Pronunciation:

hye-droe-klor-oh-THYE-a-zide

Brand Names:

• Aquazide H
• Hydrocot
• Microzide
• Zide

Dosage Forms:

• Capsule
• Tablet

Classifications:

Therapeutic—

Cardiovascular Agent

Pharmacologic—

Diuretic

Chemical—

Thiazide

Uses of This Medicine:

Hydrochlorothiazide is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Hydrochlorothiazide is also used to treat fluid retention (edema) that is caused by congestive heart failure, severe liver disease (cirrhosis), kidney disease, or treatment with a steroid or hormone medicine.

Hydrochlorothiazide is a thiazide diuretic (water pill). It is used to help reduce the amount of water in the body by increasing the flow of urine. It may also be used for other conditions as determined by your doctor.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of hydrochlorothiazide capsules or tablets in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of hydrochlorothiazide capsules in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving hydrochlorothiazide capsules.

No information is available on the relationship of age to the effects of hydrochlorothiazide tablets in geriatric patients. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving hydrochlorothiazide tablets.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Dofetilide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Albuterol
• Alogliptin
• Amphetamine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Benzphetamine
• Bromfenac
• Bromocriptine
• Bufexamac
• Buprenorphine
• Canagliflozin
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Codeine
• Dapagliflozin
• Deslanoside
• Desmopressin
• Dexibuprofen
• Dexketoprofen
• Dextroamphetamine
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dipyrone
• Droperidol
• Droxicam
• Dulaglutide
• Empagliflozin
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Formoterol
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indomethacin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Ketanserin
• Ketoprofen
• Ketorolac
• Levomethadyl
• Linagliptin
• Liraglutide
• Lisdexamfetamine
• Lithium
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Methamphetamine
• Methotrexate
• Metildigoxin
• Miglitol
• Morniflumate
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Ouabain
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Porfimer
• Pramlintide
• Proglumetacin
• Propyphenazone
• Proquazone
• Proscillaridin
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• Sotalol
• Sulindac
• Tapentadol
• Tenoxicam
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Topiramate
• Valdecoxib
• Vildagliptin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aminolevulinic Acid
• Bepridil
• Carbamazepine
• Cholestyramine
• Ginkgo
• Gossypol
• Licorice

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Anuria (not able to urinate) or
• Sulfa drug allergy (eg, sulfamethoxazole/trimethoprim, Bactrim®, Septra®)—Should not be used in patients with these conditions.

• Asthma or
• Diabetes or
• Electrolyte imbalance (eg, high calcium or low magnesium, potassium, sodium in the body) or
• Glaucoma, angle-closure or
• Gout or
• Hypercholesterolemia (high cholesterol in the blood) or
• Hyperuricemia (high uric acid in the blood) or
• Hypoglycemia (low blood sugar) or
• Liver disease or
• Myopia (nearsightedness) or
• Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.

• Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt) or potassium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to receive it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For fluid retention (edema):
  • For oral dosage form (tablets):
    • Adults—The usual dose is 25 to 100 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):
    • Adults—At first, 12.5 milligrams (mg) or one capsule once a day. 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.
  • For oral dosage form (tablets):
    • Adults—At first, 25 milligrams (mg) once a day. Your doctor may increase your dose as needed and may be taken as a single dose or divided into two doses.
    • Children—Dose is based on body weight and must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Check with your doctor right away if you have seizures, decreased urine, drowsiness, dry mouth, excessive thirst, increased heart rate or pulse, muscle pains or cramps, nausea or vomiting, or unusual tiredness or weakness. These may be symptoms of a condition called hypokalemia or potassium loss.

Check with your doctor right away if you have blurred vision, difficulty in reading, eye pain, or any other change in vision during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may cause some people to become dizzy. Do not drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (eg, tests for parathyroid function) may be affected by this medicine.

This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

Do not take other medicines unless they have been discussed with your doctor. This includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Back, leg, or stomach pains

black, tarry stools

bleeding gums

blistering, peeling, or loosening of the skin

bloating

blood in the urine or stools

blue lips and fingernails

blurred vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain or tightness

chills

clay-colored stools

cloudy urine

cold sweats

confusion

constipation

cough or hoarseness

coughing that sometimes produces a pink frothy sputum

coughing up blood

cracks in the skin

darkened urine

decrease in urine-concentrating ability

decreased frequency or amount of urine

diarrhea

difficult, fast, or noisy breathing

difficulty with swallowing

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position

dry mouth

fast or irregular heartbeat

fever

flushed, dry skin

fruit-like breath odor

general body swelling

general feeling of discomfort or illness

greatly decreased frequency of urination or amount of urine

headache

hives, itching, rash

increased hunger

increased sweating

increased thirst

increased urination

indigestion

joint pain, stiffness, or swelling

loss of appetite

loss of heat from the body

lower back or side pain

muscle cramps or pain

nausea or vomiting

nosebleeds

numbness, tingling, pain, or weakness in the hands or feet

painful or difficult urination

pains in the stomach or side, possibly radiating to the back

pale skin

persistent non-healing sore

pink growth

pinpoint red spots on the skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red, irritated eyes

red skin lesions, often with a purple center

red, swollen skin

reddish patch or irritated area

redness, soreness, or scaly skin

seizures

shiny bump

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sores, welting, or blisters

swelling of the face, fingers, legs, ankles, feet, or lower legs

swollen or painful glands

tenderness of salivary glands

thickening of bronchial secretions

trembling

trouble breathing

unpleasant breath odor

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight loss

vomiting of blood

weakness and heaviness of the legs

weight gain

white, yellow or waxy scar-like area

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Cramping

decreased interest in sexual intercourse

difficulty having a bowel movement (stool)

feeling of constant movement of self or surroundings

hair loss or thinning of the hair

inability to have or keep an erection

increased sensitivity of the skin to sunlight

loss in sexual ability, desire, drive, or performance

muscle spasm

redness or other discoloration of the skin

restlessness

sensation of spinning

severe sunburn

weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.