The diuretic drug hypothiazide. What does Hypothiazid help with? Instructions for use. Prevention of urolithiasis

From the category of benzothiadiazines (belongs to the group of thiazide drugs). The diuretic effect of the drug is associated with a decrease in the absorption of calcium and sodium ions in the tubules of the kidneys. This substance should be prescribed exclusively by the attending physician. If Hypothiazid is prescribed, the instructions for use should be clearly followed.

The drug is available in the form of round white tablets. active ingredient drug is hydrochlorothiazide. Each tablet contains 25 or 100 mg of the active ingredient. Additional ingredients include magnesium stearate, talc, corn starch, gelatin.

Mechanism of action and pharmacokinetic properties

The drug has a diuretic effect and enhances the excretion of chlorine and sodium. The diuretic effect of the drug is associated with a decrease in the reabsorption of chloride and sodium ions in the tubules of the kidneys. Also, as a result of the use of the drug, the reabsorption of potassium and bicarbonates is inhibited, but this effect is observed to a lesser extent.

Due to the increased excretion of sodium in the urine, the drug has an active saluretic effect. The drug has a diuretic effect in both acidosis and alkalosis of the body. With prolonged use of the product diuretic effect does not decrease.

In addition, Hypothiazide has a hypotensive effect, which allows it to be used in diseases ( arterial hypertension). At what pressure it is worth using this medicine, the attending physician will tell.

Important: To enhance the hypotensive effect of the drug, it is recommended to follow a diet low in salt. However, it is important to remember the sense of proportion. Complete rejection of this product can cause negative consequences.

The active substance of the drug is well absorbed after oral administration. Its diuretic and natriuretic effect appears within 2 hours after application. The most pronounced effect is observed after about 4 hours. This effect lasts for 6-12 hours.

The drug leaves the body through the kidneys in its original form. The half-life of the substance takes 6.4 hours. This period of time is observed during normal kidney function.

With a moderate degree of kidney failure, the half-life of the drug takes 11.5 hours. In severe cases of kidney failure, which are accompanied by creatinine clearance up to 30 ml / min, this figure is 20.7 hours.

Hydrochlorothiazide is able to cross the placental barrier. In small amounts, it passes into breast milk.

Indications for use

If the doctor prescribes Hypothiazid, you need to know what these pills are from. The drug is prescribed in such situations:

Contraindications

The medicine may not always be taken. The main contraindications to the use of the substance include the following:

• complex forms of kidney failure - while creatinine clearance is less than 30 ml / min, there is complete absence urine;
• complex forms of liver failure;
• severe diabetes mellitus;
• complex form of gout;
• drug intolerance;
• Addison's disease;
• a decrease in the content of sodium, potassium in the blood and an increase in calcium.

Please note: Great care should be taken when treating the elderly. The same applies to the cases of patients who take cardiac glycosides, have lactose intolerance or coronary disease.

Instructions for use

The dosage of the drug must be selected individually. Hypothiazid tablets should be taken orally after a meal. With arterial hypertension in adults, a single dose of 25-50 mg per day is prescribed. The drug can be used as monotherapy or in combination with others.

For some patients, the initial dosage, which is 12.5 mg, is sufficient. It is important to use the minimum effective amount, which does not exceed 100 mg per day.

When Hypothiazid is combined with other drugs for hypertension, it may be necessary to reduce the dosage of the second drug. Otherwise, the pressure may drop too much.

The hypotensive effect of the drug appears within 3-4 days. For maximum effect, at high blood pressure the medicine should be used for 3-4 weeks. The effect of the drug persists for 1 week after the end of the course of therapy.

In the presence of nephrogenic diabetes insipidus, the usual daily volume is used at the level of 50-150 mg. Usually this amount of medicine is divided into several times.

With the development of premenstrual tension syndrome, the substance is prescribed in a volume of 25 mg per day. It is used at the very beginning of the onset of symptoms before the onset of menstruation.

With puffiness different origin 25-100 mg per day may be given. The medicine is prescribed once or 1 time in 2 days. This amount can be reduced to 25-50 mg per day. In difficult situations at the initial stage of therapy, it may be necessary to increase the dosage of the drug to 200 mg per day.

For children, the dosage is set depending on the body weight of the baby. Usually daily doses are 1-2 mg per 1 kg of body weight. Children 3-12 years old are prescribed 37.5-100 mg of the drug.

Side effects

chief side effect, which causes the drug Hypothiazide, is considered an imbalance of electrolytes in the blood. As a result, a decrease in the content of magnesium, sodium, potassium and chlorine is observed. An increase in calcium levels may also occur.

Small losses of potassium do not provoke severe symptoms. Some people experience drowsiness, general weakness, thirst, dizziness.

With serious losses of this substance, there is a risk of impaired cardiac conduction in the heart, convulsions, weakening of intestinal tone, and even paralysis. In most cases, potassium loss is characteristic of patients with kidney failure and cirrhosis of the liver.

Lack of magnesium leads to a deterioration in performance, general weakness, heart rhythm disturbances, and headaches. There is also a risk of a steady increase in blood pressure, memory impairment and reduced concentration. In addition, convulsions and trembling in the body often occur.

Sodium deficiency provokes headaches, general weakness, high fatigue, muscle cramps, impaired consciousness. With a serious lack of this substance, a person falls into a coma or death occurs.

Excess calcium in the body is accompanied by the formation of kidney stones, an increase in the daily volume of urine, and an increase in blood pressure.

A person may experience depressive states, slowing heart rate, disruption of the parathyroid gland. In this condition, lesions of the digestive organs are often observed, which are accompanied by constipation, loss of appetite, nausea and vomiting.

In addition, the use of the drug can cause such side effects:

Also, the use of the drug can cause changes in the composition of the blood. It leads to a decrease in the number of platelets and leukocytes. Due to problems with the synthesis of red blood cells or their destruction, anemia develops. In some situations, Hypothiazide causes a decrease in potency.

Overdose

With excessive use of the drug, there is an acute loss of fluid and electrolytes. This condition causes the following symptoms:

• polyuria;
• paresthesia;
• drop in blood pressure;
• general weakness;
• feeling of thirst;
• tachycardia;
• dizziness;
• an increase in the level of urea in the blood;
• nausea and vomiting;
• spasms in the calf muscles.

If these signs appear, the patient should immediately contact a specialist. There is no specific antidote. Deal with symptoms of overdose medicine gastric lavage, the use of enterosorbents and symptomatic treatment will help.

Interaction with other drugs

If Hypothiazid is taken simultaneously with lithium salts, there is a risk of increasing its toxicity and reducing renal clearance. Do not combine the medicine with Colestyramine, since this combination provokes a violation of the absorption of hydrochlorothiazide.

The combination of hypothiazide with cardiac glycosides causes a decrease in the content of potassium and magnesium in the blood. When a diuretic is combined with corticosteroids, the rate of potassium excretion increases.

If you take Hypothiazide with amiodarone, the risk of arrhythmias associated with a decrease in the level of potassium in the blood increases. The combination of a diuretic with oral hypoglycemic agents provokes the appearance of hyperkalemia.

Interaction with alcohol

When Hypothiazide is combined with ethanol, its orthostatic hypotensive effect increases. Therefore, such combinations are not recommended.

The use of drugs in pediatrics

The medicine is prescribed to children depending on body weight. The annotation states that 1-2 mg of the drug per 1 kg of the child's weight should be taken per day. For babies from 2 months to 2 years, the daily volume is 12.5-37.5 mg. Patients 3-12 years old are usually prescribed 37.5-100 mg of Hypothiazide. children early age The tablet should be crushed and mixed with water.

Use during pregnancy and lactation

Hypothiazide should not be taken in the first trimester of pregnancy. At a later date, the remedy can be used only if the benefit to the mother is higher than the threat to the fetus.

The key danger of the drug is that it leads to a decrease in the amount of circulating blood plasma. As a result, the blood supply to the placenta decreases and there is a threat of placental insufficiency.

In addition, the drug can cross the placental barrier and provoke the development of jaundice in the fetus or newborn. Also, the substance often causes a decrease in the number of platelets and other adverse reactions.

Hypothiazide is able to penetrate into breast milk. Therefore, for the period of treatment with this remedy, lactation should be stopped.

special instructions

During the period of use of Hypothiazide, blood tests should be systematically taken. Equally important is the control of blood pressure and kidney function. With the appearance of vomiting, impaired consciousness, a feeling of dryness in the oral cavity, you should refuse to take the pills and immediately contact a specialist.

For people who have serious liver problems, Hypothiazide is prescribed with great care. In this case, the medicine should be taken under the supervision of a specialist. Even a slight change in liver transaminases poses a threat of hepatic coma.

1 tablet contains hydrochlorothiazide 25 mg

pharmachologic effect

Diuretic.

At maximum therapeutic doses, the diuretic / natriuretic effect of all thiazides is approximately the same. Natriuresis and diuresis occur within 2 hours and reach their maximum after about 4 hours. They also reduce the activity of carbonic anhydrase by increasing the excretion of bicarbonate ion, but this effect is usually weak and does not affect urine pH.

Hydrochlorothiazide also has antihypertensive properties. Thiazide diuretics do not affect normal blood pressure.

Indications

• arterial hypertension (in the form of monotherapy, as part of complex antihypertensive therapy);
• edematous syndrome various genesis(including chronic heart failure, nephrotic syndrome, premenstrual tension syndrome, acute glomerulonephritis, chronic kidney failure, portal hypertension, treatment with corticosteroids);
• control of polyuria, predominantly in nephrogenic diabetes insipidus;
• prevention of stone formation urinary tract in predisposed patients (reduction of hypercalciuria).

Dosage and administration

The dose should be selected individually. With constant medical supervision, the minimum effective dose is established. The drug should be taken orally after meals.

Adults

At arterial hypertension the initial dose is 25-50 mg / day once, as monotherapy or in combination with other antihypertensive agents. For some patients, an initial dose of 12.5 mg is sufficient (both in the form of monotherapy and in combination). It is necessary to use the minimum effective dose, not exceeding 100 mg / day. When combined Hypothiazide with other antihypertensive drugs, it may be necessary to reduce the dose of another drug to prevent an excessive decrease in blood pressure.

The hypotensive effect is manifested within 3-4 days, but it may take 3-4 weeks to achieve the optimal effect. After the end of therapy, the hypotensive effect persists for 1 week.

At edematous syndrome of various origins the initial dose is 25-100 mg / day once or 1 time in 2 days. Depending on the clinical response, the dose may be reduced to 25-50 mg / day once or 1 time in 2 days. In some severe cases, at the beginning of treatment, it may be necessary to increase the dose of the drug to 200 mg / day.

At premenstrual tension syndrome the drug is prescribed at a dose of 25 mg / day and is used from the onset of symptoms to the onset of menstruation.

At nephrogenic diabetes insipidus normal is recommended daily dose the drug 50-150 mg (in divided doses).

Due to the increased loss of potassium and magnesium ions during treatment (serum potassium levels may be<3.0 ммоль/л) возникает необходимость в замещении калия и магния.

children

Doses should be set based on the body weight of the child. Usual pediatric daily doses: 1-2 mg / kg of body weight or 30-60 mg / m2 of body surface 1 time / day. The daily dose for children aged 3 to 12 years is 37.5-100 mg.

Contraindications

• anuria;
• severe renal insufficiency (KK<30 мл/мин);
• severe liver failure;
• difficult-to-control diabetes mellitus;
• Addison's disease;
• refractory hypokalemia, hyponatremia, hypercalcemia;
• children's age up to 3 years
• hypersensitivity to the components of the drug;
• hypersensitivity to sulfonamide derivatives.

special instructions

The use of potassium-containing drugs or foods rich in potassium (including fruits, vegetables), especially with loss of potassium due to increased diuresis, prolonged diuretic therapy, or simultaneous treatment with digitalis glycosides or corticosteroid drugs, avoids hypokalemia.

An increase in the excretion of magnesium in the urine with the use of thiazides can lead to hypomagnesemia.

Alcohol, barbiturates, opioid analgesics enhance the orthostatic hypotensive effect of thiazide diuretics.

At the initial stage of the drug use (the duration of this period is determined individually), it is forbidden to drive a car and perform work that requires increased attention.

Storage conditions

The drug should be stored out of the reach of children, protected from light at a temperature of 15° to 25°C.

Quite often, diuretic tablets "Hypothiazid" are prescribed by specialists. This is due to the fact that they not only contribute to the removal of excess fluid from the body, but also help prevent the development of stone disease. In addition, the drug eliminates swelling caused by various problems in the body.

Dosage form and packaging

"Hypothiazid" is available in the form of tablets. In color, they are either pure white or beige. On one side of the tablet there is always an engraving "H", and on the other a line is drawn in the form of a recess that passes through the center. There are two release options - 0.025 and 0.1 grams of the active substance. Sold by 20 tablets in a carton.

The composition of the diuretic « »

The main action is provided by the substance hydrochlorothiazide. Its content in 1 tablet is 25 or 1 milligram. Also in the preparation there are additional substances. First of all, it is magnesium stearate, which acts as a dietary supplement based on fatty acids. Talc and starch provide glide. Gelatin has a binding effect. Lactose monohydrate is used as a sweetener.

Pharmacology

This drug has a diuretic effect. This effect is achieved due to the excretion of sodium and chlorine from the kidneys. The action of the tablets begins 1-2 hours after ingestion. In addition, it is prescribed to reduce blood pressure. Gynecologists sometimes attribute the diuretic "Hypothiazid" to pregnant women with severe toxicosis. The diuretic effect on the body is not reduced by prolonged use.

Indications

The main indications include high blood pressure. Moreover, it can be used in combination with other drugs. Also, "Hypothiazid" is used for edema, which are the result of various diseases. It is effective for increased urination and as a prevention of urolithiasis. Less commonly, it is prescribed for cirrhosis of the liver and chronic kidney disease.

Contraindications

"Hypothiazid" diuretic has a number of contraindications. First of all, it is individual sensitivity to the constituent components of the drug. Also, do not prescribe a remedy for violations of the flow of urine. Severe forms of renal and hepatic insufficiency are the reason for the abolition of the diuretic. In addition, with a high level of potassium, sodium and magnesium in the body, the drug is contraindicated. The same applies to patients with Addison's disease.

Side effects

The wrong way to use "Hypothiazid" or use with existing contraindications can provoke a number of side effects. So, from the gastrointestinal tract, it can be diarrhea, constipation or the development of pancreatitis. From the side of the heart, arrhythmia is possible. Other side effects include dizziness, nausea that turns into vomiting, dry mouth, hives, and muscle cramps.

Overdose

Incorrectly chosen dosage or regimen of application leads to abundant excretion of fluid from the body. This is fraught with a sharp drop in blood pressure and tachycardia; lack of urination or disturbances in this process; vomiting, which brings with it thirst. There is no means for removing hydrochlorothiazide from the body. Therefore, gastric lavage in conjunction with the intake of activated charcoal or another sorbent can help.

Dosage and administration

Tablets should be taken after meals with a moderate amount of liquid. The following are the average dosages of the drug for adults:

1. In case of high blood pressure, 25–50 mg of the active substance is prescribed per dose. The daily norm is not more than 100 mg. The duration of the course is 3 weeks.
2. In the case of application from edema, the dose is 25-100 mg of the substance. Use 1 time per day or 2 days.
3. In diabetes insipidus origin, take 50-150 mg per day.

When prescribing the drug to children, the pediatrician calculates the dose based on 1-2 mg per kilogram of the child's weight.

Recipe (international)

Rep: Tab. Hydrochlorothiazidi 0.025

S: 1 tablet in the morning

Prescription form - 107-1/u (Russia)

pharmachologic effect

Diuretic. The main principle of action of the drug Hypothiazid is its inhibitory effect on the function of the epithelium of the renal tubules. This is manifested mainly in a decrease in the reabsorption of sodium ions, chlorine and the corresponding amounts of water.
Hypothiazide inhibits the reabsorption of sodium and chloride ions mainly in the initial part of the distal tubules by inhibiting the transport system of sodium and chloride ions. The drug also has some effect on the proximal tubules. To a small extent, inhibits carbonic anhydrase, which is manifested in a decrease in the reabsorption of bicarbonate. Increases the secretion of potassium ions, disrupts the excretion of magnesium ions.
All this leads to an increase in the excretion of sodium, chlorine ions, as well as potassium, magnesium and bicarbonate ions in the urine, without a significant change in the pH of the urine. Elderly patients are more sensitive to the diuretic effect of the drug. In addition to the diuretic effect, the drug also has a hypotensive effect, due to a decrease in the volume of extracellular fluid, which is achieved as a result of the excretion of sodium, chlorine and water ions; and expansion of arterioles. Against the background of the action of the drug Hypothiazid, the effectiveness of many antihypertensive drugs increases.
Hypothiazide does not affect normal blood pressure. With prolonged use, the drug Hypothiazid delays the excretion of calcium ions by the kidneys, which can have a beneficial effect in the presence of kidney stones containing calcium salts.
In small doses, hypothiazide reduces the excretion of uric acid and can cause hyperuricemia, in the presence of gout, its course is exacerbated in this case. In high doses, it promotes the excretion of uric acid. Retains activity in acidosis and alkalosis. Addiction to the drug Hypothiazide practically does not occur. In diabetes insipidus, the drug paradoxically reduces diuresis (the mechanism of action is unclear). After oral administration, the diuretic effect occurs after 2 hours, reaches a maximum after 4 hours and lasts 6-12 hours. The antihypertensive effect occurs after 3-4 days, but it may take 3-4 weeks to achieve the optimal therapeutic effect. The hypotensive effect persists for a week after discontinuation of the drug.

Mode of application

For adults: The dose should be selected individually under constant medical supervision. In connection with the increased loss of potassium and magnesium during treatment (the level of potassium in the blood serum may drop below 3 mmol / l), there is a need for their timely compensation. Particular caution is required in patients with heart failure, with impaired liver function, or in patients treated with digitalis glycosides.

Tablets should be taken after meals.
Adults for the treatment of arterial hypertension The recommended initial daily dose is 25-100 mg in a single dose, as monotherapy or in combination with other antihypertensive drugs. For some patients, it is enough to take the drug at an initial dose of 12.5 mg, both as monotherapy and as part of combination therapy. It is necessary to use the minimum effective dose not exceeding 100 mg / day. When combining the drug Hypothiazide with other antihypertensive drugs, it may be necessary to reduce their doses to prevent an excessive hypotensive effect.
The antihypertensive effect appears within 3-4 days, but it may take up to 3-4 weeks to achieve the optimal effect. After the end of treatment, the hypotensive effect persists for 1 week.
In diabetes insipidus, the recommended daily dose is 50-150 mg (in 2-4 doses).
In the treatment of edematous syndrome, the recommended dose is 25-100 mg of the drug 1 time / day or 1 time in two days. Depending on the clinical response, the dose should be reduced to 25-50 mg 1 time / day or 1 time in two days. In severe cases, it may be necessary to prescribe the drug at an initial dose of up to 200 mg / day.
With edematous syndrome in the premenstrual period, the recommended dose is 25 mg / day and is used from the onset of symptoms to the onset of menstruation.
The frequency of administration and duration of use depends on the patient's response to treatment and is determined individually by the attending physician.
Elderly patients may require a dose reduction.

For children, the dose is set individually, taking into account the body weight of the child. The recommended daily dose is 1-2 mg / kg of body weight or 30-60 mg / m2 of body surface area, the frequency of administration is 1 time / day. The total daily dose for children aged 2 months to 2 years is 12.5-37.5 mg; at the age of 2 to 12 years - 37.5-100 mg.
For young children, tablets should be given crushed with liquid.

Indications

- arterial hypertension of I and II stages (in the form of monotherapy and in combination with other antihypertensive drugs);
- diabetes insipidus;
- hypercalciuria;
- edematous syndrome of various origins: with heart, liver or kidney failure (as part of complex therapy), premenstrual tension syndrome caused by taking medications (for example, during treatment with corticosteroids).

Contraindications

- anuria;
- severe renal insufficiency<30 мл/мин);
- severe liver failure;
- lactation period (breastfeeding);
- hypersensitivity to the components of the drug;
- Hypersensitivity to other sulfonamide derivatives.

Side effects

- From the side of water-electrolyte and acid-base balance: hypokalemia, hypomagnesemia, hypercalcemia and hypochloremic alkalosis (dry mouth, thirst, arrhythmias, mood and mental changes, muscle cramps or pain, nausea, vomiting, unusual fatigue and weakness; with hypochloremic alkalosis may develop hepatic encephalopathy or hepatic coma), hyponatremia (confusion, lethargy, convulsions, excitability, muscle cramps).

- From the side of the central nervous system and peripheral nervous system: dizziness, headache, temporary blurred vision, paresthesia.

- From the hemopoietic system: very rarely - leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia.

- From the side of the cardiovascular system: arrhythmia, orthostatic hypotension, vasculitis.

- From the digestive system: cholecystitis, pancreatitis, cholestatic jaundice, diarrhea, sialadenitis, constipation, anorexia.

- From the side of metabolism: hyperglycemia, glucosuria, hyperuricemia (which can cause an attack of gout in patients with asymptomatic gout), the manifestation of latent diabetes mellitus, when used in high doses - an increase in blood lipid levels.

- Allergic reactions: urticaria, purpura, necrotizing vasculitis, Stevens-Johnson syndrome, respiratory distress syndrome (pneumonitis, non-cardiogenic pulmonary edema), photosensitivity, anaphylactic reactions (up to anaphylactic shock).

- From the urinary system: interstitial nephritis, impaired renal function.

- Other: sexual dysfunction.

Release form

Tab. 100 mg: 20 pcs.
1 tab.
hydrochlorothiazide 100 mg

The drug is dispensed by prescription tab. 25 mg: 20 pcs.
Tablets are white or almost white, flat, marked "H" on one side and with a dividing line on the other.
1 tab.
hydrochlorothiazide 25 mg
Excipients: magnesium stearate, gelatin, talc, corn starch, lactose monohydrate.
20 pcs. - blisters (1) - cardboard boxes.

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diuretic
Drug: HYPOTHIAZID®

The active substance of the drug: hydrochlorothiazide
ATX code: C03AA03
CFG: Diuretic
Registration number: P No. 013510/01
Date of registration: 21.11.07
The owner of the reg. Credit: CHINOIN Pharmaceutical and Chemical Works Private Co. Ltd. (Hungary)

Hypothiazid release form, drug packaging and composition.

Tablets are white or almost white, round, flat, engraved with "H" on one side and a notch on the other. 1 tab. hydrochlorothiazide 25 mg - "- 100 mg
Excipients: magnesium stearate, talc, gelatin, corn starch, lactose monohydrate.
20 pcs. - blisters (1) - packs of cardboard.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action Hypothiazid

Diuretic.
The primary mechanism of action of thiazide diuretics is to increase diuresis by blocking the reabsorption of sodium and chloride ions at the beginning of the renal tubules. As a result, the excretion of sodium and chlorine and, consequently, water increases. The excretion of potassium and magnesium also increases.
At maximum therapeutic doses, the diuretic / natriuretic effect of all thiazides is approximately the same. Natriuresis and diuresis occur within 2 hours and reach their maximum after about 4 hours. They also reduce the activity of carbonic anhydrase by increasing the excretion of bicarbonate ion, but this effect is usually weak and does not affect urine pH.
Hydrochlorothiazide also has antihypertensive properties. Thiazide diuretics do not affect normal blood pressure.

Pharmacokinetics of the drug.

Suction and distribution
Hydrochlorothiazide is incompletely but fairly rapidly absorbed from the gastrointestinal tract. This effect persists for 6-12 hours. After an oral dose of 100 mg, Cmax in plasma is reached after 1.5-2.5 hours. At the maximum diuretic activity (approximately 4 hours after ingestion), the concentration of hydrochlorothiazide in blood plasma is 2 μg / ml .
Plasma protein binding is 40%.
breeding
The primary route of excretion is by the kidneys (filtration and secretion) in unchanged form. T1 / 2 for patients with normal renal function is 6.4 hours. T1 / 2 for patients with moderate renal insufficiency is 11.5 hours. T1 / 2 for patients with CC<30 мл/мин составляет 20.7 ч. Гидрохлоротиазид проникает через плацентарный барьер и выделяется с грудным молоком.

Indications for use:

Arterial hypertension (in the form of monotherapy, as part of complex antihypertensive therapy);
- edematous syndrome of various origins (including chronic heart failure, nephrotic syndrome, premenstrual tension syndrome, acute glomerulonephritis, chronic renal failure, portal hypertension, treatment with corticosteroids);
- control of polyuria, mainly in nephrogenic diabetes insipidus;
- prevention of stone formation in the urinary tract in predisposed patients (reduction of hypercalciuria).

Dosage and method of application of the drug.

The dose should be selected individually. With constant medical supervision, the minimum effective dose is established. The drug should be taken orally after meals.
Adults
In arterial hypertension, the initial dose is 25-50 mg / day once, as monotherapy or in combination with other antihypertensive agents. For some patients, an initial dose of 12.5 mg is sufficient (both in the form of monotherapy and in combination). It is necessary to use the minimum effective dose, not exceeding 100 mg / day. When combining Hypothiazide with other antihypertensive drugs, it may be necessary to reduce the dose of another drug to prevent an excessive decrease in blood pressure.
The hypotensive effect is manifested within 3-4 days, but it may take 3-4 weeks to achieve the optimal effect. After the end of therapy, the hypotensive effect persists for 1 week.
With edematous syndrome of various origins, the initial dose is 25-100 mg / day once or 1 time in 2 days. Depending on the clinical response, the dose may be reduced to 25-50 mg / day once or 1 time in 2 days. In some severe cases, at the beginning of treatment, it may be necessary to increase the dose of the drug to 200 mg / day.
With premenstrual tension syndrome, the drug is prescribed at a dose of 25 mg / day and is used from the onset of symptoms to the onset of menstruation.
In nephrogenic diabetes insipidus, the usual daily dose of the drug is 50-150 mg (in divided doses).
Due to the increased loss of potassium and magnesium ions during treatment (serum potassium levels may be<3.0 ммоль/л) возникает необходимость в замещении калия и магния.
children
Doses should be set based on the body weight of the child. Usual pediatric daily doses: 1-2 mg / kg of body weight or 30-60 mg / m2 of body surface 1 time / day. The daily dose in children aged 3 to 12 years is 37.5-100 mg.

Side effects Hypothiazid:

From the side of the central nervous system and peripheral nervous system: dizziness, temporarily blurred vision, headache, paresthesia.
From the digestive system: cholecystitis, pancreatitis, cholestatic jaundice, diarrhea, sialadenitis, constipation, anorexia.
From the side of the cardiovascular system: arrhythmia, orthostatic hypotension, vasculitis.
From the urinary system: impaired renal function, interstitial nephritis.
From the hematopoietic system: very rarely - leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia.
On the part of metabolism: hyperglycemia (a decrease in glucose tolerance can provoke a manifestation of previously latent diabetes mellitus), glucosuria, hyperuricemia (with the development of a gout attack), hypokalemia, hypomagnesemia, hypercalcemia, hyponatremia (including confusion, convulsions, lethargy, slow thinking, fatigue, irritability, muscle cramps), hypochloremic alkalosis (including dry mouth, thirst, irregular heart rate, mood or mental changes, muscle cramps and pain, nausea, vomiting, unusual tiredness or weakness) . Hypochloremic alkalosis can cause hepatic encephalopathy or hepatic coma. When using the drug in high doses, it is possible to increase the levels of lipids in the blood serum.
Allergic reactions: urticaria, purpura, necrotizing vasculitis, Stevens-Johnson syndrome, respiratory distress syndrome (including pneumonitis, non-cardiogenic pulmonary edema), photosensitivity, anaphylactic reactions up to shock.
Others: reduced potency.

Contraindications to the drug:

Anuria;
- severe renal insufficiency<30 мл/мин);
- severe liver failure;
- hard-to-control diabetes mellitus;
- Addison's disease;
- refractory hypokalemia, hyponatremia, hypercalcemia;
- children's age up to 3 years (for solid dosage form);
- Hypersensitivity to the components of the drug;
- Hypersensitivity to sulfonamide derivatives.
With caution, the drug should be used for hypokalemia, hyponatremia, hypercalcemia, coronary artery disease, cirrhosis, gout, lactose intolerance, the use of cardiac glycosides, as well as in elderly patients.

Use during pregnancy and lactation.

The use of the drug in the first trimester of pregnancy is contraindicated. In the II and III third trimesters of pregnancy, the use of the drug is possible only if the intended benefit to the mother outweighs the potential risk to the fetus.
Hydrochlorothiazide crosses the placental barrier. There is a danger of fetal or neonatal jaundice, thrombocytopenia and other consequences.
The drug is excreted in breast milk. If necessary, the use of the drug during lactation should decide on the termination of breastfeeding.

Special instructions for use Hypothiazid.

With prolonged course treatment, clinical symptoms of water and electrolyte imbalance should be carefully monitored, first of all, in patients at high risk: patients with diseases of the cardiovascular system, impaired liver function, with severe vomiting or signs of water and electrolyte imbalance (in including dry mouth, thirst, weakness, lethargy, drowsiness, anxiety, muscle pain or cramps, muscle weakness, hypotension, oliguria, tachycardia, gastrointestinal complaints).
The use of potassium-containing drugs or foods rich in potassium (including fruits, vegetables), especially with loss of potassium due to increased diuresis, prolonged diuretic therapy, or simultaneous treatment with digitalis glycosides or corticosteroid drugs, avoids hypokalemia.
An increase in the excretion of magnesium in the urine with the use of thiazides can lead to hypomagnesemia.
With reduced renal function, control of creatinine clearance is necessary. In patients with impaired renal function, the drug can cause azotemia and the development of cumulative effects. If impaired renal function is evident, discontinuation of the drug should be considered upon the onset of oliguria.
In patients with impaired liver function or progressive liver disease, thiazides should be used with caution, since a slight change in fluid and electrolyte balance, as well as serum ammonium levels, can cause hepatic coma.
In severe cerebral and coronary sclerosis, the use of the drug requires special care.
Treatment with thiazide drugs may impair glucose tolerance. During a long course of treatment for overt and latent diabetes mellitus, systematic monitoring of carbohydrate metabolism is necessary due to the potential need to change the dose of hypoglycemic drugs.
Enhanced monitoring of the condition of patients with impaired uric acid metabolism is required.
Alcohol, barbiturates, opioid analgesics enhance the orthostatic hypotensive effect of thiazide diuretics.
In rare cases, with prolonged therapy, a pathological change in the parathyroid glands was observed, accompanied by hypercalcemia and hypophosphatemia.
Thiazides can reduce the amount of iodine that binds to serum proteins without showing signs of thyroid dysfunction.
The possibility of gastrointestinal complaints in patients with lactose intolerance should be considered, since Hypothiazid 25 mg tablets contain 63 mg of lactose, Hypothiazid 100 mg - 39 mg of lactose.
Influence on the ability to drive vehicles and control mechanisms
At the initial stage of the drug use (the duration of this period is determined individually), it is forbidden to drive a car and perform work that requires increased attention.

Drug overdose:

Symptoms: due to the loss of fluid and electrolytes with an overdose of the drug, tachycardia, a decrease in blood pressure, shock, weakness, confusion, dizziness, spasms of the calf muscles, paresthesia, impaired consciousness, fatigue, nausea, vomiting, thirst, polyuria, oliguria or anuria may occur. (due to hemoconcentration), hypokalemia, hyponatremia, hypochloremia, alkalosis, increased levels of urea nitrogen in the blood (especially in patients with renal insufficiency).
Treatment: artificial vomiting, gastric lavage, the use of activated charcoal. With a decrease in blood pressure or a state of shock, the BCC and electrolytes (including potassium, sodium) should be replaced. The state of water and electrolyte balance (especially the level of potassium in the serum) and kidney function should be monitored until normal values ​​are established. There is no specific antidote.

Interaction Hypothiazid with other drugs.

The simultaneous use of hypothiazide with lithium salts should be avoided, since the renal clearance of lithium decreases and its toxicity increases.
With the simultaneous use of Hypothiazide with antihypertensive drugs, their action is potentiated and it may be necessary to adjust the dose.
With the simultaneous use of Hypothiazide with cardiac glycosides, hypokalemia and hypomagnesemia, associated with the action of thiazide diuretics, can increase the toxicity of digitalis.
With the simultaneous use of hypothiazide with amiodarone, the risk of arrhythmias associated with hypokalemia increases.
With the simultaneous use of Hypothiazide with oral hypoglycemic agents, the effectiveness of the latter decreases and hyperglycemia may develop.
With the simultaneous use of Hypothiazide with corticosteroid drugs, calcitonin, the degree of potassium excretion increases.
With the simultaneous use of Hypothiazide with NSAIDs, the diuretic and hypotensive effect of thiazides is weakened.
With the simultaneous use of Hypothiazid with non-depolarizing muscle relaxants, the effect of the latter is enhanced.
With the simultaneous use of Hypothiazide with amantadine, the concentration and toxicity of the latter increases, as a result, its clearance decreases.
With the simultaneous use of hypothiazide with cholestyramine, the absorption of hydrochlorothiazide decreases.
With the simultaneous use of Hypothiazide with ethanol, barbiturates and narcotic analgesics, the risk of developing orthostatic hypotension increases.
Thiazides can reduce plasma levels of protein-bound iodine; increase the concentration of bilirubin in the blood serum.
Thiazides should be discontinued before testing for parathyroid function.

Conditions of sale in pharmacies.

The drug is dispensed by prescription.

The timing of the storage conditions of the drug Hypothiazid.

The drug should be stored out of the reach of children, protected from light at a temperature of 15° to 25°C. Shelf life - 5 years.