High blood pressure raises your risk of heart attack or stroke. If you stop taking it suddenly Your swelling can increase and your blood pressure might increase rapidly.
If you don't take it on schedule Your swelling can increase and your blood pressure might rise. If you take too much If you take too much hydrochlorothiazide, your blood pressure might drop too low. You might feel faint or dizzy. If your symptoms are severe, call or go to the nearest emergency room right away. What to do if you miss a dose If you forget to take your dose, take it as soon as you remember. Never try to catch up by taking two doses at once.
This could cause dangerous side effects. How to tell if the drug is working If this drug is working, your blood pressure may be lower or the swelling in your legs and feet may get better. Your doctor will monitor your blood pressure at your checkups. You can also check your blood pressure at home. Keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments. Keep these considerations in mind if your doctor prescribes hydrochlorothiazide for you.
General You can take hydrochlorothiazide with or without food. Take this drug in the morning, not the evening. For oral dosage form tablets: Adults—The usual dose is 25 to 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. Children—Dose is based on body weight and must be determined by your doctor. For high blood pressure: For oral dosage form capsule: 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. Children—Use and dose must be determined by your doctor. Adults—At first, 25 milligrams mg once a day. During normal pregnancy there is hypervolemia which is not harmful to the fetus or the mother in the absence of cardiovascular disease. However, it may be associated with edema, rarely generalized edema.
If such edema causes discomfort, increased recumbency will often provide relief. Rarely this edema may cause extreme discomfort which is not relieved by rest.
In these instances, a short course of diuretic therapy may provide relief and be appropriate. Contraindications Hypersensitivity to this product or to other sulfonamide-derived drugs. Warnings Use with caution in severe renal disease.
In patients with renal disease, thiazides may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function. Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma. Thiazides may add to or potentiate the action of other antihypertensive drugs.
Sensitivity reactions may occur in patients with or without a history of allergy or bronchial asthma. The possibility of exacerbation or activation of systemic lupus erythematosus has been reported.
Precautions General All patients receiving diuretic therapy should be observed for evidence of fluid or electrolyte imbalance: Serum and urine electrolyte determinations are particularly important when the patient is vomiting excessively or receiving parenteral fluids. Warning signs or symptoms of fluid and electrolyte imbalance, irrespective of cause, include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal disturbances such as nausea and vomiting.
Hypokalemia may develop, especially with brisk diuresis, when severe cirrhosis is present or after prolonged therapy. Interference with adequate oral electrolyte intake will also contribute to hypokalemia.
Hypokalemia may cause cardiac arrhythmia and may also sensitize or exaggerate the response of the heart to the toxic effects of digitalis e. Hypokalemia may be avoided or treated by use of potassium sparing diuretics or potassium supplements such as foods with a high potassium content.
Although any chloride deficit is generally mild and usually does not require specific treatment except under extraordinary circumstances as in liver disease or renal disease , chloride replacement may be required in the treatment of metabolic alkalosis. Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction, rather than administration of salt, except in rare instances when the hyponatremia is life threatening.
In actual salt depletion, appropriate replacement is the therapy of choice. Hyperuricemia may occur or acute gout may be precipitated in certain patients receiving thiazides.
In diabetic patients dosage adjustments of insulin or oral hypoglycemic agents may be required. Hyperglycemia may occur with thiazide diuretics. Thus latent diabetes mellitus may become manifest during thiazide therapy.
An often unrecognized problem accompanying chronic medical disorders. Seelig CB "Magnesium deficiency in two hypertensive patient groups.
Beaudry C, Laplante L "Severe allergic pneumonitis from hydrochlorothiazide. Levay ID "Hydrochlorothiazide-induced pulmonary edema. Geanon JD, Perkins TW "Bilateral acute angle-closure glaucoma associated with drug sensitivity to hydrochlorothiazide. Biron P "Thiazide-induced pulmonary edema. Klein MD "Noncardiogenic pulmonary edema following hydrochlorothiazide ingestion.
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