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Hydrochlorothiazide: Frequently Asked Questions Answered

What Is Hydrochlorothiazide?

Hydrochlorothiazide (HCTZ) is a blood pressure-lowering drug of the diuretic class. The drug was first approved in 1959 and has been used to treat high blood pressure and swelling for more than half a century. The Hydrochlorothiazide acts on Kidneys (specifically distal convoluted tubules of nephrons), inhibiting the sodium chloride transport system. The inhibition of the sodium chloride pump leads to a decrease in the reabsorption of water in the kidney and thus increases urine output leading to a decrease in swelling and blood pressure. HCTZ is still a choice of drug in many cases due to its long-lasting effect with a single dose

What Are the Uses of Hydrochlorothiazide?

Hydrochlorothiazide was primarily used for the management of high blood pressure. The drug is available in 12.5mg, 25mg, 50mg dosage, and 100mg. The drug is administered orally.

HCTZ is also used for

  • Approved for the treatment of edema associated with congestive heart failure, liver cirrhosis
  • Approved for the treatment of edema related to kidney dysfunction.

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    What Are the Side Effects of Hydrochlorothiazide?

    Hydrochlorothiazide is contraindicated in patients with Kidney diseases due to its effect of leading stress on Kidneys. The drug should be avoided in patients with a history of Liver diseases, Diabetes, Lower blood potassium, and lower blood sodium levels.

    The common side effects seen in patients using HCTZ are

    • Weakness
    • Excessive Sweating
    • Excessive thirst and urination
    • Light-headedness

    Some patients may experience serious side effects like;

    • Elevated serum creatinine and blood urine nitrogen levels increase in blood glucose levels.

    What is Hydrochlorothiazide

    Uses of Hydrochlorothiazide

    Side effects of Hydrochlorothiazide

    References

    1. Hydrochlorothiazide: Uses, Dosage, Side Effects [Internet]. Drugs.com. [cited 2021 Aug 11]. Available from: https://www.drugs.com/hydrochlorothiazide.html
    2. Herman LL, Bashir K. Hydrochlorothiazide. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Aug 11]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK430766/
    3. Grossman E, Verdecchia P, Shamiss A, Angeli F, Reboldi G. Diuretic Treatment of Hypertension. Diabetes Care. 2011 May 1;34(Supplement 2): S313–9.
    4. Taglietti F, Del Nonno F, Baiocchini A, Falasca L, Pieri S, Capone A, et al. Acute hepatocellular and cholestatic injury during therapy with hydrochlorothiazide – clinicohistopathologic findings: a case report. J Med Case Reports. 2010 Oct 21;4:332.
    5. Sinha AD, Agarwal R. Thiazide Diuretics in Chronic Kidney Disease. Curr Hypertens Rep. 2015 Mar;17(3):13.

    Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.

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    Frequently Asked Questions about Hydrochlorothiazide

    Hydrochlorothiazide is a thiazide class of diuretic that targets Kidneys for increasing urine output and bringing in a decrease in swelling and blood pressure.

    ACE inhibitors are more specific in action, which is brought by blocking of Angiotensin-Converting Enzymes, which inhibits the conversion of angiotensin I to angiotensin II. Decreased angiotensin II enzyme leads to the dilation of blood vessels which in turn leads to a decrease in blood pressure.

    Hydrochlorothiazide is Non-Potassium Sparing Diuretics. Potassium Sparing diuretics increase urination without loss of potassium from the body. HCTZ however doesn’t restrict the flow of potassium in urine and is thus termed as a non-potassium sparing diuretic

    Due to its non-potassium sparing the special precautions are needed when the drug is prescribed to individuals with Kidney Disorders, Liver Disorders, and Diabetes.

    Hydrochlorothiazide and similar non-potassium sparing diuretics are known to adversely affect the liver causing impaired bile secretion in the liver. HCTZ causes hypokalemia, an increase in plasma concentration of low-density lipoprotein, hyperglycemia, which is hypothesized to cause liver damage.

    Various case studies have shown that patients on HCTZ show altered liver function tests indicative of drug interfering with normal liver function.

    The Hydrochlorothiazide drug can lead to dehydration symptoms like feeling very thirsty, hot, heavy sweating, dry skin. Some patients may show signs of electrolyte imbalance like confusion, muscle pain, leg cramps. In such a case it is advised to stop the drug and immediately consult your physician for further evaluation.

    Hydrochlorothiazide has many alternatives like Potassium Sparing Diuretics like spironolactone are preferred alternatives for the treatment of edema due to congestive heart failure and kidney dysfunction. ACE inhibitors like Captopril have preferred blood pressure-lowering drugs, due to their selective mode of action.

    The available literature on Kidney Damage of Hydrochlorothiazide is conflicting. Few studies have observed Hydrochlorothiazide be effective in reducing blood pressure in patients with Chronic Kidney Disorders. Some studies have suggested the electrolyte imbalance caused by Hydrochlorothiazide can be related to adverse effects on kidney function.

    Several studies have shown that the use of thiazide diuretics like Hydrochlorothiazide has led to increased glucose levels in patients. Increased blood sugar levels are known side effects of HCTZ. In many undiagnosed cases of diabetes, consumption of HCTZ has led to hyperglycaemic attack leading to detection of latent diabetes.

    Hair Loss is not a documented side effect of Hydrochlorothiazide. The electrolyte imbalance due to HCTZ can cause itchy and dry skin and scalp. In case you observe excess hair fall while consuming HCTZ please consult your physician and review any other medication that has Hair loss as documented side effects.

    Hydrochlorothiazide is known to increase urine output and this particular effect leads to a rapid decrease of water content in the body. The decrease in water volume will temporarily result in a decrease in weight. However, the drug is not known to cause permanent weight loss. It is not recommended to use Hydrochlorothiazide as a weight-reducing drug and should not be consumed unless prescribed by a registered medical practitioner.

    Hydrochlorothiazide is considered a water pill as it is responsible for increasing urine output from the body. The increased urination will lead to short term (for few hours to a day) decrease in body weight. However, weight loss comes with an increased risk of dehydration, electrolyte imbalance, and an increased risk of severe side effects like hypokalaemia, hyperglycemia if taken without consultation with a physician.