Hydrochlorothiazide, pills 25mg 20pcs

Composition

Active ingredient:

hydrochlorothiazide 25 mg;

Auxiliary substances:

lactose monohydrate,

povidone,

cellulose,

corn starch,

magnesium stearate.

Pharmacological action

 A diuretic. The primary mechanism of action of thiazide diuretics is to increase diuresis by inhibiting the reabsorption of sodium and chlorine ions in the initial part of the renal tubules. This leads to an increase in the excretion of sodium and chlorine and, consequently, water. The excretion of other electrolytes, namely potassium and magnesium, also increases. At maximum therapeutic doses, the diuretic / natriuretic effect of all thiazides is approximately the same.

Natriuresis and diuresis occur within 2 hours and reach the maximum level after about 4 hours.

Thiazides also reduce the activity of carbonic anhydrase by increasing the excretion of bicarbonate ions, but this effect is usually weak and does not affect the pH of urine.

Hydrochlorothiazide also has antihypertensive properties. Thiazide diuretics do not affect normal blood pressure.

Indications

• Treatment of hypertension-monotherapy or combination with other hypertensive drugs;
• various genesis (in acute and chronic CHF, premenstrual syndrome, corticosteroid treatment and toxicosis of pregnant women); edema-nephrotic syndromeprenal insufficiency
• nephrogenic diabetes insipidus (polyuria control).

Contraindications

 Severe renal impairment, liver failure, severe forms of gout and diabetes mellitus, hypersensitivity to sulfonamides.

Side effects

Electrolyte imbalance

Hypokalemia, hypomagnesemia, hypercalcemia and hypochloremic alkalosis:  dry mouth, thirst, irregular heart rate, mood or mental changes, muscle cramps and 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 events:  hyperglycemia, glucosuria, hyperuricemia with the development of a gout attack. Treatment with thiazides may reduce glucose tolerance, and latent diabetes mellitus may manifest. When using high doses, serum lipids may increase.

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

Cardiovascular and blood disorders (hematopoiesis, hemostasis):  arrhythmias, orthostatic hypotension, vasculitis; very rarely — leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia.

Nervous system and sensory disorders:  dizziness, blurry vision (temporary), headache, paresthesia.

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

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

Interaction

With the simultaneous use of antihypertensive agents, non-depolarizing muscle relaxants, their effect is enhanced.

Concomitant use of barbiturates, diazepam, and ethanol increases the risk of orthostatic hypotension.

When used concomitantly with corticosteroids, there is a risk of hypokalemia, as well as orthostatic hypotension.

When used concomitantly with ACE inhibitors (including captopril, enalapril), the antihypertensive effect increases.

Severe hypotension is possible, especially after taking the first dose of hydrochlorothiazide, apparently due to hypovolemia, which leads to a transient increase in the hypotensive effect of an ACE inhibitor.

The risk of impaired renal function increases. The development of hypokalemia is not excluded.

Concomitant use of oral hypoglycemic drugs reduces their effectiveness.

Concomitant use of high-dose calcium and/or vitamin D supplements may lead to hypercalcemia and the risk of metabolic acidosis due to delayed urinary excretion of calcium under the influence of thiazide diuretics.

Concomitant use with allopurinol increases the risk of allergic reactions, especially in patients with impaired renal function.

When used concomitantly with digoxin, the risk of developing glycoside intoxication may increase.

When used concomitantly with Indometacin, piroxicam, naproxen, phenylbutazone, a slight decrease in the hypotensive effect is possible.

When used concomitantly with irbesartan, an additive hypotensive effect may develop.

Hyponatremia has been reported with concomitant use with carbamazepine.

When used concomitantly with colestipol, colestyramine, the absorption and diuretic effect of hydrochlorothiazide decreases.

When used concomitantly with lithium carbonate, it is possible to increase the concentration of lithium salts in the blood to a toxic level.

When used concomitantly with orlistat, the effectiveness of hydrochlorothiazide decreases, which can lead to a significant increase in blood pressure and the development of a hypertensive crisis.

When used concomitantly with sotalol, hypokalemia and the development of ventricular arrhythmia of the “pirouette” type are possible.

How to take, course of use and dosage

They are installed individually. Single dose-25-50 mg, daily dose-25-100 mg. The frequency of admission depends on the indications and the patient’s response to treatment.

Special instructions

Use with caution in patients with gout and diabetes mellitus.

In patients with renal insufficiency, systematic monitoring of plasma concentrations of electrolytes and creatinine clearance is necessary.

If there are signs of potassium deficiency, as well as with the simultaneous use of cardiac glycosides, corticosteroids and ACTH, the appointment of potassium preparations or potassium-sparing diuretics is indicated.

With prolonged use, you should follow a diet rich in potassium.

Concomitant use of diuretics with NSAIDs is not recommended.

Form of production

Pills.

Storage conditions

In a dark place, at a temperature not exceeding 25 °C. In a sealed package.

Shelf life

3 years

Active ingredient

Hydrochlorothiazide

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Description

For children over 3 years of age, For adults as prescribed by a doctor, For children as prescribed by a doctor

Indications

Hypertension, Heart Failure