GENERIC NAME

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HYDROCHLOROTHIAZID
E

BRAND NAME

Microzide

DRUG

thiazide diuretics

CLASSIFICATION
SUGGESTED DOSE

Usual Adult Hydrochlorothiazide Dose for Edema:

25 to 100 mg orally as a single or divided dose.
Usual Adult Dose for Hypertension:
Initial dose: 25 mg orally once a day.
Maintenance dose: May increase to 50 mg orally as a single
or 2 divided doses.
Usual Adult Hydrochlorothiazide Dose for
Nephrocalcinosis:
Initial: 25 mg orally once a day
Maintenance dose: May increase to 50 mg twice a day
Usual Adult Dose for Osteoporosis:
Initial: 25 mg orally once a day
Maintenance dose: May increase to 50 mg per day
Usual Adult Hydrochlorothiazide Dose for Diabetes

Insipidus:
Initial: 50 mg orally once a day
Maintenance dose: May increase to 100 mg per day

MODE OF ACTION

It reduces blood volume by acting on the kidneys to

reduce sodium (Na+) reabsorption in the distal convoluted
tubule. The major site of action in the nephron appears on
an electroneutral NaCl co-transporter by competing for the
chloride site on the transporter. By impairing Na transport in
the distal convoluted tubule, hydrochlorothiazide induces
a natriuresis and concomitant water loss. Thiazides increase
the reabsorption of calcium in this segment in a manner
unrelated to sodium transport. Additionally, by other
mechanisms, HCTZ is believed to lower peripheral vascular
resistance

INDICATION
This medication is used to treat high blood pressure.
Lowering high blood pressurehelps prevent strokes, heart
attacks, and kidney problems. Hydrochlorothiazide is a
"water pill" (diuretic) that causes you to make more urine.
This helps your body get rid of extra salt and water.
This medication also reduces extra fluid in the body (edema)
caused by conditions such as heart failure, liver disease,
or kidney disease. This can lessen symptoms such as
shortness of breath or swelling in your ankles or feet.
CONTRAINDICATION
S
DRUG
INTERACTIONS

Hypersensitivity to thiazides or other sulfonamides;

anuria, pregnancy (category B), lactation
Amphotericin B, CORTICOSTEROIDS increase
hypokalemic effects;
SULFONYLUREAS, insulin may antagonize
hypoglycemic effects;
cholestyramine, colestipol decrease THIAZIDE a
bsorption;
diazoxide intensifies hypoglycemic and
hypotensive effects;

increased potassium and magnesium loss may

cause digoxin toxicity;
decreases lithium excretion and increases
toxicity; increases risk ofNSAID-induced renal

SIDE EFFECTS

failure and may attenuate diuresis.

Common side effects include lower blood pressure

(especially when standing up from sitting or lying

down), dizziness, headache, weakness, trouble
getting or keeping an erection (erectile dysfunction),
and tingling in your hands, legs, and feet.
NURSING
RESPONSIBILITIES

Assessment & Drug Effects

Monitor for therapeutic effectiveness. Antihypertensive

effects may be noted in 34 d; maximal effects may
require 34 wk.

Lab tests: Baseline and periodic determinations of serum

electrolytes, blood counts, BUN, blood glucose, uric acid,
CO2, are recommended.

Check BP before initiation of therapy and at regular

intervals.

Monitor closely for hypokalemia; it increases the risk of

digoxin toxicity.

Monitor I&O and check for edema.

Note: Drug may cause hyperglycemia and loss of

glycemic control in diabetics.

Note: Drug may cause orthostatic hypotension, dizziness.

Patient & Family Education

Consult physician before using OTC drugs. Many contain

large amounts of sodium as well as potassium.

Monitor weight daily.

Note: Diabetic patients need to monitor blood glucose

closely. This drug causes impaired glucose tolerance.

Report signs of hypokalemia (see Appendix F) to

physician.

Change positions slowly; avoid hot baths or showers,

extended exposure to sunlight, and sitting or standing still
for long periods.

Note: Photosensitivity reaction may occur 1014 d after

initial sun exposure.

Do not breast feed while taking this drug