active substance: hydrochlorothiazide;
one tablet contains 25 mg hydrochlorothiazide; excipients: lactose monohydrate, povidone, microcrystalline cellulose, corn starch, magnesium stearate.
Pharmacotherapeutic group: Moderately active diuretics, thiazide group. Simple thiazide diuretics. Hydrochlorothiazide. ATX code С03А А03.
Indications for use:
Arterial hypertension; edema with congestive heart failure, cirrhosis of the liver with ascites; treatment with corticosteroids and estrogens; some disorders of renal function (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.
Anuria or severe renal dysfunction, severe gout and diabetes mellitus, liver dysfunction, hypercalcemia, a history of systemic lupus erythematosus, pancreatitis, hypersensitivity to thiazide diuretics or other sulfa drugs, sympathectomy. Pregnancy (1 trimester), lactation.
Method of administration and dosage:
Hydrochlorothiazide is given by mouth during or after meals. The dose is set individually. A single dose when taking the drug as a diuretic is from 0.025 g to 0.2 g. In mild cases, 0.025 g 0.05 g (1-2 tablets) per day is prescribed, in more severe cases, 0.1 g per day. With long-term treatment, the drug is sometimes 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. In case of hypertension, 0.025-0.05 g (1-2 tablets) per day are prescribed, as a rule, together with antihypertensive drugs. For glaucoma, take 0.025 g per day. Children are prescribed orally at a daily dose of 1-2 mg / kg of body weight once or in two doses. For the prevention of calculus formation in the kidneys, 50 mg twice a day. With diabetes insipidus at the beginning of treatment, the daily dose is 100 mg in 2-4 doses, in the future, the dose may be reduced. The dose is adjusted depending on the patient’s condition.
The ability to influence the reaction rate when driving or operating machinery:
Until the individual reaction to the drug is clarified, one should refrain from driving vehicles or other mechanisms, given that during treatment, a decrease in the ability to concentrate and speed of psychomotor reactions, dizziness, and visual impairment may occur.
Use during pregnancy or lactation:
Hydrochlorothiazide during pregnancy can be prescribed only after assessing the benefit to the mother / risk to the fetus ratio, since the drug reduces the plasma volume in the mother, the uteroplacental blood supply and penetrates the placental barrier. There is a risk of fetal or neonatal jaundice, thrombocytopenia, and other side effects in the fetus. Since hydrochlorothiazide passes into breast milk, breastfeeding should be discontinued if necessary.
Symptoms: dehydration, hypokalemia, hyponatremia, hypochloremia. The result is: thirst, nausea, vomiting, tachycardia, fatigue, weakness, dizziness, impaired consciousness, arterial hypotension, bradycardia, cardiac arrhythmias, spasms / cramps of the calf muscles, paresthesia, polyuria, oliguria or anuria, shock, alkalosis, increased levels blood urea nitrogen (especially in patients with renal failure).
Treatment: symptomatic and supportive therapy, there is no specific antidote. Gastric lavage and the use of activated charcoal are recommended to reduce absorption. In case of arterial hypotension, it is necessary to provide the patient with a horizontal position with raised legs. It is necessary to compensate for the volume of fluid and normalize the electrolyte imbalance (in case of arterial hypotension or shock). If necessary, provide oxygen or artificial respiration. It is necessary to monitor the water and electrolyte balance (especially the level of potassium in the blood serum) and laboratory indicators of renal function until they are normalized.
Interaction with other medicinal products and other types of interactions:
Cardiac glycosides: the likelihood of toxic effects of glycosides (including increased excitability of the ventricles) increases due to the development of thiazide-induced hypokalemia and hypomagnesemia. Amphotericin B (parenteral), laxatives that stimulate intestinal motility, glucocorticosteroids, ACTH, calcitonin: Hydrochlorothiazide may exacerbate electrolyte imbalances, especially hypokalemia. Calcium salts and vitamin D: Thiazide diuretics reduce calcium excretion and may increase plasma calcium levels. Serum calcium levels should be monitored and the calcium / vitamin D dose adjusted.
Drugs that cause changes in serum potassium levels: an increased risk of cardiac arrhythmias, including ventricular tachycardia (for example, torsade de pointes):
- Class Ia antiarrhythmic drugs (quinidine, hydroquinidine, disopyramide);
- Class III antiarrhythmic drugs (amiodarone, sotalol, dofetilide, ibutilide);
- Antipsychotics (for example, thioridazine, chlorpromazine, levomepromazine, trifluoperazine, cyamemazine, sulpiride, sultopride, amisulpiride, tiapride, pimozide, haloperidol, droperidol);
- Others (eg, bepridil, cisapride, diphemanil, erythromycin, halofantrine, mizolastine, pentamidine, terfenadine, vincamine);
Carbamazepine: development of hyponatremia. It is necessary to control the level of electrolytes, if necessary, use diuretics of other groups. Non-steroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, acetylsalicylic acid> 3 g / day, and non-selective NSAIDs: while taking NSAIDs, they can weaken the antihypertensive effect of hydrochlorothiazide and increase the effect of hydrochlorothiazide on serum potassium levels. Difluzanil: the concentration of hydrochlorothiazide in the blood plasma increases and its hyperuricemic effect decreases. Ethanol, barbiturates (for example, phenobarbital), diazepam, narcotic analgesics, antidepressants: may increase the hypotensive effect of hydrochlorothiazide. Pressor amines (eg epinephrine, norepinephrine): hydrochlorothiazide reduces their effect on blood pressure.
Conditions and shelf life:
Store in a dry place out of the reach of children at a temperature not exceeding 25 C.
Produced in Ukraine