Yes

Diuretic, Thiazide

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

B

Hypersensitivity to methyclothiazide or any component, thiazides, or sulfonamide-derived drugs; anuria; renal decompensation

Avoid in severe renal disease (ineffective). 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. Can cause SLE exacerbation or activation. 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): Necrotizing angiitis, vasculitis, cutaneous vasculitis, erythema multiforme, Stevens-Johnson syndrome, aplastic anemia, hemolytic anemia, leukopenia, agranulocytosis, thrombocytopenia, hepatic function impairment, respiratory distress

Symptoms of overdose include hypermotility, diuresis, lethargy

GI decontamination and supportive care; fluids for hypovolemia

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.

Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water, as well as, potassium and hydrogen ions

Onset of diuresis: Oral: 2 hours

Peak effect: 6 hours

Duration: ~1 day

Distribution: Crosses the placenta; appears in breast milk

Elimination: Unchanged in urine

Adults: Oral:

Hypertension: 2.5-5 mg/day; may add another antihypertensive if 5 mg is not adequate after a trial of 8-12 weeks of therapy

Blood pressure, fluids, weight loss, serum potassium

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 rarely cause agranulocytosis; use caution with clozapine and carbamazepine; may cause photosensitivity; use psychotropics with caution; 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 exactly as directed - with meals. May take early in day to avoid nocturia. Include bananas or orange juice in daily diet but do not take dietary supplements without advice or consultation of prescriber. Do not use alcohol or OTC medication without consulting prescriber. Weigh weekly at the same time, in the same clothes. Report weight gain >5 lb/week. May cause dizziness or weakness; change position slowly when rising from sitting or lying position and avoid driving or tasks requiring alertness until response to drug is known. You may experience nausea or loss of appetite (small frequent meals may help), impotence (reversible), constipation (fluids, exercise, dietary fiber may help), photosensitivity (use sunscreen, wear protective clothing and eyewear, and avoid direct sunlight). This medication does not replace other antihypertensive interventions; follow instructions for diet and lifestyle changes. Report flu-like symptoms, headache, joint soreness or weakness, difficulty breathing, skin rash, or excessive fatigue, swelling of extremities, or difficulty breathing. Pregnancy/breast-feeding precautions: Do not get pregnant while taking this medication; use appropriate barrier contraceptive measures. Consult prescriber if breast-feeding.

Assess weight, I & O reports daily to determine fluid loss; take blood pressure with patient lying down and standing

Tablet: 2.5 mg, 5 mg