Hydrochlorothiazide

Гидрохлоротиазид Constitutional formula

The description is actual on 06.08.2015

  • Latin name: Hydrochlorothiazidum
  • ATH code: C03AA03
  • Chemical formula: C7H8ClN3O4S2
  • CAS code: 58-93-5

Chemical name

6-Хлор-3,4-дигидро-2Н-1,2,4-бензотиадиазин-7-сульфонамид-1,1-диоксид

Chemical properties

Substance represents white or yellowish crystals, slightly soluble in water, methyl alcohol. Means is not dissolved on air, but it is easy – in alkalis.

The molecular mass of the Hydrochlorothiazide – 297,7 grams on mol. Medicine is let out in the form of capsules, oral suspensions and tablets.

Pharmacological action

Hypotensive, diuretic.

Pharmacodynamics and pharmacokinetics

Means influences process of a reabsorption of ions of sodium in a cortical segment of a loop of Gentle, without exerting impacts on a medulla of kidneys. Thanks to ability of substance not to mention a medulla, its diuretic effect is slightly lower and softer, than at furosemide.

Medicine inhibits enzyme to a karboangidraz and strengthens removal of potassium ions, phosphates and hydrocarbonates. The hydrochlorothiazide does not exert impact on an acid-base condition of an organism, at acidosis there is a removal of chlorides, at an alkalosis more intensively – hydrocarbonates, both in that and in other case sodium ions are washed away. Also drugs on the basis of this component stimulate removal of ions of magnesium, meanwhile as calcium is late in an organism.

After substance reception the diuretic effect is observed in 1-2 hours, reaching the maximum value in 4 hours. Effect of drug lasts about 11 hours. If the glomerular filtration rate is lowered, then action begins to decrease at indicators less than 30 mg a minute.

At patients with not diabetes mellitus means increases concentration and reduces urine volume, shows antidiuretic action.

Substance lowers the ABP a little, reducing the volume of the circulating blood and changing reactivity of a wall of vessels, reducing influence on pressure of Norepinephrinum and Epinephrinum.

After penetration into a digestive tract medicine quickly, but is not completely soaked up through a mucous membrane. After reception 0,1 grams of substance its maximum concentration in blood is observed in 1,5-2 hours. AUC directly proportionally depends on a dosage. If frequency rate of reception of means once a day, then it does not kumulirutsya in an organism. About 50% of the Hydrochlorothiazide contact proteins of a blood plasma.

The elimination half-life makes of 6,4 o'clock and changes up to 11,5 hours at a chronic renal failure of moderate severity. If KK less than 30 ml a minute, then T1/2 makes 20 hours.

Substance is not exposed to a metabolism in tissues of a liver and is removed by means of kidneys in not changed look (only 4% are allocated in the form of a metabolite) by means of glomerular filtering.

Indications to use

Medicine is appointed:

  • as monotherapy or as a part of complex treatment with the increased arterial pressure;
  • according to indications during the premenstrual period;
  • at a chronic heart or renal failure for removal of hypostases;
  • for prevention of formation of sand and stones in kidneys and urinary tract at the patients predisposed to it;
  • at treatment by glucocorticosteroids;
  • for control of a polyuria at patients with not diabetes mellitus;
  • to persons with an edematous syndrome at portal hypertensia, an acute glomerulonephritis, a nephrotic syndrome.

Contraindications

Substance is contraindicated:

  • at an anury;
  • sick diabetes mellitus;
  • to pregnant women in the first trimester;
  • at an allergy to streptocides or this means;
  • if KK at a chronic renal failure makes less than 30 ml a minute;
  • to children till 3 flyings;
  • to patients with a serious illness of a liver, cirrhosis;
  • at Addison's illness;
  • to the persons suffering from a hypercalcemia, a hypopotassemia and a hyponatremia;
  • to the nursing women.

If lactose is a part of drug on the basis of the Hydrochlorothiazide, then patients cannot accept it with a lactose intolerance, glyukozo-galaktozny malabsorption, deficit of lactase.

Treatment has to is carried out under supervision of medical personnel:

  • at patients with coronary heart disease;
  • at gout, slight and moderate renal failure;
  • if therapy is at the same time carried out by cardiac glycosides;
  • at the progressing liver diseases;
  • on 2 and 3 trimesters of pregnancy;
  • at elderly patients.

Side effects

The most frequent of serious side effects is disturbances of balance of electrolytes.

Also can arise:

  • gipokhloremichesky alkalosis, hypopotassemia, - a kaltsiyemiya and – a magniyemiya (symptoms dryness of mucous membranes, disturbance of a normal heart rhythm, a spasm, mental disorders, vomiting, nausea, weakness are, up to a hepatic coma and encephalopathy);
  • gout, glucosuria, hyperglycemia, decrease in tolerance to glucose, increase of level of lipids in blood;
  • lowering of arterial pressure, vasculitis, arrhythmias cordial, is rare — an agranulocytosis, aplastic anemia, thrombocytopenia, a leukopenia, hemolitic anemia;
  • skin allergic reactions, the small tortoiseshell, necrotic vasculitis, pneumonitis, Stephens-Johnson's syndrome, sensitivity of skin to light, an acute anaphylaxis, purpura;
  • hyponatremia (the fatigue or strong excitement, spasms is shown in the form of convulsions, confusion of consciousness, a lethargy);
  • diarrhea, anorexia, cholecystitis, lock, pancreatitis, sialadenitis;
  • headaches, illegibility of sight, paresthesia and dizziness;
  • decrease in sexual desire, intersticial nephrite, disturbances in work of kidneys.

During the period after registration of substance there were identifications cases of increase of intraocular pressure, development of an acute tranzitorny miotopiya and closed-angle glaucoma (up to a blindness). These diseases begin with decrease in sight, painful feelings in eyes. In the presence of such symptoms during treatment means recommends to stop administration of drug.

Hydrochlorothiazide, application instruction (Way and dosage)

Depending on an illness and a dosage form use various schemes of treatment about daily dosages.

If medicine is appointed for fight against arterial hypertension, a daily dosage usually = by 25-50 mg. Often in addition use APF inhibitors, beta-adrenergic agonists, vazodilatator, sympatholytics. Also there is a scheme of treatment at which substance use as a part of monotherapy, and the initial daily dosage makes 12,5 mg of means.

As the effect of reception of tablets of the Hydrochlorothiazide depends on a dose, at its increase in from 25 to 100 mg diuresis in proportion increases, increases also intensity of a natriuresis, extent of decrease in the ABP.

Duration of treatment depends on the achieved results and is defined by the attending physician. The effect of therapy comes for 3-4 days. As a rule, the course of treatment lasts 3-4 weeks.

During PMS appoint 25 mg of drug a day, once, up to approach of periods.

For removal of puffiness use also from 25 to 100 mg of means, once in the morning, or once in 2 days. If necessary the dosage can be lowered to 50 mg a day (or 50 mg of times in 2 days) or to increase up to 200 mg.

It is sometimes reasonable to appoint a discontinuous course of treatment — reception of tablets or capsules of 1 times in 3 days. Thus, it is possible to reduce probability and frequency of development of side reactions, without having affected efficiency of medicine.

For treatment of not diabetes mellitus appoint 50-150 mg of drug a day, for several receptions. After achievement of desirable effect it is possible to make correction of a dosage.

As a prophylactic from stones in kidneys the Hydrochlorothiazide use in a dosage 100 mg a day, for 2 receptions.

Elderly people and children require correction of a daily dosage and mode of reception.

Overdose

At abuse of medicine arise: electrolytic disturbances, dryness of mucous membranes, weakness in muscles, dehydration, a lethargy, drowsiness, disturbances of a cordial rhythm, strong decrease in the ABP, an oliguria, shock.

It is necessary to cause vomiting in the victim, to wash out a stomach, intravenous administration of electrolytes and additional liquid is shown, carrying out symptomatic therapy, there is no antidote.

Interaction

It is not recommended to appoint drug together with the lithium salts, drugs influencing arterial pressure, the cardiac glycosides, glucocorticosteroids, non-steroidal anti-inflammatory drugs, Colestyraminum, barbiturates, narcotic anesthetics increasing risk of developing of orthostatic hypotension.

At the combined reception with Amiodaronum the risk of developing of arrhythmias and a hypopotassemia increases.

The concomitant use of peroral hypoglycemic means can lead to a hyperglycemia.

The calcitonin can cause a hypopotassemia.

Substance strengthens effect of not depolarizing muscle relaxants.

The hydrochlorothiazide reduces renal clearance of an amantadin that leads to increase of concentration of the last in a blood plasma, increases its toxicity.

At a drug combination to tiazida there is a decrease in concentration of iodine in blood.

Terms of sale

The recipe can be required.

Special instructions

Extra care demands treatment of patients with a cerebral or coronary sclerosis.

At the patients who are in risk group it is necessary to make periodic control of clinical symptoms of disturbances of balance of waters and electrolytes, shows consideration for complaints to health.

Also during treatment it is recommended to eat kaliysoderzhashchy fruit and vegetables, in order to avoid a hypopotassemia.

At persons, with diseases of kidneys it is recommended to carry out control of the KK level, at such patients the azotemia, drug cumulation can develop.

Seldom, at long use of drug changes in work of epithelial bodies were observed, the state was followed by a hypophosphatemia and a hypercalcemia.

In a treatment stage when there is a correction of a dosage of medicine it is impossible to steer the car and to perform works which demand the high speed of psychomotor reactions.

To children

Daily dosage for children from 3 to 18 years – on 1 or 2 mg on weight kg a day. In 3-5 days it is necessary to take a break for 3 days. The supporting dosage – on 1-2 mg on weight kg a day, 2 times in 7 days.

Elderly

For elderly patients the recommended daily dosage makes from 12,5 mg to 25 mg distributed on 1 or 2 receptions.

With alcohol

Medicine cannot be combined with alcohol and alcohol-containing drinks.

Substance is a part of drugs: Hydrochlorthiazidum, Hypothiazid, Hydrochlorothiazide SAR.

Also means can be met as a part of recently synthesized combined drugs. The combination Lozartan + the Hydrochlorothiazide meets in: Bloktran of GT, Gizaar, Gizortan, Lozartan-N Richter, Lorista of N, Lozap plus, Vazotenz N.

Valsartan and the Hydrochlorothiazide – the main active ingredients of drugs: Valsakor, Vanateks Kombi, Ko-Diovan, Duopress.

In a combination + Digidralazin + the Hydrochlorothiazide substance is a part of the medicine Adelfan-Ezidreks.

The combination the Hydrochlorothiazide + Enalapril is in structure: Berlipril plus, Prilenap, Enalapril N, Enalapril Acre N, Enam of N, Enap of NL, Co-renitek, Renipril of GT, NL Enalapril Acre, Enafarm-N.

About the Hydrochlorothiazide

About this means very good. Seldom who mentions development of side reactions (dizziness, dryness in a mouth, a frequent urination). At observance of the mode of dosing which was appointed by the attending physician drug is well transferred by patients.

Review of substance at treatment of not diabetes mellitus:

  • "… Whom I only did not address, nobody could write out to me something that it is not so frequent to go to a toilet. And at my diagnosis, I constantly want to drink. She is so grateful to the doctor who wrote out to me the Hydrochlorothiazide. Now I go to a toilet not often, however dryness in a mouth all the same torments, but to stop drinking medicine I cannot".

The Hydrochlorothiazide price where to buy

It is possible to buy the drug Hypothiazid approximately for 108-130 rubles, 20 tablets on 100 mg.

The cost of tablets of the Hydrochlorothiazide – about 70-80 rubles, for the same amount of substance.

Section: Active ingredients
PAY ATTENTION! Information on active ingredients on the website is help generalizing, collected from public sources and can form the basis for making decision on use of these substances it is not aware of treatment. Before substance Hydrochlorothiazide use surely consult with the attending physician.
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