Hydrochlorthiazidum

General characteristics. Structure:

International and chemical names: Hydrochlorothiazide;
6-хлор-7-сульфамоил-3,4-дигидро-2Н-1,2,4-бензотиадиазин-1,1-диоксид;основные physical and chemical properties: tablets of color, white or white with a yellowish shade, with a biconvex surface. On a surface of tablets the mramornost and impregnations of gray color is allowed; structure: one tablet contains Hydrochlorthiazidum 25 mg; excipients: lactoses monohydrate, povidone, cellulose microcrystallic, starch corn, magnesium stearate.

Pharmacological properties:

Pharmacodynamics. Hydrochlorthiazidum – diuretic and saluretichesky means. Blocks a reabsorption of ions of sodium, chlorine and water in distal tubules of nephron. Increases removal of potassium ions, magnesium, bicarbonate; reduces removal of calcium with urine as a result of direct action by distal tubules that can prevent formation of calcic renal concrements.
Drug promotes decrease in the increased arterial pressure, causes reduction of a polyuria in patients with not diabetes mellitus (the action mechanism is finally not found out). In some cases drug lowers intraocular pressure at glaucoma.

Pharmacokinetics. After intake of 60-80% of Hydrochlorthiazidum it is quickly soaked up from a digestive tract. The diuretic effect occurs in 2 h, reaches a maximum in 4 h and proceeds to 12 h.
About 95% of Hydrochlorthiazidum are removed in not reversed look almost through kidneys. The elimination half-life makes 5,6-14,8 h. Insignificant amounts of drug are removed with bile.
Hydrochlorthiazidum gets through a placental barrier, gets to maternal milk.

Indications to use:

Arterial hypertension; hypostases at congestive heart failure, cirrhosis with ascites; treatment by corticosteroids and estrogen; some renal failures (including a nephrotic syndrome, an acute glomerulonephritis, a chronic renal failure); the central and nephrogenic not diabetes mellitus, glaucoma (the subcompensated forms).
Hydrochlorthiazidum is applied also to prevention of formation of calcic renal concrements, at an idiopathic hypercalcuria.

Route of administration and doses:

Hydrochlorthiazidum is appointed inside in time or after food. The dose is established individually. A single dose at administration of drug as diuretic from 0,025 g to 0,2 g. In mild cases appoint 0,025 g – 0,05 g (1-2 tablets) a day, in more hard cases – on 0,1 g a day.
At prolonged treatment sometimes appoint drug on 2-3 times a week. Duration of each course and the general duration of reception depends on character and weight of pathological process, effect of portability.
At an idiopathic hypertensia appoint 0,025-0,05 g (1-2 tablets) a day, as a rule, contain with hypotensive drugs.
At glaucoma accept 0,025 g a day.
To children appoint inside in a daily dose 1-2 mg/kg of body weight once or in two steps.
For prevention of formation of concrements in kidneys – on 50 mg twice a day.
At not diabetes mellitus in an initiation of treatment the daily dose makes 100 mg in 2-4 receptions, the dose decline is possible further.
The dose is korrigirut it is dependent on a condition of the patient.

Features of use:

Treatment by drug should be carried out under control of the doctor.
Doses for days need to be distributed so that to minimize the inconveniences connected with diuretic effect of drug (except for not diabetes mellitus).
The habit to accept Hydrochlorthiazidum at the same time helps to adhere to the recommended mode and the scheme of use.
If you passed a dose, then it is necessary to accept it as soon as possible. Do not accept drug if already time of reception of the following dose almost came, that is do not double a dose.
At use of Hydrochlorthiazidum as anti-hypertensive means it is important to keep to a diet, to limit consumption of sodium and/or to reduce body weight.
Patients with hypersensitivity to sulfanamide drugs, a bumetanid, furosemide or inhibitors of a karboangidraza can have hypersensitivity to Hydrochlorthiazidum.
Patients of advanced age can be more sensitive to drug that demands correction of doses.
It is necessary to be careful at selection of doses for patients with gout (in connection with ability of Hydrochlorthiazidum to increase the level of uric acid), and also for patients with severe forms of coronary or cerebral atherosclerosis.
At a diabetes mellitus there can be a hyperglycemia, especially against the background of a hypopotassemia.
At a renal failure it is necessary to watch electrolytic balance and clearance of creatinine carefully. The expressed loss of water and electrolytes at prolonged treatment by high doses of Hydrochlorthiazidum can aggravate symptomatology of a renal failure.
During беременíprom-rus.com/admin/preparat_edit.phpости of the indication for use of drug have to be carefully proved. It is not necessary to appoint Hydrochlorthiazidum at an eclampsia, a preeclampsia or hypostases of any genesis during pregnancy.
In view of existence at drug of the photosensitizing properties it is necessary to avoid excessive insolation.
The patient can not feel hypertensia symptoms therefore it is important to accept drug even at good health.
It is not recommended to appoint drug at disturbances of lipidic exchange, a hypercholesterolemia, gipertriglitseridemiya, hyponatremia.

Side effects:

Hydrochlorthiazidum, as a rule, is well transferred. From side effects the hypopotassemia, the dispeptic phenomena most often meet, is more rare – confusion of consciousness, a spasm, weakening of processes of thinking, fatigue, irritability, spasms in muscles; dryness in a mouth, feeling of thirst, nausea or vomiting; unrhythmical heartbeat, low pulse. Seldom – an agranulocytosis, allergic reactions, cholecystitis or pancreatitis, abnormal liver functions (yellowness of scleras or skin), thrombocytopenia (unusual bleeding, a tar-like chair, blood in urine or Calais, petechias on skin). Sometimes – anorexia, decrease in sexual function, diarrhea, orthostatic hypotension, a photosensitization.

Interaction with other medicines:

Hydrochlorthiazidum can reduce renal clearance of an amantadin that leads to increase in concentration of the last in a blood plasma and to increase in probability of toxic action of an amantadin.
At simultaneous use of Hydrochlorthiazidum and Amiodaronum increase in risk of developing of the cardiac arrhythmias connected with a hypopotassemia is possible.
At simultaneous use of Hydrochlorthiazidum and anticoagulants (derivatives of coumarin or an indandion) anticoagulating properties of the last can decrease, and also synthesis of blood-coagulation factors can increase that demands correction of doses.
Drug can increase glucose level in blood that demands correction of doses of insulin and peroral antidiabetic means.
Non-steroidal anti-inflammatory drugs, especially indometacin, can reduce anti-hypertensive and diuretic effect of Hydrochlorthiazidum that demands careful observation of a condition of the patient.
Non-steroidal anti-inflammatory drugs increase risk of development of a renal failure at simultaneous use with Hydrochlorthiazidum.
Simultaneous use of Hydrochlorthiazidum with high doses of drugs, calciferous, can lead to development of a hypercalcemia.
At simultaneous use of Hydrochlorthiazidum and drugs of a foxglove the probability of the toxic action of a foxglove connected with a hypopotassemia and a hypomagnesiemia increases.
At simultaneous use of Hydrochlorthiazidum with dopamine increase in a diuretic and natriuretic effect is possible.
At simultaneous use of Hydrochlorthiazidum and means which cause a hypopotassemia there is a risk of development of a heavy hypopotassemia that demands monitoring of potassium concentration in blood serum and action of the heart, and also additional purpose of drugs of potassium.
At simultaneous use of Hydrochlorthiazidum with anti-hypertensive drugs increase in hypotensive effect is possible that demands correction of doses.
Simultaneous use of Hydrochlorthiazidum with drugs of lithium is not recommended in connection with a possibility of increase in toxic effect of lithium and danger of development of nephrotic effects.

Contraindications:

Anury or the expressed renal failures, severe forms of gout and diabetes mellitus, abnormal liver function, hypercalcemia, system lupus erythematosus in the anamnesis, pancreatitis, hypersensitivity to thiazide diuretics or other sulfanamide drugs, a sympathectomy.
Pregnancy (1 trimester), lactation.

Overdose:

Disturbances of water and electrolytic balance, nausea, the general weakness, dizziness, an exacerbation of gout can be observed. In case of overdose to carry out a symptomatic treatment with monitoring of concentration of salts and functions of kidneys. At a hypopotassemia appoint an asparkam, potassium chloride; at a giperkhloremichesky alkalosis enter isotonic solution of sodium of chloride, for smaller displays of gout appoint Allopyrinolum.

Storage conditions:

To store in the place, dry, unavailable to children, at a temperature not above 25 °C.

Period of validity - 5 years.

Issue conditions:

According to the recipe

Packaging:

On 20 tablets in a blister strip packaging or 2 blister strip packagings on 10 tablets in a pack.