Hypothiazid

Hypothiazid – diuretic means.

Form of release and structure

Dosage form: tablets are round, flat, with dividing risky on one party and an engraving of "N" – on another, white or almost white color (on 20 pieces in blisters, in a cardboard pack 1 blister).

The operating component – a hydrochlorothiazide, its contents in 1 tablet – 25 or 100 mg.

Auxiliary components: gelatin, magnesium stearate, starch corn, talc, lactoses monohydrate.

Indications to use

• Edematous syndrome of various origin: portal hypertensia, nephrotic syndrome, chronic renal failure, chronic heart failure, acute glomerulonephritis, syndrome of premenstrual tension;
• Arterial hypertension: monotherapy and treatment in combination with other anti-hypertensive means;
• Prevention of a lithogenesis in urinary tract: decrease in a hypercalcuria at predisposed patients;
• Control of a polyuria: mainly at a nephrogenic not diabetes mellitus.

Contraindications

• Liver failure of heavy degree;
• Renal failure of heavy degree;
• Unmanageable diabetes mellitus;
• Anury;
• Addison's disease;
• I trimester of pregnancy and period of breastfeeding;
• Refractory hyponatremia, hypopotassemia, hypercalcemia;
• Age up to 3 years;
• Hypersensitivity to components of drug and to derivatives of sulfonamides.

With care it is recommended to appoint drug in II and III trimesters of pregnancy, to patients with the coronary heart disease (CHD), at a hypercalcemia, a hyponatremia, a hypopotassemia, cirrhosis, a lactose intolerance, gout, in case of simultaneous use of cardiac glycosides and the patient of advanced age.

Route of administration and dosage

Pill is taken inside after food.

The dose is selected during treatment individually. Estimating a clinical condition of the patient, the doctor appoints minimum effective dose of drug.

Initial dosing for adults:

• Edematous syndrome of various etiology: 25-100 mg of 1 times a day or 1 time in 2 days, in hard cases – 200 mg a day. Considering clinical reactions, the dose decline to 25-50 mg a day once or 1 time in 2 days is possible;
• Syndrome of premenstrual tension: 25 mg of 1 times a day, begin reception with the moment of emergence of the first symptoms prior to the beginning of periods;
• The arterial hypertension (combined also monotherapy): 25-50 mg of 1 times a day, for some patients are enough 12,5 mg. Minimum effective dose should not exceed 100 mg a day. Therapeutic action is shown within 3-4 days, 3-4 weeks can be necessary for optimum stabilization of the arterial pressure (AP). After drug withdrawal the hypotensive effect lasts for 1 week. For the prevention of strong decrease in the ABP at a combination therapy, the dose decline of other anti-hypertensive means can be required;
• Nephrogenic not diabetes mellitus: 50-150 mg a day in stages.

Dosing for children is appointed taking into account the child's weight. The pediatric daily dose usually makes 1-2 mg on 1 kg of weight of the child or 30-60 mg on 1 sq.m of a body surface of 1 times a day, for children from 3 to 12 years – 37,5-100 mg a day.

Side effects

Use of Hypothiazid can cause the following side effects:

• Alimentary system: anorexia, diarrhea or lock, cholecystitis, cholestatic jaundice, pancreatitis, sialadenitis;
• Metabolism: a lethargy, confusion of consciousness, delay of process of thinking, convulsion, excitability, fatigue, muscular spasms against the background of a hypercalcemia, hypomagnesiemia, hypopotassemias, hyponatremias. An irregular heart rhythm, dryness in a mouth, thirst, unusual fatigue or weakness, changes in mentality or mood, spasms and muscle pains, nausea, vomiting against the background of a gipokhloremichesky alkalosis (besides, the gipokhloremichesky alkalosis can become the reason of hepatic encephalopathy or a coma). A glycosuria, a hyperuricemia with development of an attack of gout. A hyperglycemia which can provoke development of earlier latent diabetes mellitus. Treatment in high doses can lead to increase in level of lipids in blood serum;
• Cardiovascular system: arrhythmia, vasculitis, orthostatic hypotension;
• System of a hemopoiesis: very seldom – thrombocytopenia, a leukopenia, hemolitic anemia, an agranulocytosis, aplastic anemia;
• Nervous system: temporary vagueness of sight, headache, dizziness, paresthesias;
• Urinary system: intersticial nephrite, functional disturbances of kidneys;
• Allergic reactions: a small tortoiseshell, a photosensitization, a necrotic vasculitis, a purpura, Stephens-Johnson's syndrome, anaphylactic reactions up to shock. A respiratory distress syndrome, including a pneumonitis and not cardiogenic hypostasis of a lung;
• Others: decrease in a potentiality.

Special instructions

During long course treatment it is necessary to control clinical signs of disturbance of water and electrolytic balance, especially at patients with abnormal liver functions, diseases of cardiovascular system.

Use of drug promotes the strengthened removal of ions of magnesium and potassium therefore in parallel in the course of treatment it is necessary to hold events for elimination of their deficit.

At patients with the lowered function of kidneys it is necessary to control systematically clearance of creatinine, in case of approach of an oliguria it is necessary to resolve an issue of drug withdrawal.

At patients with an abnormal liver function of a tiazida it is necessary to apply with care as minor changes of water and electrolytic balance and level of ammonium in blood serum can cause a hepatic coma.

Use of drug for patients with a severe form of a coronary and cerebral sclerosis demands extra care.

Prolonged treatment at a latent and manifest diabetes mellitus needs to be accompanied with systematic control of metabolism of carbohydrates and dose adjustment of hypoglycemic drugs.

Constant assessment of a state is demanded by patients with the broken metabolism of uric acid.

Long therapy, in rare instances, can lead to pathological change of epithelial bodies.

In an initial stage of therapy it is forbidden to manage vehicles and to perform the works requiring special attention, duration of the period of prohibition is defined individually.

Medicinal interaction

Simultaneous use of a hydrochlorothiazide with lithium salts as against the background of decrease in renal clearance of lithium its toxicity increases is not recommended.

Simultaneous use of diuretic: with cardiac glycosides can increase toxicity of a foxglove; Amiodaronum – increases risk of developing of the arrhythmias connected with a hypopotassemia.

Drug reduces efficiency of peroral hypoglycemic means that increases risk of development of a hyperglycemia.

Administration of drug with corticosteroids, a calcitonin promotes increase in extent of removal of potassium.

At a combination to non-steroidal anti-inflammatory drugs, Colestyraminum hypotensive and diuretic action of Hypothiazid decreases.

Drug can strengthen action of not depolarizing muscle relaxants.

Simultaneous use with amantadiny can cause decrease in its clearance and increase risk of toxicity.

Simultaneous use with barbiturates, ethanol, opioid analgetics promotes increase in orthostatic hypotensive effect.

Drug should be cancelled before carrying out analyses on function of epithelial bodies.

Terms and storage conditions

To store in the place protected from light at a temperature up to 25 °C. To protect from children.

Period of validity – 5 years.