Yes

Diuretic, Thiazide

Management of mild to moderate hypertension; treatment of edema in congestive heart failure and nephrotic syndrome

B (per manufacturer); D (based on expert analysis)

Hypersensitivity to benzthiazide or any component, other thiazides, or sulfonamide-derived drugs; anuria; renal decompensation; pregnancy

Use with caution in severe renal disease. Electrolyte disturbances (hypokalemia, hypochloremic alkalosis, hyponatremia) can occur. Use with caution in severe hepatic dysfunction; hepatic encephalopathy can be caused by electrolyte disturbances. Gout can be precipitate in certain patients with a history of gout, a familial predisposition to gout, or chronic renal failure. Cautious use in diabetics; may see a change in glucose control. Hypersensitivity reactions can occur. Use with caution in patients with moderate or high cholesterol concentrations. Photosensitization may occur. Correct hypokalemia before initiating therapy.

1% to 10%:

Cardiovascular: Orthostatic hypotension

Endocrine & metabolic: Hypokalemia

Dermatologic: Photosensitivity

Gastrointestinal: Anorexia, epigastric distress

<1% (Limited to important or life-threatening symptoms): Purpura, rash, urticaria, necrotizing angiitis, vasculitis, cutaneous vasculitis, hyperuricemia or gout, hyponatremia, sexual ability (decreased), hyperglycemia, glycosuria, nausea, vomiting, cholecystitis, pancreatitis, diarrhea or constipation, aplastic anemia, hemolytic anemia, leukopenia, agranulocytosis, thrombocytopenia, hepatic function impairment, uremia

Symptoms of overdose include hypermotility, diuresis, lethargy, confusion, muscle weakness

Following GI decontamination, therapy is supportive with I.V. fluids, electrolytes, and I.V. pressors if needed

Angiotensin-converting enzyme inhibitors: Increased hypotension if aggressively diuresed with a thiazide diuretic.

Beta-blockers increase hyperglycemic effects in Type 2 diabetes mellitus.

Cyclosporine and thiazides can increase the risk of gout or renal toxicity; avoid concurrent use.

Digoxin toxicity can be exacerbated if a thiazide induces hypokalemia or hypomagnesemia.

Lithium toxicity can occur by reducing renal excretion of lithium; monitor lithium concentration and adjust as needed.

Neuromuscular blocking agents can prolong blockade; monitor serum potassium and neuromuscular status.

NSAIDs can decrease the efficacy of thiazides reducing the diuretic and antihypertensive effects.

Like other thiazide diuretics, it inhibits sodium, chloride, and water reabsorption in the renal distal tubules, thereby producing diuresis with a resultant reduction in plasma volume; hypothetically may reduce peripheral resistance through increased prostacyclin synthesis

Onset of action: Within 2 hours

Duration: 12 hours

Adults: Oral:

Hypertension: 50-100 mg/day; maintenance: individualize dose (maximum effective dose: 200 mg/day)

Assess weight, I & O reports daily to determine fluid loss; blood pressure, serum electrolytes, BUN, creatinine

Thiazide diuretics are effective first-line therapeutic agents in the management of hypertension and have proven to be of benefit in terms of cardiovascular outcome. They may act synergistically to lower blood pressure when combined with an ACE inhibitor or beta-blocker. The initial concern about thiazide diuretic-induced hypokalemia, glucose intolerance, and lipid profiles does not appear to be of substantial clinical consequence in the treatment of hypertension. The benefits of this class of agents in the treatment of hypertension is established and compares well with other first-line therapeutic agents.

May cause drowsiness

May produce orthostatic hypotension; use caution with concurrent psychotropic use; rare reports of agranulocytosis; caution with clozapine and carbamazepine; may decrease lithium clearance resulting in an increase in serum lithium levels and potential lithium toxicity; monitor serum lithium levels

No information available to require special precautions

No effects or complications reported

Take early in the day and take last dose in early evening to avoid frequent night urination. Take with food to reduce GI upset. Weigh yourself on a regular basis (same time, same clothes). Report unresolved weight gain (more than 3-5 pounds in 3 days). You may experience dizziness or drowsiness; change positions slowly and use caution when driving or engaging in tasks that require alertness until response to drug is known. May cause photosensitivity; use sunscreen wear protective clothing and eyewear, and avoid direct sunlight. You may experience decreased sexual function; this will resolve when medication is discontinued. Report increased swelling of ankles, fingers, dizziness or trembling, cramps, or muscle pain. Pregnancy/breast-feeding precautions: Do not get pregnant while taking this medication; use appropriate barrier contraceptive measures. Consult prescriber if breast-feeding.

Take blood pressure with patient lying down and standing

Tablet: 50 mg