each course and the total duration of admission depends on the nature and severity of the pathological process, the effect of tolerance.
When hypertension is prescribed by 0.025-0.05 g (1-2 tablets) per day, as a rule, together with antihypertensive drugs.
With glaucoma take on 0,025 g per day.
Children should be taken orally at a daily dose of 1-2 mg / kg of body weight once or in two doses.
For the prevention of the formation of stones in the kidneys - 50 mg twice a day.
With diabetes mellitus at the beginning of treatment, the daily dose is 100 mg in 2-4 doses, in the future it is possible to reduce the dose.
Dose corrected depending on the condition of the patient.

Adverse effects

Hydrochlorothiazide is generally well tolerated. Of the side effects most often occur hypokalemia, dyspeptic phenomena, less often - confusion, convulsions, weakening of thought processes, fatigue, irritability, muscle spasms; dry mouth, thirst, nausea, or vomiting; irrhythmic heartbeat, weak pulse. Rarely - agranulocytosis, allergic reactions, cholecystitis or pancreatitis, abnormal liver function (jaundice of the sclera or skin), thrombocytopenia (unusual bleeding, tarry stools, blood in urine or feces, petechiae on the skin). Sometimes - anorexia, decreased sexual function, diarrhea, orthostatic hypotension, photosensitivity.

Contraindications

Anuria or severe renal dysfunction, severe forms of gout and diabetes, liver dysfunction, hypercalcemia, systemic lupus erythematosus in anamnesis, pancreatitis, increased sensitivity to thiazide diuretics or other sulfa drugs, sympathectomy.
Pregnancy (1 trimester), lactation.

Overdosage

Disorders of water and electrolyte balance, nausea, general weakness, dizziness, exacerbation of gout may occur. In case of overdose, carry out symptomatic treatment with monitoring of salt concentration and kidney function. When hypokalemia prescribed Asparkam, potassium chloride; with hyperchloremic alkalosis injected isotonic solution sodium chloride, for the smaller manifestations of gout prescribed Allopurinol.

Application features

Treatment with the drug should be under the supervision of a physician.
Doses throughout the day should be distributed in such a way as to minimize the inconvenience associated with the diuretic effect of the drug (with the exception of diabetes insipidus).
The habit of taking Hydrochlorothiazide at the same time helps adhere to the recommended regimen and regimen of application.
If you miss a dose, you need to take it as soon as possible. Do not take the drug if it is almost time to take the next dose, that is, do not double the dose.
When using Hydrochlorothiazide as an antihypertensive, it is important to follow a diet, limit sodium intake and / or reduce body weight.
Patients with hypersensitivity to sulfa drugs, bumetanida, Furosemide or inhibitors Carbonic anhydrases may have an increased sensitivity to hydrochlorothiazide.
Elderly patients may be more sensitive to the drug, which requires dose adjustment.
You must be careful when selecting doses for patients with gout (due to the ability of hydrochlorothiazide to increase the level of uric acid), as well as for patients with severe forms coronary or cerebral atherosclerosis.
Diabetes mellitus may cause hyperglycemia, especially on the background of hypokalemia.
In case of kidney failure, it is necessary to carefully monitor electrolyte balance and creatinine clearance. Severe loss of water and electrolytes during long-term treatment with high doses of hydrochlorothiazide may exacerbate the symptoms of renal failure.
During pregnancy, indications for the use of the drug should be carefully justified. Hydrochlorothiazide should not be prescribed for eclampsia, preeclampsia or edema of any origin during pregnancy.
Due to the presence of photosensitizing properties of the drug, excessive insolation must be avoided.
The patient may not feel the symptoms of hypertension, so it is important to take the drug, even with good health.
It is not recommended to prescribe the drug for disorders of lipid metabolism, hypercholesterolemia, hypertriglyceridemia, hyponatremia.

Interaction with other drugs

Hydrochlorothiazide can reduce the renal clearance of amantadine, which leads to an increase in the concentration of the latter in plasma blood and increase the likelihood toxic action amantadine.
With simultaneous use of hydrochlorothiazide and Amiodarone may increase the risk of heart arrhythmiaassociated with hypokalemia.
With simultaneous use of hydrochlorothiazide and anticoagulants (derivatives of coumarin or indandion) the anticoagulant properties of the latter may decrease, and the synthesis of blood coagulation factors may also increase, which requires dose adjustments.
The drug may increase glucose in the bloodstream, which requires an adjustment of the doses of insulin and oral antidiabetic agents.
Nonsteroidal anti-inflammatory drugs, especially Indomethacin, can reduce the antihypertensive and diuretic effect of hydrochlorothiazide, which requires careful monitoring of the patient's condition.
Nonsteroidal anti-inflammatory drugs increase the risk of developing renal failure while using it with hydrochlorothiazide.
The simultaneous use of hydrochlorothiazide with high doses of calcium supplements can lead to the development of hypercalcemia.
With the simultaneous use of hydrochlorothiazide and digitalis preparations increases the likelihood of the toxic action of digitalis associated with hypokalemia and hypomagnesiemia.
With simultaneous use of hydrochlorothiazide with dopamine, an increase in diuretic and natriuretic action is possible.
With simultaneous use of hydrochlorothiazide and agents that cause hypokalemia, there is a risk of developing severe hypokalemia, which requires monitoring of the concentration of potassium in serum and heart activity, as well as supplemental potassium supplements.
With the simultaneous use of hydrochlorothiazide with antihypertensive drugs may increase the hypotensive effect, which requires an adjustment of doses.
The simultaneous use of hydrochlorothiazide with lithium preparations is not recommended due to the possibility of increasing the toxic effect of lithium and the risk of nephrotic effects.

Product Overview

Store in a dry place inaccessible to children at a temperature not exceeding 25 ° C.

5 years.

On prescription.

20 pills in a blister pack or 2 blister packs of 10 pills per pack.

ZAO NPTs "Borschagovsky Chemical Pharmaceutical Plant