Drug Interaction:
Thiazides and related diuretics include-
Bendroflumethiazide, Benzthiazide, Chlorthiazide, Hydrochlorthiazide, Hydroflumethazide, Indapamide, Methyclothizide, Metolazone, Polythiazide, Quinethazone, Trichlormethiazide
Refer Hydrochlorthiazide- Thiazide and related diuretics
Indication:
Edema, hypertension
Thiazides and related diuretics include
- Bendroflumethiazide, Benzthiazide, Chlorthiazide, Hydrochlorthiazide, Hydroflumethazide, Indapamide, Methyclothizide, Metolazone, Polythiazide, Quinethazone, Trichlormethiazide
Refer Hydrochlorthiazide- Thiazide and related diuretics
Adverse Reaction:
Refer Hydrochlorthiazide- Thiazide and related diuretics
Contra-Indications:
Refer Hydrochlorthiazide- Thiazide and related diuretics
Dosages/ Overdosage Etc:
Indication:
Edema, hypertension
Dosage:
Edema- 5mg once daily,preferably in the morning. Initial- upto 20mg once daily or in 2 divided doses.
Maintenance- 2.5 to 5mg daily. Hypertension-
Initial- 5 to 20mg daily. Maintenance- 2.5 to 15mg daily
Patient Information:
Thiazide diuretics
1. May cause GI upset, may be taken with food
2. Drug will initially increase urination which should subside after a few weeks, take early during the day or as directed
3. Notify physician, if muscle pain,weakneess or cramps, nausea, vomiting, restlessness, excess thirst, tiredness, drowsiness, increased heart rate or pulse, diarrhea, or dizziness occurs
4. May cause photosensitivity (sensitivity to sunlight). Avoid prologed exposure to the sun and ultraviolet light. Use sunscreens and wear protective clothing until tolerance is determined
5. May increase blood sugar levels in diabetes
6. Do not drink alcohol or take other medications without physicians approval, this includes nonprescription medicines for appetite control, asthma, colds, cough,hay fever or sinus
7. Do not interrupt , discontinue or adjust the dose, even if feeling well. Follow physicians instruction regarding missed dose.
Pharmacology/ Pharmacokinetics:
Ref- Drug Facts And Comparison (2010)
Thiazides and related diuretics include-
Bendroflumethiazide, Benzthiazide, Chlorthiazide, Hydrochlorthiazide, Hydroflumethazide,
Indapamide, Methyclothizide, Metolazone, Polythiazide, Quinethazone, Trichlormethiazide
Refer Hydrochlorthiazide- Thiazide and related diuretics
Pharmacology-
Thiazide diuretics increase the urinary excretion of sodium and chloride in approximately
equivalent amounts. The inhibiton and the reabsorption of sodium and chloride in the cortical thick ascending limb of the loop of Henle and the early distal tubules.
The exact anihypertensive mechansism of the thiazides is unknown although sodium depletion appears to be of primary importance
Pharmacokinetics-
The antihypertensive action requires several days to produce results. Administration for
upto 2 to 4 weeks is usually required for optimal therapeutic effect. The duration of the
antihypertensive effect of thiazides is sufficiently long to adequately control blood pressure
with a single daily dose.
Despite extensive use of diuretics pharmacokinetic data are limited. It is important to
emphasise the lack of relationship between plasma levels and diuretic effect.
Pharmacokinetics of Thiazides and Related Compounds
Diuretic Onset Peak Duration Equivalent Percent Half life
(h) (h) (h) dose (mg) absorbed (h)
Bendoflumethiazide 2 4 16 to 12 5 ~100 3 to 3.9
Chlorthiazide 2 4 16 to 12 500 10 to21 0.75 to 2
Chlothalidone 2 to 3 2 to 6 24 to 72 50 64 40
Hydrochlorthiazide 2 4 to 6 16 to 12 50 65 to 75 5.6 to14.6
Indapamide 1 to 2 within2 upto 36 2.5 93 ~14
Methyclothiazide 2 6 24 5 nd nd
Metolazone 1 2 12 to 24 5 65 nd
Trichlormethiazide 2 6 24 2 nd 2.3 to 7.3
nd= no data
Interaction with Food:
May be taken with food or milk
Pregnancy and lactation:
Refer Hydrochlorthiazide- Thiazide and related diuretics
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